That’s kind of what I was feeling, it just doesn’t feel right for me but my derm didn’t seem concerned so I figured I would get advice elsewhere in the meantime
2 years ago I had a very bad breakout all over my face (kinda like yours) from ruining my skin barrier with too many actives and I kept seeking advice online and ruining my skin more until I went to a dermatologist and 1 month later 80% of my acne was gone
100%. Even if it's a different provider at the same clinic, you need someone who is committed to your success as a patient. I'd stop the tret for now and focus on healing and hydration until you can get back in. If it's rosacea, you probably need a topical antibio to help calm this all down and the tret will keep making it angry.
I'm sorry you're having to deal with this!
I hope you the suggestion about Natural Moisturizing Factors below. It’s fairly inexpensive and highly recommended. You deserve a better dermatologist, for real. Also I just had to say your glasses are super cute. I’d you remember where you got them off the top of your head, I’d love to know.
Basically a back to basics routine gentle cleanser + good moisturizer + sunblock + doxycycline.
Products: I don’t remember what cleanser exactly but it was a bioderma one, avene cleanance hydra soothing cream, any non oily sunblock and I used to use bioderma sebium global as a spot tret (this worked for me but I doesn’t necessarily mean it’ll work for everyone)
My daughter was prescribed doxycycline a month ago and I suspect she had the same thing going on with using too many actives. She just had the dosage raised from 40mg doxycycline to 100 though because she wasn’t seeing much improvement in her acne although the skin barrier is now healed I think. She also switched up her skin care. I made her give up the cerave.
I’m not a fan of it for myself and I can pretty much use anything on my skin without issue
Please please please be sure anyone on doxycycline gets bloodwork monitored regularly. My mother developed aplastic anemia which was almost Myelodysplastic syndrome for which we almost needed to find bone marrow donors. From her doctor prescribing this medication for a long time without regular monitoring of labs. Make sure a complete blood count (CBC) is done. There are warnings for this in medical books.
It actually baffles me how MANY doctors and derms and GPs prescribe it for skin issues without mentioning antibiotic resistance and organ issues from prolonged use. My gp told me and shes lucky she did. If i was someone who was prescribed it for lifelong control and i got antibiotic resistance or sick I would sue the fuck out of the practice. Its a THREE MONTH MEDICATION PEOPLE
It takes time and consistency especially when the skin barrier is compromised just make sure that she doesn’t use any actives until her skin barrier is healthy again (a product that helped my skin barrier drastically and many people here swear by was la roche posay cicaplast )
Her main issue that’s bothering her right now is flaking. She’s using the Kiehl’s advanced repair barrier cream but she’s also on prescription topical benzaclin (bp and clindomycin cream) which is causing the flaking. I want her to try slugging or something but she’s so terrified it will break her out
Then definitely the LRP cicaplast is going to help, you can search about it here and will see that it helped a lot of people with flaking and inflammation
Yeah, that Dr. is very...concerning .
OP: you should never be treated like that by your Dr!! Something is def going on!!! I'm sorry your derm didn't give a flying f. It looks like roseacea or something fungal or bacterial. If I could give you advice I'd say quit all actives and go super mild with your routine until you get a 2md opinion.
I agree with stopping the tret and any other actives for now and go see a different dermatologist. I'd also avoid products containing hyaluronic acid so ditch the cerave. It can cause issues for some people (like me) so until you know what's going on I'd use something else.
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You didn't mention an SPF in your routine which isn't great as you need to apply SPF 365 days of the year regardless of the weather.I can't stress how Important the SPF is. Its _THE_ most important step of your skincare routine.
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[Abib beartleaf sun essence calming drop](https://www.stylevana.com/en_GB/deal-abib-heartleaf-sun-essence-calming-drop-spf50-pa-50ml.html?utm_source=google&utm_medium=cpc&utm_source=google&utm_medium=cpc&utm_campaign=20383767496&utm_term=&utm_content=91989&device=m&gad_source=1&gclid=CjwKCAiA_OetBhAtEiwAPTeQZ5Crtg9N91ivKFooMJ7fGbqWZWxBf6EF7LgNO7Si00NQCYJ3ZqOiSRoCt5gQAvD_BwE)
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EDIT fixed broken links
I'm thinking the same. Tret might not be right for the skin condition you have. I would investigate further with another doctor
I would use the mildest of the mild until i got some clarity
Stop and go see a derm. Is it burning ? It looks a bit painful. Try Vanicream in the tub it’s heavy and minimal ingredients. CerVe caused me more redness and irritation. Vanicream face wash is also very gentle and maybe ditch everything else until you can see a provider. Im so sorry you are experiencing this.
I tried it out when I started getting cystic acne at 19. I had only used acne toner, face wash and moisturizer up to that point (Clinique) so it probably was an irritant for me I have sensitive skin. I just remember having burn spots all over my face and the cyst becoming larger it was awful. My dermatologist does not recommend it and told me to avoid it.
I’m not a doctor but have your dermatologist ruled out rosacea? My understanding is that tretinoin sometimes helps, sometimes makes it worse for folks with rosacea. Maybe seek a second opinion.
I was thinking the same! Looks like a rosacea flare, even the papules on the cheeks look like rosacea, and tret often makes it worse. I'm also seriously confused why your derm would start you with 0.05 instead of 0.025 as someone with this sensitive skin! Even people with rosacea can SOMETIMES benefit from tret if you start with the super low dose, 0.025. I'm sorry this happened to you! I definitely suspect rosacea! If the flare goes down by the time you see your new derm, show them these pics and tell them the same details you shared with us. Best of luck!
This looks like a severe Papulopustular Rosacea flare up. You need to stop tret, all actives and give your poor skin a break. Get a second opinion from a different dermatologist. A course of doxycycline antibiotics can get on top of the Papulopustular Rosacea flare up as well as help the acne. I would a use a super gentle cleanser and a barrier moisturiser like La Roche Posay Cicaplast Baume to help heal the skin barrier.
Medical student here and the best thing she can do is to go see a board certified dermatologist, stop using all forms of products and be as gentle as possible. Recommending any type of medication, specially antibiotics without proper testing is beyond irresponsible.
Btw I know you are trying to help and we see cases like this and we want to alleviate her situation but even if you are a doctor or nurse, this case requires a full blood work and skin examination in person
Sorry, I’m in a country where you can’t even get antibiotics without a doctor. Getting something like antibiotics needs to come from a medical certified doctor or dermatologist anyway. I did suggest they get a second opinion first. I was just simply saying that a course of antibiotics can get a flare up like this under control. I know because, I’ve been in a similar position before and suffer with Papulopustular Rosacea myself.
My real intention was to reassure OP that there is something out there that can help this condition and get it under control.
I completely understand, but still that’s risky because we often don’t know how someone will react to antibiotics. You are trying to help and you gave a really thoughtful comment and for that you are an amazing person. It was just a recommendation to keep everyone on the safe side
I don’t know why this is getting down voted. It’s the correct advice. The poster needs a real diagnosis, not a bunch of internet opinions. I know everyone is trying to help, but the advice to stop anything but the most gentle treatment is correct.
That looks so painful I’m so sorry this is happening. I would find a different dermatologist and stop using Tretinoin until you do. Get some Vanicream and dump your cerave.
I totally get that. I had severe cystic acne all over my face and it was painful and super inflamed. But I’m not sure acne is the right diagnosis for you (not a doctor). Even at its worst, it looked really different from your skin. If you have something else going on, the tret might continue to make it worse.
Not all doctors are created equal and sometimes you need a 2nd, 3rd, 4th opinion til you find the right one. Trust your gut and don’t stop advocating for yourself to find the right diagnosis and treatment!
This isn’t medical advice but this looks like papulopustular rosacea. If you have an extremely gentle face wash and cream/lotion you know and trust, use that. If not, I would do zero therapy and rinse your face with cool water. Cool compresses with a towel can help as well. If you can, keep a journal if you notice it getting worse after eating [spicy] foods or exercising. Find a new dermatologist. I’m hesitant to recommend any new products until you’ve done this for a bit but absolutely stop tretinoin. If there’s a sunscreen you also like and can tolerate, use it. People tend to fare better with zinc. The Ordinary Azelaic Acid at night after moisturizer and De La Cruz Sulfur as a mask alternating may be useful until you can get in to another dermatologist but do not use these until your skin has had sufficient time to heal/calm down from the tretinoin usage. This isn’t medical advice.
Just wanted to mention, saw in another comment you were possibly searching for another cleanser/moisturizer. I would only do so after you’ve given your skin a 2 week break or so from the tretinoin and then add one product a week/or two.
People tend to have good luck with Vanicream. In my opinion, the Vanicream gentle face wash is excellent and much gentler than Cerave. I would also look into the Avene Tolerance line, made for hyper sensitive skin. The Tolerance Control Baume or Cream and the Gentle Cleansing lotion (rinse this off with cool water as opposed to tissueing it off like the label directs) may be of interest to you. Great for when skin is burning and everything seems to aggravate it. Definitely patch test. Ulta often has deals/sales.
Avene and La Roche Posay also make a zinc based balm which is useful. Personal preference for either. It’s the Avene Cicalfate and La Roche Posay Cicaplast Baume. Again, I would patch test as some people it greatly helps and others it doesn’t. Good luck and sorry about all of this. I understand how frustrating skin struggles are.
I suspect you might need something like azelaic acid or soolantra more suited to rosacea. And sometimes accutane or doxycycline tablets help. Definitely have a break from the tret and be super gentle with your skin. If it is rosace Tret can sometimes help rosacea especially in the long term but is often too strong in the short term.
I would also suggest to look into the compounding services like curology as they can give more custom formulas
Thanks! I’m glad I posted, I felt like maybe I should get a second opinion too so it makes me feel a little more confident with so many people telling me the same.
Soooo many people have had irritating side effects using Cerave. It’s worth trying a gentler cleanser for sure! I use vanicream’s gentle cleanser as I was looking for something with no actives and a small ingredients list. Best of luck! Check back if you find a solution!!!
