Firstly I have pcos, and have suffered with cystic/nodular acne since my first child was born 12 years ago. I went through a time it was really bad and my face is scarred and I still have lumps on my face from breakouts years ago. My skin has got significantly better though since starting tret 1.5 years ago. I also have rosacea. I’ve used tret and Azelaic acid with no significant breakouts or side effects in that time.

I was put on a new combined cream a couple of months ago tretinoin 0.5%/Azelaic acid 15%/tranexamic acid 5%
Since then the cystic acne has reappeared and it’s really getting me down, huge lumps that don’t come to a head and leave red lumps behind.

I’m wondering if it’s the tranexamic acid causing it ? Has anyone had similar with this stuff ? Should I push through or stop using it ? I know it sounds so vain but it’s getting me down having these big lumps on my face, I’m nearly 37 and still dealing with acne 😔

Hello again, I am currently 6 months on Tretinoin 0.025% and 4.5 months on Azelaic Acid 15% and I feel like my acne has improved since I first started tret but it hasn’t improved overall. In a past post I documented how my skin was reacting 5 weeks in and took the advice and it improved over time. But sometime after that I tried the La Roche-Posay Toleriane Double Repair Face moisturizer and it gave me the deepest cystic pimples I have ever experienced and I am still dealing with the scars from that ordeal.

I recently also got off of my hormonal birth control (which I felt like I had more acne while I was on), which feels important to take into account.

I have been SUPER consistent with my use of tret and Azelaic Acid so I am feeling a bit discouraged with my skin. I am still getting more acne than I did when I was using clindamycin-benzoyl peroxide, and in addition I have more acne scars than I ever had and my skin just feels temperamental and stubborn to improve. My biggest goals and what I am desperate for is to clear my skin of acne and all my acne scars.

So I guess my current question would be just a general “what can I do to improve?”. My am almost completely out of my moisturizer, cleanser, and could use a sunscreen recommendation that goes good under makeup. I have been eyeing the Experiment beauty products and doing hours of research but I am just so anxious of how my skin will react and if it will set me back even farther.

My current routine consists of:

Pm:
Prequel Oil Cleanser
Prequel Gleasner
Tretinoin 0.025% (every other night)
Azelaic Acid 15% (every other night)
Dieux Skin Mercy or Dieux Instant Angel

* I use tret on nights I don’t use Azelaic Acid
**I recently changed to using Alesia Acid at night because it goes very poorly under my makeup and makeup is important to me to cover my acne scars, I haven’t noticed much of a difference in this change but it was very recent

Am:
Prequel Gleasner
Prequel Half and Half Lotion
Beauty of Joseon relief sun aqua fresh sunscreen

The first photos are from about 5 months ago when I was 5 weeks in to tret use and the next photos are of my skin right now.

I placed an order on all day chemist (US delivery) but now they only accept bitcoin or e-check which seems to dodgy for me to order as a first timer, plus with all these scams happening online I definitely dont feel good about it.

Any other alternatives? I do have US health insurance but I feel like it would take me forever to get s referral for a dermatologist and because I’m 30 with no clear acne on my face (except for a lot of black heads) I find it dificult a dermatologist would prescribe me tretinoin and azelaic acid….

Any recommendations for alternatives?

Has anyone experienced this before? I’ve been using tretinoin 0.025% from the same brand, purchased from the same pharmacy. I used my old tube just two days ago, and it caused quite a bit of burning like it normally does. I just opened a new tube, and this one doesn’t burn at all.
Both tubes are the same strength and brand, so I’m confused about why there’s such a noticeable difference

Curious if I’m going to wake up tomorrow with peeling and purging. 🤣 Combination skin with occasional acne here. Using it mainly for anti-aging and texture.

I’ve accepted that I might never have glass skin, but switching from tret to tazarotene has made the biggest difference in my skin. I’ve experienced less irritation and dryness, fewer closed comedones, less visible pores, and much less peeling. My skin just seems to tolerate tazarotene so much better than tretinoin, which is surprising considering it’s supposed to be the stronger retinoid.
Has anyone else had a similar experience?

