Sun’s out, lockdown is sort-not-really lifted here in Ontario, and I saw my dermatologist for the 2nd time. My 1st visit was back in October 2018 so I was definitely overdue for a follow-up. It was quite a productive appointment, so I thought I’d share what’s new in my pursuit to clearer skin!

Previous Skin Updates:

• Skin Update [#1] December 2018: Acne + Scars
• Skin Update [#2]: August 2019: My Skin’s Progress so Far!
• SKIN UPDATE #3: 1+ Year using Differin

Recap of what I’ve been doing since January 2020:

• Using 5% Dapsone (Aczone) day and night
• 2 at-home microneedling sessions with the Banisher 2.0
• Eating High Fat Low Carb (Keto) and working out consistently
• Visited dermatologist – prescribed 0.04% Tretinoin (Retin-A Micro) and Spironolactone

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ACNE

Staying consistent with Aczone for the past 4 months has really helped to control my acne. Reflecting more, this is the first topical prescription I have tried that had a minimal adjusting period. It reduces inflammation quickly, prevents painful large breakouts (my last update I had that huge AF cyst -_-). It also plays really well with other actives – Adapalene, Tretinoin, L-Ascorbic Acid, AHA, BHA. Despite my concerns and initial redness in the first couple of months using it, Dapsone has been fairly easy to use. It is also a topical that I had minimal to no side effects from *knocks on wood*.

Alongside my nightly use of 0.3% Adapalene (Differin), eating Keto and working out consistently has also contributed to my skin’s clarity. I found most of the time my skin stays pretty clear, I don’t get a painful cyst during my period, and any inflammatory breakout subsides quickly. My guess on this is that my hormones are becoming more balanced.

A major issue I have with my acne though is when I just want to indulge in something sweet and/or carby. On the off days when I do eat carbs (say once every 2 weeks), my skin is NOT having any of it. I break out no matter what and turn red. Why not just eliminate sweet/carby foods completely? Cause I’d like to enjoy foods like gelato once in a blue moon. I also do not be picky at a family gathering when someone has spent an entire morning and afternoon cooking.

At the appointment, I discussed with my dermatologist what my eating habits are, digestive history, oral medication history, and my future plans. She prescribed me Spironolactone and bumped my Vitamin A prescription to 0.04% Tretinoin (Retin-A Micro (RAM)). I have read many positive experiences about Spironolactone and I’m excited to see how it contributes to my skin’s health. For tretinoin, I asked the derm if it was “lowering” the dose. I asked this because most studies compare 0.3% Adapalene to 0.05% Tretinoin and find similar effects with acne control. She said 0.04% Tretinon is still stronger than Adapalene. It should have a better effect for acne prevention and of course, preventative aging benefits!

Here’s hoping that 5% Dapsone, 0.04% Tretinoin and Spironolactone together helps. That it will show greater improvement in my skin clarity and health, especially on my cheat days :3

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ATROPHIC SCARS

The original reason for my appointment was for a consultation on Acne Scar Revision. In short, the 2 options presented to me were Microneedling (3 sessions to start) or Fraxel laser (also 3 sessions, not sure if she meant Halo – Hybrid Fractional Laser or ProFractional). However because I am still breaking out, I must wait to clear my face again (maybe a month or 2) until I can book a treatment. In the meantime, I’ll continue the at-home microneedling. Once my face is more consistently clear, I can book an appointment. I’m leaning more towards microneedling because 1) the down time is only a day 2) 3 sessions would cost me $1350, whereas Fraxel is $1000 PER SESSION, and I would need to do around 3! So given that, I’d rather pay for 6 microneedling sessions.

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PLAN OF ACTION

I only just started my new prescriptions, so my plan of action is just to follow what my derm told me to do:

• 100mg of Spiro daily to start; Decrease the amount by 25mg once acne looks more controlled until I only take 25mg daily.
• 0.04% Tret twice a week; Increase the usage as tolerability goes up
• 5% Dapsone day and night
• If in a month my skin has cleared up, I can book an appointment for an Acne Scar Revision treatment

I am definitely still continuing Keto (and working out) – I have never seen such a drastic change in my gut health and I feel a lot better and healthier. My derm is aware of my lifestyle choices so I trust she wouldn’t have prescribed Spiro otherwise.

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And that’s it for this skin update! Not as complicated, but still a work in progress.

If you’ve ever been on Spiro or currently taking it, let me know how it’s been going for you in the comment section down below!

xo, M