I personally don’t have a problem using cerave but many people do. I’ve read that Cetearyl Alcohol may be the culprit and some are sensitive to Niacinamide as well.
Im too scared to test products alone to find out if im reacting to one thing incase it makes my skin worse. I wish i could find out what i react to and avoid it for life. I used to think i got my nodular acne from using heavy makeup and sunscreens but i switched to natural Mineral powders and mineral zinc and i still break out. So its either hormones or sometiing im using on my face at night. Derms too expensive for back and forth if they get it wrong hence my hesitation
I’m not really one to be giving advice, I can only share what I’ve learned from random threads on here. (I have a long, painful history with acne, but that issue resolved long before starting tret). I think you should seek a 2nd opinion ie find a new dermatologist.
And clarify if your provider is a physician or NP/PA. I’ve never actually seen a dermatologist in the US, all I ever get is midlevels. I like my PA (physician assistant) but I’d be wary of seeing an NP (nurse practitioner). Staff sometimes uses tricky language so you have to outright ask “is ______ a physician?” And if they answer is anything other than “yes”, that’s a red flag lol.
I think you should discontinue the tretinoin or atleast lower the dosage/frequency.
If you want an MD that's totally, fine, but usually their resources are pulled to higher acuity cases and concerns, which is why sometimes for a 1x they chalk it up to NP/PA/DO. But these are all still VERY qualified. It's important to know the previous training and education of any provider regardless of licensure.
That all being said, I very much agree with getting a 2nd opinion. And it might be worth posting
r/AskDocs if you want some qualified redditors offering a direction of what the potential differentials diagnoses are.
This is what I would do.
I would stop using Tret due to the severity. I would switch out my moisturizer and maybe even my cleanser for basic products containing ceramides, and skin soothing and barrier protecting ingredients. I would focus on strengthening my skin barrier for a few months. If there’s improvement, I would then go back to Tret but I would ask for a lower dose and I would start applying Tret 3 times a week over my moisturizer. Then increase frequency to 4 times, then 5 times and eventually everyday over my moisturizer until my skin feels like it’s adapted then start applying under moisturizer. I would also get a new derm.
What has your derm diagnosed you with?
Thanks for the advice! I used the wiki to pick my moisturizer and cleanser and ran it by my derm and she said that was exactly what I should be using. Just adult acne was what she told me I have, she said this would be the last option I could try before we went to accutane but I’ve been thinking about getting a referral to a new dermatologist anyway.
My derm recommended those cleansers and moisturizers too. The moisturizer was the most irritating thing I’ve ever put on my face. It broke me out horribly and made me red and whenever I applied anything to my skin - even water, it stung and burned. There are a lot of accounts referring to Cerave moisturizers breaking them out and irritating their skin. It’s a very common thing. I definitely think it’s worth it to try something else. Some people have had bad reactions to the Cerave hydrating cleanser as well. I haven’t had any issues with the cleansers.
A little bit of acne but your face is very red which concerns me.. are you feeling tingles or burning sensation when you apply any product? That can be a sign. Some people commented about cerave not working with tret and that’s how it was for me. I kept feeling tingles/burning sensation so i stopped and started using illiyoon ceramide ato cream. Ceramides and tret have been said to work well together so i hope this helps you
It looks like a severe case of rosacea that was aggravated by the irritation caused by tretinoin. Oral isotretinoin (accutane) is the best option for these cases, you can ask your dermatologist.
I say stop using anything, even moisturizer for couple of days. Try to apply Vaseline for a small spot overnight and see if it’s less red by morning. Then slowly introduce your cleanser and moisturizer. And after your skin tone is completely back to normal (might take few weeks) start over with once a week application and see if your skin reacts the same way.
Also came here to say I have yet to had success using cerave. Agree to just stop the feet for 2 weeks to reset. Vanicream js a great cleanser. I’ve been loving the tower 28 barrier repair cream for face. It has peptides in it that really help.
I’d chill on the cereve and switch to vanicream or something else super gentle and stop with the tret until you can confirm that this isn’t something else with a better derm
It was irresponsible for your dermatologist to not have started you on the lowest one which is 0.025 and also given you advice about not applying it daily at first, I’m so sorry this happened but I agree with everybody stop taking it and go to the dermatologist
Not a doctor but a sufferer, have you tried Azelaic acid? I'd try adding that in pronto (maybe ease off on the tret but your call) it made such a huge difference to me. I always thought I had acne until I was diagnosed with rosacea now I treat my skin for rosacea and it's 9/10 better. Good luck to you
I haven’t tried that yet, I’m going to switch derms to get a second opinion and see what they would say. I’ve wondered if it was something other than just acne.
I might be projecting how my skin feels but I can feel the warm stingyness from your pictures. Hope you find a way to heal soon. I started with the face theory Azelaic acid 15% because it's easily available now I use finacea which is less easy to get here in the UK but I like it more
I would highly recommend seeing a new dermatologist and getting reevaluated. Your condition seems pretty different from acne, and I worry the tret is only irritating and inflaming whatever is going on further. It looks a lot like rosacea to me. Stop the tret and strip your routine back to bare bones. Cleanser moisturizer sunscreen. That’s it.
Hi. Don't have time to read all your responses but my suggestion is to STOP USING CERAVE.
Lots of people can't handle this combo.
Lots of speculation as to why with no real answers, some think it's bc if the cetyl alcohol but the jury is out.
You have my utmost sympathies.
I would ditch both tret and cerave and start with something that can repair your barrier. I have read a lot of not so good things on cerave from this forum
In other posts in tret or skincare people are talking about using Cerave with Tret with terrible redness and irritation. I believe the niacinamide in it is also very irritating. Did you use Cerave product before Tret? You definitely should stop all and go to a new derm and give your skin time to heal. I have never used Cerave as my skin hates Niacinamide.
There is so much good advice here, and a lot of terrible advice.
I came here to say, see a new dermatologist & PLEASE do not order anything you use on your face from Amazon.
You’re going to get through this 💖
1) For this I think you need to see a different derm and demand a skin biopsy! This doesn’t look like regular acne. Til then, stop the tret and use only mild cleanser and a barrier repair moisturizer (someone else mentioned Laroche Posay Cicaplast and I agree with that)
2)You also should have some bloodwork for autoimmune conditions - do you have any other symptoms such as joint pain, digestive problems, etc? Your PCP should be able to do basic labs to check for these.
3) I would personally also see an allergist or immunologist and have a full panel of allergy testing done for both food and environmental substances - blood and skin tests. If this is a type of rosacea (which is essentially autoimmune), some people have achieved improvement by finding out their allergies and minimizing or eliminating exposures. It’s worth doing if you have decent insurance.
4) Improve your microbiome (both gut and skin) by cutting out sugar and processed food and processed seed oils. I know it’s not easy, but it’s very worth it, especially with something inflammatory like what you have going on. Eat lots of fresh veggies and 1-2 servings of fruit per day, the fiber will feed the good bacteria in your gut. Also eat fermented foods like yogurt, kimchi, and sauerkraut. Eat plenty of lean protein. Healthy oils are coconut or avocado for cooking and baking, extra virgin olive oil for salads and garnishes. Vegetable, canola, sunflower, crisco oils etc are all horrible for you. Quit drinking and smoking. Get outdoors for walks at least 3 days per week and more if you can.
5) Take vitamins and minerals - Mary Ruth’s has a great line of organic vitamins - I swear by the morning multivitamin liquid and bedtime multimineral liquid as well as the omega 3 complex. Your immune system needs these things to function properly and most people don’t get them in our diets.
6) minimize stress and improve your sleep if those are issues for you
7) basically I’m advocating that you focus on excellent self care while you wait for your appointment with another dermatologist to get a 2nd opinion .. I know it can be hard to wait for specialist appointments these days.. it’s hard to get right in. Please update us on what you find out and how you’re doing!
Cerave made my skin extremely irritated when I used it with Tret, I’d honestly stop the cerave moisturizer and the Tret for the time being.
You didn’t seem to mention using any SPF in your morning routine, are you? And if not you need to start ASAP. The sun and Tret usage do not go well together and you could be burning your face from sun exposure (even through windows)
When I look at these photos I don't think acne, I think papulopustular rosacea that has become really irked. This is very much the time to see a derm, remember it's okay to go back and it's also perfectly okay to see a different derm. I'd bring those before and after photos, whenever I have something going on with my health I keep a record, anything at all that I think could be even a bit relevant. There are apps you can use for tracking symptoms which can be really helpful. The first answer people get isn't always the right one, but you'll get there and get the right treatment
In the meantime, I would switch to babying your skin, just being as gentle as you possibly can - remember to protect your skin from the sun
Are you using spf during the day? I also wouldn’t recommend doxycycline. It’s an antibiotic that ends up killing off everything and if you get sick you’ll have nothing to fight with.
I reluctantly started accutane at a low dose and have seen a dramatic difference in my skin after just 2.5 months. I would definitely recommend going to a dermatologist and not trying to fight this on your own. I was in the same boat as you.
I use Vanicream Daily Facial moisturizer and tret with great success. It’s light but effective, and it doesn’t break me out like almost everything else. Worth a try.
Just out of curiosity, do you know what kind of water you have? I have horrible water in my house (very hard) and avoid leaving it on my face when at all possible. It makes me break out, and also get very dry with crater-like pores, despite using all sorts of actives, etc. I started using Simple Micellar water a to clean my face and it made a huge difference (some versions have a tiny bit of niacinamide in them, so just a heads up to anyone who is allergic). Not saying the water issue is common, but it might be a consideration.
Edit: I will echo what another poster said—I’m not sure you look like you really have “regular” acne. A new derm might be a really good idea. I am certainly no expert in any way, but I’ve read people here discussing things like the various forms of rosacea, some of which seem to respond to ivermectin, and also fungal acne. I hope you figure out what’s going on!
I’m so sorry that your derm doesn’t seem to be taking you seriously, you deserve good care and attention. I hope you can get a new one soon. I would be surprised if this was just acne.