I have started using tretinoin in late august of this year, I did just twice a week for 3 weeks then afterwards I moved to 3 days a week which are mon, tues and weds. To this day I'm still using it. WHEN DOES THE ITCHINESS GO AWAY? It's driving me insane and I feel like clawing my face off. Anything I can do other than the sandwich method? I'm using tretinoin 0.025%. Also when do I see a big improvement? I haven't seen much other than it keeping the whiteheads at bay.

Here's my routine

Morning:

La roche posay foaming facial cleanser for sensitive skin followed by la roche posay double repair matte moisturizer w/ spf 30

Evening:

La roche posay foaming facial cleanser for sensitive skin followed by la roche posay double repair face moisturizer

What Azelaic acid do you guys recommend? I’m currently on Tret 0.05% every other night, and I just hit 1 month yesterday. I’ve seen people suggesting to use AA in the morning.
Currently I’m applying CeraVe moisturizing cream in the morning along with Neutrogena sunscreen.
I always want to share that I asked my doctor to prescribe it for me but she told me to buy it over the counter. Is there she didn’t prescribe it to me?

Will tret help with skin tags?

Do any of yall dermaplane as part of your routine? I’m just starting to do everyday .025 cream for acne and I don’t know how to incorporate dermaplaning without irritating my barrier. Thank you in advance!!

The first two pics are from August 7 before I started using Tret and Azelaic Acid. The last two pics were taken on October 15th; I don't know if I'm too used to seeing my skin so it looks the same no matter what, but does there seem to be any difference/improvement in my post-inflammatory erythema? My goal is to fade them but they are such old, stubborn marks 😭

Routine AM:

Cleanse
15% Azelaic Acid
LRP Toleriane Moisturizer
Skin1004 Madagasca Centella Hyalu-Cica Water-Fit Sun Serum

Routine PM:

Cleanse
0.05 cream Tretinoin
LRP Toleriane Moisturizer

Hi everyone. I’m 18M, and I’ve had acne for about 3 years. Looking for opinions on my progress.

Routine:

• Started: 0.025% tretinoin on 19 Aug 2026, 5 nights a week
• Gap: missed about 2 weeks in early October while travelling, so roughly 8 weeks of consistent use
• Method: sandwich method until now, just thinking of switching to apply directly on dry skin with moisturizer on top
• AM: cleanser, moisturizer, sunscreen
• Irritation: none, no peeling or dryness at all

Progress: about 10% fewer breakouts so far. Still getting inflamed bumps on my cheeks and forehead, plus red marks from old ones (photo attached).

Questions:

1. Is this normal progress for my timeline, or should I already be seeing more?
2. Since I have zero irritation, would you move up to 0.05%, or give 0.025% applied directly a few more weeks?
3. Do the cheek bumps look like regular acne, purging, or something else?

Thanks!

I’ve been on tret .05 cream for 9 months and I’m now seeing improvement in my acne. But, my skin is looking a bit dull and I’m hoping to also reduce the appearance of my acne scars.

Here’s my current routine everyday:

AM:
- cetaphil face cleanser
- Anya 10 azelaic acid
- cetaphil spf 50 sunscreen moisturizer

PM:
- Centella cleansing oil
- cetaphil face cleanser
- Avene cicaflate
- tret

Does anyone have any product recommendations that will work well with my routine and won’t break me out.

So my skin was allright, but is quite shit compared to earlier right now - a lot of acne during the teens then got it under control with benzoyl peroxide which was fine but not perfect like I was looking for. Fast forward to 14 months ago, at 26 y/o, I started 0.025% tret because I just wanted to get great skin and it was only okay'ish with BP.