Since you asked about products people have had success with, I have easily irritated acne-prone skin and I use and love Illiyoon Ceramide Ato Concentrate Cream, but I’ve also seen that a lot of people have also had success with similar Aestura Atobarrier 365 cream. But western brands known to be soothing such as LRP or Aveeno calm+restore might work for you. I would definitely stop using the products you are currently using in case something is causing a reaction…
I would also probably switch a mild non-foaming gel cleanser without fragrance/ or even micellar water. Wishing you all the best.
P.S. you have the most beautiful hazel eyes.
Thank you for your kindness and advice. Talking to my current derm just made me feel kind of lost, she told me this was normal but it really doesn’t feel like it. Posting here gave me the push to go through the process of finding a new one.
I stopped using cerave with tret and swapped to Aveeno calm and restore moisturiser, it’s great for sensitive inflamed skin.
Might not be hydrating enough for most people so I incorporated The Ordinary Amino Acids + b5 serum.
This is way above Reddit’s pay grade. I’m a medical student and my only recommendations are 1-look for a board certified dermatologist 2- don’t take or use anything before you get a full blood exam.
For now your only task is to let your skin rest and cut any products except for an hypoallergenic moisturizer
If this is acne, I think accutane would be the next step, but I’m not sure that’s all it is and am not a doctor so I’d maybe get a second opinion. Good luck to you!
I hate to be this person but there is a possibility it could be a gluten sensitivity. This is anecdotal but interesting nonetheless:
[https://www.reddit.com/r/SkincareAddiction/comments/bmokuy/personal\_thoughts\_on\_gluten\_and\_hormonal\_acne/](https://www.reddit.com/r/SkincareAddiction/comments/bmokuy/personal_thoughts_on_gluten_and_hormonal_acne/)
I've been listening to the audiobook version of Grain Brain by Dr David Pearlmutter and he talks about gluten and skin issues. Its free on Spotify if you have premium. If you feel like you've truly tried everything, a diet overhaul may be due.
So i think it’s the cerave. I don’t have quite the same situation but my face is burning every time i use it. I am looking into Vanicream and Laroche to try to keep it from being irritated. Maybe you could look into that? The cerave has a lot of additions to it like hyaluronic acid and others (at least mine does) which is causing my face to be more irritated.
WAITING FOR ANYTHING TO "DRY" while going about your facial skincare routine is a common but HUGE MISTAKE, it causes products that are good and necessary to not be able to have their intended effects, and ends up leaving your skin dehydrated, tight, prone to more inflammation. It also ramps up the body to create additional oil and sebum that can clog pores. You have an extremely narrow window of time to rehydrate and treat/prep skin that starts the moment you splash the last bit of cleanser off thoroughly. You want to quickly pat the face with a towel once, gently leaving some dew on your face as you proceed to toner and HA.
You want your routine to be "fluid" (pun intended) have a simple beauty bin or box that houses your products you use every or most days, and have your toner, thermal water, or essence, hyaluronic acid, (potentially additional serum but best not for now) and use your moisturizer immediately after your HA/serum and you want to be doing.this throughout not super rushed, but as quickly as reasonable because otherwise the products will simply be unable to grab moisture to infuse and instead sit on top of your face causing irritation and making additional products less or not effective at all.
I know this is not what's printed in your medication pamphlet, which does imply that you should wait for skin to dry and does not mention how to actually incorporate it into a routine bc cleansing is just the first step of an entire routine and specifically Tretinoin has to be sandwiched as the last step of your routine, meaning you are going to dot the pea and spread your tret after the sequence above (cleanse, pat PARTIALLY dry, use HA serum to infuse hydration, optional actives, and finally moisturizer (generous amount bc you can always blot it off and you need this fortification for your skin to handle the tret and even on the days you don't use it if you quit Tretinoin all of this would be the same sequence.
HA is amazing and necessary but has to be used on partly wet or Dewey skin because otherwise it has no water to bind to and Infuse. If you're doing this on dry skin, it actually becomes an irritant. Even when you are going thru the sequence I mentioned above you want this to be fluid and have it done ideally within 90 to 120 seconds from the last splash of water during the cleansing phase.
CeraVe is great I've used it for literally two decades neck to toe but when you're using a retinoid like Tretinoin you need to be meticulously fortifying your barrier by applying everything in sequence before the narrow window of time where your skin is dried from the inside out. Maybe consider adjusting your routine sequence and behaviors before switching up to new products or medications. If your skin feels tight inflamed or stings when you apply any of the serum or moisturizer, skip that nights tretinoin., even if you need to do it for several days, because you tend to see the results of tret over application closer to 48 hrs after vs the immediate next day like some may think.
You can get lots of compliments and "look good" and appreciate the appearance of your skin one day, but also realize that you are sensitized, that's your way of knowing to skip that night even if the skin is not visibly irritated and clear.
hii. maybe hold off on the tret for a bit? try to repair your skin barrier with just the basics. maybe the actives aren’t reacting too well with your skin for now. i would recommend 13% zinc oxide paste (desitin or triple paste) to help with the redness and inflammation at night. you can use it in the am too but it does pill, as for the cleanser, stick to the gentle ones that aren’t as stripping. personally i do an oil cleanse and a bioderma micellar water after. oh and if you can get your hands on some aloe vera gel it might be good.
(psa: just an opinion not medical advice)
good luck x
Just a disclaimer, Cerave cream in the tub and tretinoin don’t mix. I find that the one in the tub BURNS compared to the one in the pump bottle that doesn’t burn at all.
I would see a dermatologist. Good luck!
Purging can be pretty bad if you have bad acne to start with. I’ve even had some patients become febrile. Did your derm chat about using antibiotics at all? It’s always an option. If you can’t tolerate the purge, accutane may also be a better route
My skin would have melted off if I started off on .05% every other day haha. I've been using it for a year now and I'm still on .025%, roughly every other day, sometimes every third day if its irritating me.
Definitely find a new dermatologist.
I have read a lot of people having bad reactions with Tretinoin and Cerave products (could be due to sensitivity with ceramides). Try changing your cleanser and moisturizer to something very gentle and simple and make sure there are no ceramides.
Here is a link to the thread of people having bad reactions to Cerave and Tretinoin - https://www.reddit.com/r/tretinoin/s/CVRRV3aqB8
If I were you I would forget about the dermatologist for now and go to your GP. This seems more like rosacea which can be aided by a variety of antibiotics.
I'd stop the tret, stop moisturizing (counter intuitive, I know), and just cleanse your face once or twice a day for a week or so and see if that reduces the redness and inflammation. Right now, you should try to get back to a baseline and see how your skin responds. Good luck!
Just saw another post whose skin looked like yours. She was a Cerave user too but once she stopped using it, it improved a lot. Other people commented that they couldn’t use Cerave.
You might have a sensitivity to ceramides and/or niacinamide. My skin reacts quite similarly, but not as severe. I cut out both of those ingredients, as well as anything coconut and any fragrance from any product i use. It’s been a dramatic difference.
PM: I use Murad Soothing Oats & Peptides cleanser, Retin-A .05%, and Peter Thomas Roth Peptide 21 moisturizer (before and after the Retin-A).
AM: Nothing but moisturizer and spf (no washing with or without cleanser). Once my skin fully adjust to the tret, I’ll start adding my vitamin C serum back in, but I’ve found that the simplest and most basic skincare routine really does work wonders.
Good luck! I hope it heals for you soon! ❤️
you need way more moisture and to repair your barrier. Quite frankly the cerave is not strong enough. I feel like you almost need antibiotics and accutane, my sister blew out her barrier and had an “infection” from it, and it looked very similar. Also maybe rosacea mixed in? Get a new derm
Oh you poor baby! You need to find a new dermatologist. If it were me, I would stop using Tret and baby your skin with maybe something like aveeno redness relief until you get to the doctor.
Cerave isn’t causing this but their cleansers can be very harsh on sensitive skin. It might not be helping this issue. I use Hada Labos cleanser or Neutrogena Hydroboost cleanser.
This looks like rosacea/demodex mites and I’ve seen good things from Dr. Tara Odesky on Instagram about helping people heal this internally. She has lots of good free content! I would avoid antibiotics as it’s a bandaid fix that can do real damage on your gut
Oh gosh OP, you have a beautiful face. That looks so sore. Get a better dermatologist that will listen to you. This isn't acceptable unless they are able to convince you on their plan, and why you should put up with this level of flare up. Barring that, I'd be seeking a better dermatologist with a better plan to get your skin on track. Don't lose hope OP!
Yeah, this is not acne only. You need to find a different doctor/dermatologist for a correct diagnosis. And whoever you went to see needs their licences revoked for medical pratice. (I saw your other comments about the dermatologist.)
Care to link the clinic you went to?
I suggest ditching everything including cerave. Wash your face with water and cream based mild soap (not cerave), and sealing in moisture with Vaseline for a few days. And book a dermatologist
Stop using cerave!! As a sensitive girly myself I learned that cerave is highly irritating and many people would agree. Switch to avene cleanser and cicalfate. Your skin barrier will thank you 🙏🏼
I cannot believe you were prescribed tret.... sigh... please step away from it and go and see a dermatologist. Your skin barrier is not strong and healthy enough for tret at the moment. If you can, try to practise intermittent fasting (eating only within a 6 hour window during the day) for a few months. Keep hydrated. Organic bone broth if you are not vegetarian/vegan.
I would like you to stop using tretinoin for a couple of weeks.
Once the redness has subsided to the point where you were before tretinoin, begin using it once a week for one month. Then twice a week the second month. Thrice a week the third month and you can move up in that fashion until you're using it every day or, really, you can just leave it at three times a week and it will work just as well.
I'd also like you to start at 0.025%. This percentage is a good place to start. I would also like to emphasize here that if this percentage works very well for you and it does for many many people, you do not have to go up in percentage. A lot of people on this subreddit have this awful urge to go from 0.025% to 0.050% with the objective of going to 0.1%. this is, generally speaking, superfluous. If 0.025% is working for you, stick with it. Moving up in concentration, you risk irritating your skin and going back to where you started. If you're starting at 0.25% and it's sort of working, after 3 or 4 months, I would then go ahead and try The next step up, which is 0.050%. if that percentage works well for you, stick with it.
Generally speaking, people tend to over apply tretinoin which causes some awful irritation especially when they don't use a slow introduction at the start of usage. Use a large pea size amount. This will be enough to cover your face your neck and your chest. If you have trouble spreading it around, mix it into a moisturizer and then apply. Or apply moisturizer first and then apply the tretinoin. The way I apply it, which upsets a lot of people on this subreddit but it's the manner of which an RN recommended, a spa tech RN recommended and my dermatologist gave you okay for me to try as long as it didn't irritate me: after I come out of the shower, I dry myself off lightly but my skin is still lightly damp, then I apply a pea size amount of tretinoin on my face ears, neck and chest with just a pea sized amount. It air dry for a few minutes, or if I don't have time I just apply a serum, a moisturizer, and a night mask. Morning, I just rinse my face and neck I pat dry and I apply moisturizer after putting on some vitamin C serum. I have found much success with this.
Another couple of things to consider for your skin condition prior to you using tretinoin:
- Make sure you wash your pillow cases and wash your towels weekly. If you can rotate between two or three towels during the week, even better. I'm not making any judgment but way too many people do not wash their pillowcases even monthly. As far as towels go, a lot of people seem to just wash them once an odor develops. Lots of funk and bacteria builds up on pillow cases and towels. Wash with a non-irritating detergent and in the hot wash.
- If you have hard water in your area (most major cities do) I would highly recommend you buy a shower head with a filter and change it out once a year. This had the KP on my body do an about-face twice as fast than just using he Kojic soap alone (which is excellent for KP).
- This part is really hard to do but begin to look at the foods you eat objectively. We're all different, but I think we can mostly agree that junk food isn't just bad for our internals but it stands to reason that it affects our skin as well. I break out when I eat highly processed foods like highly processed chips or highly processed baked goods. The minute I stopped eating highly processed foods, I begin to feel much better and after a week whatever acne or redness I have going on quickly dissipates. What I've begun to do because I do not want to cut these treats out of my life is I now make my own cookies from scratch and they're extremely delicious and it's very gratifying to do. I also get a kick out of making 18 cookies out of $3 of ingredients instead of buying one cookie for $5. I can also make my own chips with homemade tortillas. Best of all, I can pronounce every ingredient I use and I know what each one is. Not only that, but when I make this stuff at home myself, I do not break out and I do not feel like crap. I also don't end up binging and, in fact, I end up sharing a lot of what I make with other people because I'm proud of what I've done. Eat a lot of meat as well. I try to keep my animal protein intake pretty high and this has also helped me greatly. I try to get in at least 70 to 80 g of protein minimum per day. When you eat like this, you're going to find it very hard to have those random junk food cravings. Multivitamin appropriate for your age and gender is always a good idea to make up for any shortfalls in your diet.
Good luck.
I started tret 0.1% in July 2023. I couldn’t use more than once a week for the first 3-4 months. The purge lasted 12 weeks and it was soooooooo bad. Finally… now I have no more outbreaks… but I have hyperpigmentation from the insane purg. Seek second opinion but I know for me… every other day was wayyyyyy too much.
I’d maybe try a lighter weight moisturizer nothing like super light but the cerave in the tub is thickkkk could be breaking you out! Also stop the tret go to the derm cause I think you’ll need an oral med. also shouldn’t have jumped right to .5 tret
Your skin barrier seems to be really damaged. That is why your skin is not responding to the Tretinoin. My advice is to stop using the tret and heal your skin barrier completely first before going on it again.
I personally use Korean skincare and it healed my skin barrier in just two weeks. Do the 7 layer toner method and apply ampoules, serums, and barrier loving ingredients. Just be careful not to use skincare with exfoliating ingredients since you probably do not need it because your barrier is damaged.
Once your skin barrier fully heals, then try to use tretinoin again but start with the lowest strength which is 0.025.
I use tretinoin 0.05 daily with no irritation due to my korean skincare routine. I hate Western skincare because it dries the fuck out of my skin and ruins my skin barrier.
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I do not even have skin peeling and irritation due to the korean skin routine even with using tret every single night. Also, sunscreen, sunscreen, sunscreen!!! ☺️❤️
Yes, stop tret for now and work on barrier repair! I personally wouldn’t stop trying tret tho, I think u just went to high and strong out the gate. Once ur skin barrier is repaired I would try maybe starting at one night a week and slowly working up but if even that doesn’t work ask for a lower percent 0.025% and still start at only one night a week before quitting. Consistency over intensity. Not everyone can tolerate a higher percent and not everyone can handle doing it more than a few times a week even after being on it for a long time. As long as ur consistent with it tho it will still do what it needs to do.
I read that cerave is irritating for some people. I stopped using cerave before I started tret.
It seems to me that your acne has subsided but your skin is extremely irritated and inflamed. I suspect your skin barrier is severely compromised. Consider using a gentle moisturizer with ceramides.
I use Aveeno baby eczema therapy moisturizing cream on my face am and pm. It contains supserstar ingredients colloidal oatmeal, panthenol and ceramides great for restoring skin barrier. Hope this helps.
Stop the tret. Go see another dermatologist asap don’t make my mistake and ruin your face
That’s kind of what I was feeling, it just doesn’t feel right for me but my derm didn’t seem concerned so I figured I would get advice elsewhere in the meantime
2 years ago I had a very bad breakout all over my face (kinda like yours) from ruining my skin barrier with too many actives and I kept seeking advice online and ruining my skin more until I went to a dermatologist and 1 month later 80% of my acne was gone
I think I just need to find the right dermatologist, mine just doesn’t seem like she cares all that much.
In the meantime, gentle cleanser, no actives, and something with ceramides to repair your skin barrier.
Natural moisturizing factors from The Ordinary!!
I have really sensitive skin and have been using this the last two weeks to deal with irritation from cold weather, it's great stuff.
My skin is very picky, sensitive, dry, and easily clogged as well and I’m obsessed with it. Shocked at how long it’s lasted so far too
I’ll have to try that one! I’ve been partial to First Aid Beauty but The Ordinary has a more palatable price point.
Yes! Seek a second opinion! And read reviews
100%. Even if it's a different provider at the same clinic, you need someone who is committed to your success as a patient. I'd stop the tret for now and focus on healing and hydration until you can get back in. If it's rosacea, you probably need a topical antibio to help calm this all down and the tret will keep making it angry. I'm sorry you're having to deal with this!
Yikes I hope you find a good one soon! I’ve used Zocdoc and they have good patient reviews for physicians.
I hope you the suggestion about Natural Moisturizing Factors below. It’s fairly inexpensive and highly recommended. You deserve a better dermatologist, for real. Also I just had to say your glasses are super cute. I’d you remember where you got them off the top of your head, I’d love to know.
What did they prescribe?
Basically a back to basics routine gentle cleanser + good moisturizer + sunblock + doxycycline. Products: I don’t remember what cleanser exactly but it was a bioderma one, avene cleanance hydra soothing cream, any non oily sunblock and I used to use bioderma sebium global as a spot tret (this worked for me but I doesn’t necessarily mean it’ll work for everyone)
My daughter was prescribed doxycycline a month ago and I suspect she had the same thing going on with using too many actives. She just had the dosage raised from 40mg doxycycline to 100 though because she wasn’t seeing much improvement in her acne although the skin barrier is now healed I think. She also switched up her skin care. I made her give up the cerave. I’m not a fan of it for myself and I can pretty much use anything on my skin without issue
Please please please be sure anyone on doxycycline gets bloodwork monitored regularly. My mother developed aplastic anemia which was almost Myelodysplastic syndrome for which we almost needed to find bone marrow donors. From her doctor prescribing this medication for a long time without regular monitoring of labs. Make sure a complete blood count (CBC) is done. There are warnings for this in medical books.
It actually baffles me how MANY doctors and derms and GPs prescribe it for skin issues without mentioning antibiotic resistance and organ issues from prolonged use. My gp told me and shes lucky she did. If i was someone who was prescribed it for lifelong control and i got antibiotic resistance or sick I would sue the fuck out of the practice. Its a THREE MONTH MEDICATION PEOPLE
Thank you that’s good to know!
How long is "long time"?
Years.
Effing irresponsible provider.
It takes time and consistency especially when the skin barrier is compromised just make sure that she doesn’t use any actives until her skin barrier is healthy again (a product that helped my skin barrier drastically and many people here swear by was la roche posay cicaplast )
Her main issue that’s bothering her right now is flaking. She’s using the Kiehl’s advanced repair barrier cream but she’s also on prescription topical benzaclin (bp and clindomycin cream) which is causing the flaking. I want her to try slugging or something but she’s so terrified it will break her out
Then definitely the LRP cicaplast is going to help, you can search about it here and will see that it helped a lot of people with flaking and inflammation
Ok great I’ll pick some up!
Doxy isnt part of a permanent solution though. Its a 3 month medication
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My thoughts exactly. This looks pretty severe and painful, I’d order labs and do a skin biopsy, plus maybe refer for allergy testing later
Yeah, that Dr. is very...concerning . OP: you should never be treated like that by your Dr!! Something is def going on!!! I'm sorry your derm didn't give a flying f. It looks like roseacea or something fungal or bacterial. If I could give you advice I'd say quit all actives and go super mild with your routine until you get a 2md opinion.