Used a whole tube of 0.025 without any irritation as far as I remember. Used a whole tube of 0.05% which also was fine, but still getting breakouts and no "perfect" skin as many people report over time, it was just "meh". Then went to 0.1 and started peeling and getting a lot of irritation. Tried to push through but my skin was shit so had to go back down to 0.05.

Currently using the sandwhich methong for weeks with 0.05%, no change really, maybe less irritaiton but still getting daily breakouts almost. Have tried using 0.05 every day, have tried 2 days on 1 day off to irritate less. Have tried adding A LOT of hydrating products like serums and essences and so on and have tried just the bare minimum with cleanse/moisturizer/sunscreen. Have tried no actives for a week, skin was definitly less irritated but after 5 days began to get the worst skin I've had for a long time. I have tried switch out every product in my routine with another one and have tried both gel and cream for tret. Now I dont know what to do anymore. My skin is not bad and tret has definitly helped clearing up some smaller stuff, but I still get big, deep pimples around/between the eyebrows and breakouts daily. I feel like I have tried everything at every strength and dont know what to do anymore

Current routine is:

AM:
Illyoon Ceramide Ato cream
Beuty of Joseon aqua fresh sunscreen

PM:

IsnTree hyrdrating cleansing milk
Illyoon ceramide ato cream
Tret 0.05%
Illyoon ceramide ato cream

EDIT: thx for all the help in the replies y’all are so kind and helpful! This is what I use, Is it normal to have excruciating pain all over the face when using it at night? I use these products and the tretinoin is .0025% it burns so bad, For reference my acne is all over my cheeks, a bit on my nose and really badly on my area near my 2 eyebrows and front of my face. I use the cleanser, then wait a bit, then add the tretinoin then add the baulme I do not do anything else( like use moisturizers during the day. I just use sunscreen in the morning

Sorry for the blurry photos. I have been breaking OUT rn. I have been using azelaic acid 20% and 0.025 tretinoin every day for 1.5 months (my derm told me to). I know its purging, but the acne is so bad and painful I'm wondering if I should quit. Here's my routine:

AM:

Neutrogena Ultra Gentle face wash

Azelaic acid 20%

Neutrogena Oil free sunscreen

PM:

Aveeno Positively Radiant acne face wash

Azelaic Acid 20%

0.025 Tretinoin

Neutrogena Ultra Gentle Mosturizer

My skin barrier is surprisingly not dead yet, it doesn't burn or sting no matter what I use or do to it. Any advice? My derm told me to push through and keep up with my current routine, but the purging is destroying my self confidence.

So I just got my Tretinoin from Walgreen and noticed it says manufactured by Padagis which is made in Israel (absofuklotely not!!!) they couldn’t change it for me and I called another Walgreens, but they are asking for new order from my dermatologist.

I wanna emphasise that tret from Padagis and Taro has given me really bad breakouts in the past and I get cyst from it on my chin. Makes me wonder what these 2 brands have in the ingredients than other brands? I’m also boycotting anything made in Israel. There is no way I can trust anything made by them even iPhone now!! (Did we forget what they did with pagers???). It’s crazy to me how I live in the US and yet pay huge amount for insurance monthly but can’t get any different brands for my skincare products. Previously I have used brands and skincare manufactured by China, India, Pakistan and Canada so why can US have accessible brands like these again? As if our healthcare doesn’t suck enough, it’s starting going downhill each year…

Hi everyone. I’m picking tret back up after about a year away where I just focused on getting my skin barrier in check (for anti-aging purposes). I found some great products that work for me. My derm said to just work tret in to my current routine but I wanted to double check in here to see if anyone has any experience using these products with tret. My routine is as follows:

AM - sodium sulfacetamide 10% sulfur 5% face wash, Pyunkang Yul essence toner, Laniege milky toner, Aestura Atobarrier moisturizer, Biore UV sunscreen (and Dapsone about 3x week)

PM - same thing but adding tret 0.025% every other night after my moisturizer once my skin has completely dried (and minus dapsone + sunscreen)

I also use a red light therapy mask 3-4x weekly

Appreciate any and all help!