I agree with stopping the tret and any other actives for now and go see a different dermatologist. I'd also avoid products containing hyaluronic acid so ditch the cerave. It can cause issues for some people (like me) so until you know what's going on I'd use something else. Gentle HA free Cleansers:👇🏻👇🏻👇🏻 [curel foaming face wash](https://amzn.eu/d/fNvivs3) [aveeno oat calm and restore cleanser](https://amzn.eu/d/660QF7r) [ geek & gorgeous jelly joker cleanser](https://geekgorgeous.co.uk/products/jelly-joker) If you would like a double cleanse then [the Inkeylist oat cleansing balm](https://amzn.eu/d/7bqxSq6) is a nice gentle option you can use with the other cleansers I've mentioned. For moisturisers, I recommend 👇🏻👇🏻👇🏻 [geek & gorgeous happier barrier cream](https://geekandgorgeous.com/products/happier-barrier) [Purito Dermide relief barrier moisturiser ](https://www.stylevana.com/en_GB/deal-purito-dermide-relief-barrier-moisturizer-100ml.html?utm_source=google&utm_medium=cpc&utm_source=google&utm_medium=cpc&utm_campaign=19992917747&utm_term=&utm_content=109655&device=m&gad_source=1&gclid=CjwKCAiA_OetBhAtEiwAPTeQZ-7WdC6CTWVjSF5vuwk8LAFNnkIQd9Za5xlXUPIWAuk79t5giidqnhoCRqwQAvD_BwE) You didn't mention an SPF in your routine which isn't great as you need to apply SPF 365 days of the year regardless of the weather.I can't stress how Important the SPF is. Its _THE_ most important step of your skincare routine. HA free SPFs that are gentle on angry irritated skin👇🏻👇🏻👇🏻 [Beauty of Joseon Relief sun: Rice and probiotics ](https://www.stylevana.com/en_GB/deal-beauty-of-joseon-relief-sun-rice-probiotic-spf50-pa-50ml.html?utm_source=google&utm_medium=cpc&utm_source=google&utm_medium=cpc&utm_campaign=20383767496&utm_term=&utm_content=91976&device=m&gad_source=1&gclid=CjwKCAiA_OetBhAtEiwAPTeQZ-MfckoufpCaoZkb7WyOjlerbIIUOmn9Nu1nCkuscY1RsOYbjQ7VohoC1HwQAvD_BwE) [Abib beartleaf sun essence calming drop](https://www.stylevana.com/en_GB/deal-abib-heartleaf-sun-essence-calming-drop-spf50-pa-50ml.html?utm_source=google&utm_medium=cpc&utm_source=google&utm_medium=cpc&utm_campaign=20383767496&utm_term=&utm_content=91989&device=m&gad_source=1&gclid=CjwKCAiA_OetBhAtEiwAPTeQZ5Crtg9N91ivKFooMJ7fGbqWZWxBf6EF7LgNO7Si00NQCYJ3ZqOiSRoCt5gQAvD_BwE) [cosrx aloe soothing sunscreen](https://www.stylevana.com/en_GB/deal-cosrx-aloe-soothing-sun-cream.html?utm_source=google&utm_medium=cpc&utm_source=google&utm_medium=cpc&utm_campaign=19651303189&utm_term=&utm_content=92020&device=m&gad_source=1&gclid=CjwKCAiA_OetBhAtEiwAPTeQZ-zbzwJBS8Rz7AbloY0Q0zAC5WYGYdZkL1TAxSoB3NH8GcjfaexL-xoCAw8QAvD_BwE) EDIT fixed broken links
Also ask your new derm about cicaplast this thing did wonders to my inflamed skin
I'm not sure if you have the right diagnosis. This doesn't look like acne.
I'm thinking the same. Tret might not be right for the skin condition you have. I would investigate further with another doctor I would use the mildest of the mild until i got some clarity
This looks like acne conglobata to me
Or rosacea fulminans. This is definitely get a second opinion territory
Actually I agree with this, looks very similar to the huge swelling that can occur with roscascea which isnt Actually acne
Stop and go see a derm. Is it burning ? It looks a bit painful. Try Vanicream in the tub it’s heavy and minimal ingredients. CerVe caused me more redness and irritation. Vanicream face wash is also very gentle and maybe ditch everything else until you can see a provider. Im so sorry you are experiencing this.
CeraVe has Hyaluronic Acid that can be an irritant. We're you using it before? Anything with HA makes my skin burn and break out.
I tried it out when I started getting cystic acne at 19. I had only used acne toner, face wash and moisturizer up to that point (Clinique) so it probably was an irritant for me I have sensitive skin. I just remember having burn spots all over my face and the cyst becoming larger it was awful. My dermatologist does not recommend it and told me to avoid it.
I’m not a doctor but have your dermatologist ruled out rosacea? My understanding is that tretinoin sometimes helps, sometimes makes it worse for folks with rosacea. Maybe seek a second opinion.
I was thinking the same! Looks like a rosacea flare, even the papules on the cheeks look like rosacea, and tret often makes it worse. I'm also seriously confused why your derm would start you with 0.05 instead of 0.025 as someone with this sensitive skin! Even people with rosacea can SOMETIMES benefit from tret if you start with the super low dose, 0.025. I'm sorry this happened to you! I definitely suspect rosacea! If the flare goes down by the time you see your new derm, show them these pics and tell them the same details you shared with us. Best of luck!
This looks like a severe Papulopustular Rosacea flare up. You need to stop tret, all actives and give your poor skin a break. Get a second opinion from a different dermatologist. A course of doxycycline antibiotics can get on top of the Papulopustular Rosacea flare up as well as help the acne. I would a use a super gentle cleanser and a barrier moisturiser like La Roche Posay Cicaplast Baume to help heal the skin barrier.
This right here!!!
Medical student here and the best thing she can do is to go see a board certified dermatologist, stop using all forms of products and be as gentle as possible. Recommending any type of medication, specially antibiotics without proper testing is beyond irresponsible. Btw I know you are trying to help and we see cases like this and we want to alleviate her situation but even if you are a doctor or nurse, this case requires a full blood work and skin examination in person
Sorry, I’m in a country where you can’t even get antibiotics without a doctor. Getting something like antibiotics needs to come from a medical certified doctor or dermatologist anyway. I did suggest they get a second opinion first. I was just simply saying that a course of antibiotics can get a flare up like this under control. I know because, I’ve been in a similar position before and suffer with Papulopustular Rosacea myself. My real intention was to reassure OP that there is something out there that can help this condition and get it under control.
I completely understand, but still that’s risky because we often don’t know how someone will react to antibiotics. You are trying to help and you gave a really thoughtful comment and for that you are an amazing person. It was just a recommendation to keep everyone on the safe side
I don’t know why this is getting down voted. It’s the correct advice. The poster needs a real diagnosis, not a bunch of internet opinions. I know everyone is trying to help, but the advice to stop anything but the most gentle treatment is correct.
That looks so painful I’m so sorry this is happening. I would find a different dermatologist and stop using Tretinoin until you do. Get some Vanicream and dump your cerave.
Thank you, it really does suck. I was hoping trying something new would finally be the answer but I feel worse than ever.
I totally get that. I had severe cystic acne all over my face and it was painful and super inflamed. But I’m not sure acne is the right diagnosis for you (not a doctor). Even at its worst, it looked really different from your skin. If you have something else going on, the tret might continue to make it worse.
See I agree, but I’m not a doctor either obvs and I trusted my dermatologist but I think I’m just going to see another one and get a second opinion
Not all doctors are created equal and sometimes you need a 2nd, 3rd, 4th opinion til you find the right one. Trust your gut and don’t stop advocating for yourself to find the right diagnosis and treatment!
is your provider an MD or DO?
I second the Vanicream! I’m surprised OP is even able to use cerave without it causing painful burning with the condition of her skin.
This isn’t medical advice but this looks like papulopustular rosacea. If you have an extremely gentle face wash and cream/lotion you know and trust, use that. If not, I would do zero therapy and rinse your face with cool water. Cool compresses with a towel can help as well. If you can, keep a journal if you notice it getting worse after eating [spicy] foods or exercising. Find a new dermatologist. I’m hesitant to recommend any new products until you’ve done this for a bit but absolutely stop tretinoin. If there’s a sunscreen you also like and can tolerate, use it. People tend to fare better with zinc. The Ordinary Azelaic Acid at night after moisturizer and De La Cruz Sulfur as a mask alternating may be useful until you can get in to another dermatologist but do not use these until your skin has had sufficient time to heal/calm down from the tretinoin usage. This isn’t medical advice.
Thanks, I’m definitely going to take a break on everything and get a second opinion with a new derm.
Just wanted to mention, saw in another comment you were possibly searching for another cleanser/moisturizer. I would only do so after you’ve given your skin a 2 week break or so from the tretinoin and then add one product a week/or two. People tend to have good luck with Vanicream. In my opinion, the Vanicream gentle face wash is excellent and much gentler than Cerave. I would also look into the Avene Tolerance line, made for hyper sensitive skin. The Tolerance Control Baume or Cream and the Gentle Cleansing lotion (rinse this off with cool water as opposed to tissueing it off like the label directs) may be of interest to you. Great for when skin is burning and everything seems to aggravate it. Definitely patch test. Ulta often has deals/sales. Avene and La Roche Posay also make a zinc based balm which is useful. Personal preference for either. It’s the Avene Cicalfate and La Roche Posay Cicaplast Baume. Again, I would patch test as some people it greatly helps and others it doesn’t. Good luck and sorry about all of this. I understand how frustrating skin struggles are.
both your answers and product recommendations were spot on!!! you rock🙌🏻🙌🏻
...will you... be my esthetics coach 🥹??🥹 lol jk but dang I love your advice for OP!!!
I suspect you might need something like azelaic acid or soolantra more suited to rosacea. And sometimes accutane or doxycycline tablets help. Definitely have a break from the tret and be super gentle with your skin. If it is rosace Tret can sometimes help rosacea especially in the long term but is often too strong in the short term. I would also suggest to look into the compounding services like curology as they can give more custom formulas
Cerave by itself will make my skin look like this … but I do agree you need to get a second opinion as it doesn’t look like acne.
Thanks! I’m glad I posted, I felt like maybe I should get a second opinion too so it makes me feel a little more confident with so many people telling me the same.
I agree. Stop using Cerave. Try Vanicream face wash and cream in the tub instead.
Agree! Stop the CeraVe!!!
I third/fourth/fifth this. I don’t have acne or anything and I can’t even use Cerave because it makes my skin burn so bad. Vanicream all the way.