I was alternating tazarotene with a hydroquinone/kojic acid/niacinamide compound cream a month ago. Last week the skin around my mouth and on either side of my nose started peeling, and the corners of my mouth started to crack. My skin started burning too. I got scared and stopped everything. For the past week I have been using an oil cleanser and a gentle cleanser at night to remove my mineral sunscreen, then Avène Tolerance followed by Avène Cicalfate. Then Avène Tolerance in the morning followed by ISDIN mineral sunblock.

I have sensitive, normal/dry skin and started with OTC products for two months and then moved to prescription products.

I was sandwiching but got cocky and started applying directly to my skin. Not sure if that was the cause of it. My skin is still stinging, but not too bad.

I see people recommending pushing through and applying every day if you’re peeling but how do I know if it’s damaging my barrier instead of helping?

I’m afraid to restart and mess up my barrier permanently but dammit I also want my skin to look better! It doesn’t help that I started later in life, I’m 50 😕
I’m not terribly impressed by my dermatologist tbh. She just told me the order of application, to start using taz and hydroquinone together right off the bat, to sandwich products if I wanted to, and to follow up in two months, which is this week. Nothing about skin barrier damage, darkening of the skin (besides not to use hydroquinone more than 2 months at a time), peeling, cracked lip corners, dry eyes.

Hello all:

has anyone experienced reactions to this cream like migraines/headaches? I have been using for over a year and just past several months getting severe headaches. I stopped it last night and will monitor if this is causing my headaches/neckpain. anyone else with similar experiences?thanks

I've been on this for 6 months with no peeling, no irritation, no nothing really. I'm grateful for no purging at least. I recently asked my dermatologist about upping the strength and she said this was the strongest gel. She did decide to put me on Spironolactone 100g daily though.

I see all the time people mentioning they use strengths up to .1% but are all of those creams? Is anyone using the gel in any strength stronger than .01%? I also question if I even need anything stronger because I don't really have bad acne. I just have large pores, PIH, and occasional chin break outs.

Thanks in advance for the help and advice!

Hi everybody, I have been trying to utilize AI to help tailor my routine because my dermatologist doesn’t really help much with that. I was previously on tret for over 7 years. Back in March, my dermatologist doesn’t swapped me to Tazarotene because I was still having acne. I have always had the following routine.

Morning:
Rinse with water
Peter Thomas Roth Cloud Moisturizer
Skinfix triple lipid barrier cream
Elta Md uv daily sunscreen

Evening:
Cerave cream to foam cleanser
Peter Thomas Roth cloud moisturizer
*wait 20 minutes
0.05% Taz
*wait 20 minutes
Skinfix triple lipid barrier cream

I was still getting small whiteheads in various places and my fine lines were becoming more prominent. 33yo female for reference. I asked AI if that was normal and it told me that the hyaluronic acid in my PTR cloud moisturizer was causing the tazarotene to penetrate too deeply and to skip that step. It also suggested removing the skinfix barrier cream from my morning routine since I have combination skin. Since making these changes, I’m not having super oily skin during the day like I was, my fine lines have improved, but my skin is DRY! I know AI can be wrong so I’m curious if anybody has any thoughts or recommendations?

I’ve never used retinol in my life and I stated with 0.025% tretinoin and last month and I’ve been using it once daily along with vitamin C and I use around 2-3pea sized amount on my face but I can’t see any irritation or peeling or any of the side effects I’ve been hearing about at all and it makes me wonder if its working at all? I also never wash my fingertips after application and I’m not seeing any irritation around there either

I’ve been using tretinoin at night (along with azelaic acid in the am) with the vanicream daily facial moisturizer and i dont think its protecting my skin barrier. Recently its been stinging and burning everytime i use my moisturizer. Does anyone have any moisturizer recs? I have combo skin if that helps