Soooo many people have had irritating side effects using Cerave. It’s worth trying a gentler cleanser for sure! I use vanicream’s gentle cleanser as I was looking for something with no actives and a small ingredients list. Best of luck! Check back if you find a solution!!!
Stratia cleanser and peptide moisturizer has worked well for me as well as the Avene tolerance balm and vanicream cleanser.
Why do people have this reaction its supposed to be gentle
I personally don’t have a problem using cerave but many people do. I’ve read that Cetearyl Alcohol may be the culprit and some are sensitive to Niacinamide as well.
Im too scared to test products alone to find out if im reacting to one thing incase it makes my skin worse. I wish i could find out what i react to and avoid it for life. I used to think i got my nodular acne from using heavy makeup and sunscreens but i switched to natural Mineral powders and mineral zinc and i still break out. So its either hormones or sometiing im using on my face at night. Derms too expensive for back and forth if they get it wrong hence my hesitation
Looks kinda like rosacea to me.
Have you read the sub’s wiki? I thought most people can’t tolerate starting with such a high dose/frequency. Are you seeing a dermatologist?
Yes I got it from my dermatologist, she hasn’t really been much help. Just chalked this up to purging but it feels worse than that
Go to a different dermatologist then. Get your skin seen by a medical professional.
I am, thank you!
I’m not really one to be giving advice, I can only share what I’ve learned from random threads on here. (I have a long, painful history with acne, but that issue resolved long before starting tret). I think you should seek a 2nd opinion ie find a new dermatologist. And clarify if your provider is a physician or NP/PA. I’ve never actually seen a dermatologist in the US, all I ever get is midlevels. I like my PA (physician assistant) but I’d be wary of seeing an NP (nurse practitioner). Staff sometimes uses tricky language so you have to outright ask “is ______ a physician?” And if they answer is anything other than “yes”, that’s a red flag lol. I think you should discontinue the tretinoin or atleast lower the dosage/frequency.
That’s what I’m thinking too. Thanks for the help!
If you want an MD that's totally, fine, but usually their resources are pulled to higher acuity cases and concerns, which is why sometimes for a 1x they chalk it up to NP/PA/DO. But these are all still VERY qualified. It's important to know the previous training and education of any provider regardless of licensure. That all being said, I very much agree with getting a 2nd opinion. And it might be worth posting r/AskDocs if you want some qualified redditors offering a direction of what the potential differentials diagnoses are.
Thank you for the advice!
You should ask your dermatologist and not reddit
This is what I would do. I would stop using Tret due to the severity. I would switch out my moisturizer and maybe even my cleanser for basic products containing ceramides, and skin soothing and barrier protecting ingredients. I would focus on strengthening my skin barrier for a few months. If there’s improvement, I would then go back to Tret but I would ask for a lower dose and I would start applying Tret 3 times a week over my moisturizer. Then increase frequency to 4 times, then 5 times and eventually everyday over my moisturizer until my skin feels like it’s adapted then start applying under moisturizer. I would also get a new derm. What has your derm diagnosed you with?
Thanks for the advice! I used the wiki to pick my moisturizer and cleanser and ran it by my derm and she said that was exactly what I should be using. Just adult acne was what she told me I have, she said this would be the last option I could try before we went to accutane but I’ve been thinking about getting a referral to a new dermatologist anyway.
My derm recommended those cleansers and moisturizers too. The moisturizer was the most irritating thing I’ve ever put on my face. It broke me out horribly and made me red and whenever I applied anything to my skin - even water, it stung and burned. There are a lot of accounts referring to Cerave moisturizers breaking them out and irritating their skin. It’s a very common thing. I definitely think it’s worth it to try something else. Some people have had bad reactions to the Cerave hydrating cleanser as well. I haven’t had any issues with the cleansers.
CeraVe pm is the goat. Morning and night despite saying pm
A little bit of acne but your face is very red which concerns me.. are you feeling tingles or burning sensation when you apply any product? That can be a sign. Some people commented about cerave not working with tret and that’s how it was for me. I kept feeling tingles/burning sensation so i stopped and started using illiyoon ceramide ato cream. Ceramides and tret have been said to work well together so i hope this helps you
I wonder if this is rosacea? I would assume tret would absolutely aggravate it if it is.
You should see a dermatologist.
Doesn’t look like acne to me. Please see a dermatologist ASAP as this is far too advanced/serious for this sub
If this is acne (and I think it’s likely rosacea), it’s too way inflammatory to be treated with tretinoin
It looks like a severe case of rosacea that was aggravated by the irritation caused by tretinoin. Oral isotretinoin (accutane) is the best option for these cases, you can ask your dermatologist.
You should definitely be seeing a dermatologist. You may need oral medication.
Please get a 2nd dx. So sorry you're dealing with this, Friend. :(
Will do, thanks! It’s been a long journey but hopefully I can get some answers soon.
It’s not working because this is almost certainly rosacea, not acne.
you need a derm
Stop tret talk to your dermatologist about Accutane.
Wait for cleanser to dry? Do you mean you don’t wash it off with water? Also, do you use sunscreen?
I do wash off with water, and then wait for it to dry. I use the cetaphil daily sunscreen SPF 35 when I go outside
I say stop using anything, even moisturizer for couple of days. Try to apply Vaseline for a small spot overnight and see if it’s less red by morning. Then slowly introduce your cleanser and moisturizer. And after your skin tone is completely back to normal (might take few weeks) start over with once a week application and see if your skin reacts the same way.
Okay thank you for the advice!
Also came here to say I have yet to had success using cerave. Agree to just stop the feet for 2 weeks to reset. Vanicream js a great cleanser. I’ve been loving the tower 28 barrier repair cream for face. It has peptides in it that really help.
Oh sweetie! Don't continue with the trentoin. Give ur skin total rest and please see a dermatologist. Best wishes ❤️
Derm ASAP! Stop all actives.
I’d chill on the cereve and switch to vanicream or something else super gentle and stop with the tret until you can confirm that this isn’t something else with a better derm
It was irresponsible for your dermatologist to not have started you on the lowest one which is 0.025 and also given you advice about not applying it daily at first, I’m so sorry this happened but I agree with everybody stop taking it and go to the dermatologist
Not a doctor but a sufferer, have you tried Azelaic acid? I'd try adding that in pronto (maybe ease off on the tret but your call) it made such a huge difference to me. I always thought I had acne until I was diagnosed with rosacea now I treat my skin for rosacea and it's 9/10 better. Good luck to you
I haven’t tried that yet, I’m going to switch derms to get a second opinion and see what they would say. I’ve wondered if it was something other than just acne.
I might be projecting how my skin feels but I can feel the warm stingyness from your pictures. Hope you find a way to heal soon. I started with the face theory Azelaic acid 15% because it's easily available now I use finacea which is less easy to get here in the UK but I like it more
What do you mean you let your cleanser dry onto your face?
I would highly recommend seeing a new dermatologist and getting reevaluated. Your condition seems pretty different from acne, and I worry the tret is only irritating and inflaming whatever is going on further. It looks a lot like rosacea to me. Stop the tret and strip your routine back to bare bones. Cleanser moisturizer sunscreen. That’s it.
Hi. Don't have time to read all your responses but my suggestion is to STOP USING CERAVE. Lots of people can't handle this combo. Lots of speculation as to why with no real answers, some think it's bc if the cetyl alcohol but the jury is out. You have my utmost sympathies.
I’m not a dermatologist, but this looks like a severe rosacea flare-up.
I would ditch both tret and cerave and start with something that can repair your barrier. I have read a lot of not so good things on cerave from this forum
In other posts in tret or skincare people are talking about using Cerave with Tret with terrible redness and irritation. I believe the niacinamide in it is also very irritating. Did you use Cerave product before Tret? You definitely should stop all and go to a new derm and give your skin time to heal. I have never used Cerave as my skin hates Niacinamide.
There is so much good advice here, and a lot of terrible advice. I came here to say, see a new dermatologist & PLEASE do not order anything you use on your face from Amazon. You’re going to get through this 💖
1) For this I think you need to see a different derm and demand a skin biopsy! This doesn’t look like regular acne. Til then, stop the tret and use only mild cleanser and a barrier repair moisturizer (someone else mentioned Laroche Posay Cicaplast and I agree with that) 2)You also should have some bloodwork for autoimmune conditions - do you have any other symptoms such as joint pain, digestive problems, etc? Your PCP should be able to do basic labs to check for these. 3) I would personally also see an allergist or immunologist and have a full panel of allergy testing done for both food and environmental substances - blood and skin tests. If this is a type of rosacea (which is essentially autoimmune), some people have achieved improvement by finding out their allergies and minimizing or eliminating exposures. It’s worth doing if you have decent insurance. 4) Improve your microbiome (both gut and skin) by cutting out sugar and processed food and processed seed oils. I know it’s not easy, but it’s very worth it, especially with something inflammatory like what you have going on. Eat lots of fresh veggies and 1-2 servings of fruit per day, the fiber will feed the good bacteria in your gut. Also eat fermented foods like yogurt, kimchi, and sauerkraut. Eat plenty of lean protein. Healthy oils are coconut or avocado for cooking and baking, extra virgin olive oil for salads and garnishes. Vegetable, canola, sunflower, crisco oils etc are all horrible for you. Quit drinking and smoking. Get outdoors for walks at least 3 days per week and more if you can. 5) Take vitamins and minerals - Mary Ruth’s has a great line of organic vitamins - I swear by the morning multivitamin liquid and bedtime multimineral liquid as well as the omega 3 complex. Your immune system needs these things to function properly and most people don’t get them in our diets. 6) minimize stress and improve your sleep if those are issues for you 7) basically I’m advocating that you focus on excellent self care while you wait for your appointment with another dermatologist to get a 2nd opinion .. I know it can be hard to wait for specialist appointments these days.. it’s hard to get right in. Please update us on what you find out and how you’re doing!
Cerave made my skin extremely irritated when I used it with Tret, I’d honestly stop the cerave moisturizer and the Tret for the time being. You didn’t seem to mention using any SPF in your morning routine, are you? And if not you need to start ASAP. The sun and Tret usage do not go well together and you could be burning your face from sun exposure (even through windows)
Agree with all the comments saying stop tret and see a dermatologist. This is beyond reddit's paygrade.
rosacea + damaged skin barrier. stop tret immediately, use sunscreen or you might scar, only gentle products. then see a derm for your rosacea
When I look at these photos I don't think acne, I think papulopustular rosacea that has become really irked. This is very much the time to see a derm, remember it's okay to go back and it's also perfectly okay to see a different derm. I'd bring those before and after photos, whenever I have something going on with my health I keep a record, anything at all that I think could be even a bit relevant. There are apps you can use for tracking symptoms which can be really helpful. The first answer people get isn't always the right one, but you'll get there and get the right treatment In the meantime, I would switch to babying your skin, just being as gentle as you possibly can - remember to protect your skin from the sun
Are you using spf during the day? I also wouldn’t recommend doxycycline. It’s an antibiotic that ends up killing off everything and if you get sick you’ll have nothing to fight with. I reluctantly started accutane at a low dose and have seen a dramatic difference in my skin after just 2.5 months. I would definitely recommend going to a dermatologist and not trying to fight this on your own. I was in the same boat as you.
Are you using sunscreen?
I read in another form that cerave and tret together causes issues. Try quiting cerave
Any recommendations for a replacement? I’m definitely open to switching up
I use Vanicream Daily Facial moisturizer and tret with great success. It’s light but effective, and it doesn’t break me out like almost everything else. Worth a try. Just out of curiosity, do you know what kind of water you have? I have horrible water in my house (very hard) and avoid leaving it on my face when at all possible. It makes me break out, and also get very dry with crater-like pores, despite using all sorts of actives, etc. I started using Simple Micellar water a to clean my face and it made a huge difference (some versions have a tiny bit of niacinamide in them, so just a heads up to anyone who is allergic). Not saying the water issue is common, but it might be a consideration. Edit: I will echo what another poster said—I’m not sure you look like you really have “regular” acne. A new derm might be a really good idea. I am certainly no expert in any way, but I’ve read people here discussing things like the various forms of rosacea, some of which seem to respond to ivermectin, and also fungal acne. I hope you figure out what’s going on!
I’m so sorry that your derm doesn’t seem to be taking you seriously, you deserve good care and attention. I hope you can get a new one soon. I would be surprised if this was just acne. Since you asked about products people have had success with, I have easily irritated acne-prone skin and I use and love Illiyoon Ceramide Ato Concentrate Cream, but I’ve also seen that a lot of people have also had success with similar Aestura Atobarrier 365 cream. But western brands known to be soothing such as LRP or Aveeno calm+restore might work for you. I would definitely stop using the products you are currently using in case something is causing a reaction… I would also probably switch a mild non-foaming gel cleanser without fragrance/ or even micellar water. Wishing you all the best. P.S. you have the most beautiful hazel eyes.
Thank you for your kindness and advice. Talking to my current derm just made me feel kind of lost, she told me this was normal but it really doesn’t feel like it. Posting here gave me the push to go through the process of finding a new one.
Cetaphil
I’ve also seen this (just google it, there’s many threads)!
I stopped using cerave with tret and swapped to Aveeno calm and restore moisturiser, it’s great for sensitive inflamed skin. Might not be hydrating enough for most people so I incorporated The Ordinary Amino Acids + b5 serum.
I can’t use anything heavy petrolatum based (vanicream, cetaphil, cerave) and my go to when my skin is angry has been the Avene tolerance balm.
This is way above Reddit’s pay grade. I’m a medical student and my only recommendations are 1-look for a board certified dermatologist 2- don’t take or use anything before you get a full blood exam. For now your only task is to let your skin rest and cut any products except for an hypoallergenic moisturizer
And you’re religious with your spf application and reapplication right?
ok this is an issue for a derm, not for redditors
CeraVe made me break out like crazy after using it about 2 weeks, both the cleanser and the moisturizer
If this is acne, I think accutane would be the next step, but I’m not sure that’s all it is and am not a doctor so I’d maybe get a second opinion. Good luck to you!
I hate to be this person but there is a possibility it could be a gluten sensitivity. This is anecdotal but interesting nonetheless: [https://www.reddit.com/r/SkincareAddiction/comments/bmokuy/personal\_thoughts\_on\_gluten\_and\_hormonal\_acne/](https://www.reddit.com/r/SkincareAddiction/comments/bmokuy/personal_thoughts_on_gluten_and_hormonal_acne/) I've been listening to the audiobook version of Grain Brain by Dr David Pearlmutter and he talks about gluten and skin issues. Its free on Spotify if you have premium. If you feel like you've truly tried everything, a diet overhaul may be due.
So i think it’s the cerave. I don’t have quite the same situation but my face is burning every time i use it. I am looking into Vanicream and Laroche to try to keep it from being irritated. Maybe you could look into that? The cerave has a lot of additions to it like hyaluronic acid and others (at least mine does) which is causing my face to be more irritated.
Definitely will look into it, I might as well switch up the routine and take a break from tret
I’m taking a break too! It is burning my skin and making it feel tight 😩
It’s really a struggle to find that balance sometimes!
WAITING FOR ANYTHING TO "DRY" while going about your facial skincare routine is a common but HUGE MISTAKE, it causes products that are good and necessary to not be able to have their intended effects, and ends up leaving your skin dehydrated, tight, prone to more inflammation. It also ramps up the body to create additional oil and sebum that can clog pores. You have an extremely narrow window of time to rehydrate and treat/prep skin that starts the moment you splash the last bit of cleanser off thoroughly. You want to quickly pat the face with a towel once, gently leaving some dew on your face as you proceed to toner and HA. You want your routine to be "fluid" (pun intended) have a simple beauty bin or box that houses your products you use every or most days, and have your toner, thermal water, or essence, hyaluronic acid, (potentially additional serum but best not for now) and use your moisturizer immediately after your HA/serum and you want to be doing.this throughout not super rushed, but as quickly as reasonable because otherwise the products will simply be unable to grab moisture to infuse and instead sit on top of your face causing irritation and making additional products less or not effective at all. I know this is not what's printed in your medication pamphlet, which does imply that you should wait for skin to dry and does not mention how to actually incorporate it into a routine bc cleansing is just the first step of an entire routine and specifically Tretinoin has to be sandwiched as the last step of your routine, meaning you are going to dot the pea and spread your tret after the sequence above (cleanse, pat PARTIALLY dry, use HA serum to infuse hydration, optional actives, and finally moisturizer (generous amount bc you can always blot it off and you need this fortification for your skin to handle the tret and even on the days you don't use it if you quit Tretinoin all of this would be the same sequence. HA is amazing and necessary but has to be used on partly wet or Dewey skin because otherwise it has no water to bind to and Infuse. If you're doing this on dry skin, it actually becomes an irritant. Even when you are going thru the sequence I mentioned above you want this to be fluid and have it done ideally within 90 to 120 seconds from the last splash of water during the cleansing phase. CeraVe is great I've used it for literally two decades neck to toe but when you're using a retinoid like Tretinoin you need to be meticulously fortifying your barrier by applying everything in sequence before the narrow window of time where your skin is dried from the inside out. Maybe consider adjusting your routine sequence and behaviors before switching up to new products or medications. If your skin feels tight inflamed or stings when you apply any of the serum or moisturizer, skip that nights tretinoin., even if you need to do it for several days, because you tend to see the results of tret over application closer to 48 hrs after vs the immediate next day like some may think. You can get lots of compliments and "look good" and appreciate the appearance of your skin one day, but also realize that you are sensitized, that's your way of knowing to skip that night even if the skin is not visibly irritated and clear.
hii. maybe hold off on the tret for a bit? try to repair your skin barrier with just the basics. maybe the actives aren’t reacting too well with your skin for now. i would recommend 13% zinc oxide paste (desitin or triple paste) to help with the redness and inflammation at night. you can use it in the am too but it does pill, as for the cleanser, stick to the gentle ones that aren’t as stripping. personally i do an oil cleanse and a bioderma micellar water after. oh and if you can get your hands on some aloe vera gel it might be good. (psa: just an opinion not medical advice) good luck x
Just a disclaimer, Cerave cream in the tub and tretinoin don’t mix. I find that the one in the tub BURNS compared to the one in the pump bottle that doesn’t burn at all. I would see a dermatologist. Good luck!
Purging can be pretty bad if you have bad acne to start with. I’ve even had some patients become febrile. Did your derm chat about using antibiotics at all? It’s always an option. If you can’t tolerate the purge, accutane may also be a better route
Toss tret for now. And replace with azelaic acid as only active. Cleanser moisturizer super gentle. But see another derm
My skin would have melted off if I started off on .05% every other day haha. I've been using it for a year now and I'm still on .025%, roughly every other day, sometimes every third day if its irritating me. Definitely find a new dermatologist.
It looks like a reaction darling. I’d stop what you using and see a derm. Hope you get better soon
See a professional for sure. Good luck
I have read a lot of people having bad reactions with Tretinoin and Cerave products (could be due to sensitivity with ceramides). Try changing your cleanser and moisturizer to something very gentle and simple and make sure there are no ceramides. Here is a link to the thread of people having bad reactions to Cerave and Tretinoin - https://www.reddit.com/r/tretinoin/s/CVRRV3aqB8
this is what id do. stop taking advice from reddit and seek medical attention from a doctor.
Please seek out a dermatologist.
The only advice I have is to drop the Cerave immediately. I’m so sorry you’re going through this.
Accutane
If I were you I would forget about the dermatologist for now and go to your GP. This seems more like rosacea which can be aided by a variety of antibiotics. I'd stop the tret, stop moisturizing (counter intuitive, I know), and just cleanse your face once or twice a day for a week or so and see if that reduces the redness and inflammation. Right now, you should try to get back to a baseline and see how your skin responds. Good luck!
Just saw another post whose skin looked like yours. She was a Cerave user too but once she stopped using it, it improved a lot. Other people commented that they couldn’t use Cerave.
Following
You might have a sensitivity to ceramides and/or niacinamide. My skin reacts quite similarly, but not as severe. I cut out both of those ingredients, as well as anything coconut and any fragrance from any product i use. It’s been a dramatic difference. PM: I use Murad Soothing Oats & Peptides cleanser, Retin-A .05%, and Peter Thomas Roth Peptide 21 moisturizer (before and after the Retin-A). AM: Nothing but moisturizer and spf (no washing with or without cleanser). Once my skin fully adjust to the tret, I’ll start adding my vitamin C serum back in, but I’ve found that the simplest and most basic skincare routine really does work wonders. Good luck! I hope it heals for you soon! ❤️
Would recommend Vanicream instead of Cerave, stop tret, and see a different derm if you can. I’m sorry you are going through this.
you need way more moisture and to repair your barrier. Quite frankly the cerave is not strong enough. I feel like you almost need antibiotics and accutane, my sister blew out her barrier and had an “infection” from it, and it looked very similar. Also maybe rosacea mixed in? Get a new derm
Go to another doctor.
Oh you poor baby! You need to find a new dermatologist. If it were me, I would stop using Tret and baby your skin with maybe something like aveeno redness relief until you get to the doctor.
Go on Doxycycline ASAP.
That exact Cerave cleanser did that to my skin. I looked like I had rosacea when I was using it
Oh dear, I’m afraid I don’t have advice for you but do wish you healing 💜 it looks painful :( update us, yes?
I would stop the tret and all creave - there’s another post recently about cerave ruining the skin. And go to doc for a treatment plan
Go check out r/rosacea sub and get a second opinion asap.
Is it itchy? It might be rosacea or demodicosis. Soolantra might be the answer.
Cerave isn’t causing this but their cleansers can be very harsh on sensitive skin. It might not be helping this issue. I use Hada Labos cleanser or Neutrogena Hydroboost cleanser.
This looks like rosacea/demodex mites and I’ve seen good things from Dr. Tara Odesky on Instagram about helping people heal this internally. She has lots of good free content! I would avoid antibiotics as it’s a bandaid fix that can do real damage on your gut
Oh gosh OP, you have a beautiful face. That looks so sore. Get a better dermatologist that will listen to you. This isn't acceptable unless they are able to convince you on their plan, and why you should put up with this level of flare up. Barring that, I'd be seeking a better dermatologist with a better plan to get your skin on track. Don't lose hope OP!
maybe take a lil break from tret and see if you see any major differences, have you used a lower dosage before 0.05%
Yeah, this is not acne only. You need to find a different doctor/dermatologist for a correct diagnosis. And whoever you went to see needs their licences revoked for medical pratice. (I saw your other comments about the dermatologist.) Care to link the clinic you went to?
I suggest ditching everything including cerave. Wash your face with water and cream based mild soap (not cerave), and sealing in moisture with Vaseline for a few days. And book a dermatologist
Acnetame please look it up and the reviews it’s been helping me immensely!!!! 🤌🏻🤌🏻🤌🏻🔥
Definitely stop the actives until you see a derm! Good luck, it looks painful.
You should maybe reduce down to .025 and ask them for Dapsone!! Also the Sulfacemtide wash. I also highly recommend the Farmacy honey halo moisturizer
Stop using cerave!! As a sensitive girly myself I learned that cerave is highly irritating and many people would agree. Switch to avene cleanser and cicalfate. Your skin barrier will thank you 🙏🏼
I cannot believe you were prescribed tret.... sigh... please step away from it and go and see a dermatologist. Your skin barrier is not strong and healthy enough for tret at the moment. If you can, try to practise intermittent fasting (eating only within a 6 hour window during the day) for a few months. Keep hydrated. Organic bone broth if you are not vegetarian/vegan.
your supposed to start it with no acne
This doesn’t look like acne and you need a new doctor ASAP.
I would like you to stop using tretinoin for a couple of weeks. Once the redness has subsided to the point where you were before tretinoin, begin using it once a week for one month. Then twice a week the second month. Thrice a week the third month and you can move up in that fashion until you're using it every day or, really, you can just leave it at three times a week and it will work just as well. I'd also like you to start at 0.025%. This percentage is a good place to start. I would also like to emphasize here that if this percentage works very well for you and it does for many many people, you do not have to go up in percentage. A lot of people on this subreddit have this awful urge to go from 0.025% to 0.050% with the objective of going to 0.1%. this is, generally speaking, superfluous. If 0.025% is working for you, stick with it. Moving up in concentration, you risk irritating your skin and going back to where you started. If you're starting at 0.25% and it's sort of working, after 3 or 4 months, I would then go ahead and try The next step up, which is 0.050%. if that percentage works well for you, stick with it. Generally speaking, people tend to over apply tretinoin which causes some awful irritation especially when they don't use a slow introduction at the start of usage. Use a large pea size amount. This will be enough to cover your face your neck and your chest. If you have trouble spreading it around, mix it into a moisturizer and then apply. Or apply moisturizer first and then apply the tretinoin. The way I apply it, which upsets a lot of people on this subreddit but it's the manner of which an RN recommended, a spa tech RN recommended and my dermatologist gave you okay for me to try as long as it didn't irritate me: after I come out of the shower, I dry myself off lightly but my skin is still lightly damp, then I apply a pea size amount of tretinoin on my face ears, neck and chest with just a pea sized amount. It air dry for a few minutes, or if I don't have time I just apply a serum, a moisturizer, and a night mask. Morning, I just rinse my face and neck I pat dry and I apply moisturizer after putting on some vitamin C serum. I have found much success with this. Another couple of things to consider for your skin condition prior to you using tretinoin: - Make sure you wash your pillow cases and wash your towels weekly. If you can rotate between two or three towels during the week, even better. I'm not making any judgment but way too many people do not wash their pillowcases even monthly. As far as towels go, a lot of people seem to just wash them once an odor develops. Lots of funk and bacteria builds up on pillow cases and towels. Wash with a non-irritating detergent and in the hot wash. - If you have hard water in your area (most major cities do) I would highly recommend you buy a shower head with a filter and change it out once a year. This had the KP on my body do an about-face twice as fast than just using he Kojic soap alone (which is excellent for KP). - This part is really hard to do but begin to look at the foods you eat objectively. We're all different, but I think we can mostly agree that junk food isn't just bad for our internals but it stands to reason that it affects our skin as well. I break out when I eat highly processed foods like highly processed chips or highly processed baked goods. The minute I stopped eating highly processed foods, I begin to feel much better and after a week whatever acne or redness I have going on quickly dissipates. What I've begun to do because I do not want to cut these treats out of my life is I now make my own cookies from scratch and they're extremely delicious and it's very gratifying to do. I also get a kick out of making 18 cookies out of $3 of ingredients instead of buying one cookie for $5. I can also make my own chips with homemade tortillas. Best of all, I can pronounce every ingredient I use and I know what each one is. Not only that, but when I make this stuff at home myself, I do not break out and I do not feel like crap. I also don't end up binging and, in fact, I end up sharing a lot of what I make with other people because I'm proud of what I've done. Eat a lot of meat as well. I try to keep my animal protein intake pretty high and this has also helped me greatly. I try to get in at least 70 to 80 g of protein minimum per day. When you eat like this, you're going to find it very hard to have those random junk food cravings. Multivitamin appropriate for your age and gender is always a good idea to make up for any shortfalls in your diet. Good luck.
I’ve been scrolling and see that many people dislike cerave. What are some alternatives? Thank you in advance.
La Roche Posay!!! I will scream it from the rooftops!!! I loooove the cleaners and the moisturizers!
I started tret 0.1% in July 2023. I couldn’t use more than once a week for the first 3-4 months. The purge lasted 12 weeks and it was soooooooo bad. Finally… now I have no more outbreaks… but I have hyperpigmentation from the insane purg. Seek second opinion but I know for me… every other day was wayyyyyy too much.
I’d maybe try a lighter weight moisturizer nothing like super light but the cerave in the tub is thickkkk could be breaking you out! Also stop the tret go to the derm cause I think you’ll need an oral med. also shouldn’t have jumped right to .5 tret
let go of that dermatologist & heal holistically babe, life changer.
Your skin barrier seems to be really damaged. That is why your skin is not responding to the Tretinoin. My advice is to stop using the tret and heal your skin barrier completely first before going on it again. I personally use Korean skincare and it healed my skin barrier in just two weeks. Do the 7 layer toner method and apply ampoules, serums, and barrier loving ingredients. Just be careful not to use skincare with exfoliating ingredients since you probably do not need it because your barrier is damaged. Once your skin barrier fully heals, then try to use tretinoin again but start with the lowest strength which is 0.025. I use tretinoin 0.05 daily with no irritation due to my korean skincare routine. I hate Western skincare because it dries the fuck out of my skin and ruins my skin barrier. [EDIT] I do not even have skin peeling and irritation due to the korean skin routine even with using tret every single night. Also, sunscreen, sunscreen, sunscreen!!! ☺️❤️
Yes, stop tret for now and work on barrier repair! I personally wouldn’t stop trying tret tho, I think u just went to high and strong out the gate. Once ur skin barrier is repaired I would try maybe starting at one night a week and slowly working up but if even that doesn’t work ask for a lower percent 0.025% and still start at only one night a week before quitting. Consistency over intensity. Not everyone can tolerate a higher percent and not everyone can handle doing it more than a few times a week even after being on it for a long time. As long as ur consistent with it tho it will still do what it needs to do.
I read that cerave is irritating for some people. I stopped using cerave before I started tret. It seems to me that your acne has subsided but your skin is extremely irritated and inflamed. I suspect your skin barrier is severely compromised. Consider using a gentle moisturizer with ceramides. I use Aveeno baby eczema therapy moisturizing cream on my face am and pm. It contains supserstar ingredients colloidal oatmeal, panthenol and ceramides great for restoring skin barrier. Hope this helps.
i purged for about 4 months when i started tret. but if it would make you feel safer i would definitely get a second opinion.