Skin Update #6: Acne + Scars

In this update, I will be sharing my 1 year experience with using Tretinoin (Retin-A Micro), 2 year experience using Dapsone (Aczone), why I stopped taking Spironolactone after 6 months of use, and a brief chat about my experience with CO2 Fraxel Laser.

I highly suggested looking at past skin updates to understand the context of this one:
SKIN UPDATE #5: 0.04% to 0.1% Tretinoin, 6+ Months of Spironolactone, Professional Microneedling
SKIN UPDATE #4: Switching From Adapalene (Differin) to Tretinoin (Retin-A), Taking Spironolactone, Acne Scar Revision?
SKIN UPDATE #3: 1+ Year using Differin
Skin Update [#2]: August 2019: My Skin’s Progress so Far!
Skin Update [#1] December 2018: Acne + Scars


Tretinoin 1 Year Later

If you recall, I started using Tretinoin last spring. My derm bumped up my prescription from 0.3% Adapalene.Iit was clear that its strength was not enough to controls intense breakouts. It has been just over a year since I started incorporating Retin-A Micro in my skincare routine. Here are my thoughts.

  • It is a powerful molecule. I said it before and I’ll say it again, 0.04% Tretinoin did more for my skin than 0.3% Adapalene. I noticed in a month existing acne healed quicker, pores looked smaller, overall skin texture is smoother, skin quality is just overall better.
  • Slow and steady really wins the race. When I bumped up to 0.1% Tretinoin, my skin still had to go through a bit of retinization because I did experience more sensitivity with it. I was using it every night after, but started noticing my skin would look flushed and my pores would look very exaggerated. I now cut the usage to 2-3 times a week and my skin has been in a very happy state.
  • It is not the end all of acne control and anti-aging. Yes, I noticed a number of benefits when I started using it and will continue using it for the rest of my life. However, after years of on and off using a vitamin A topical, even using sunscreen, chemical exfoliants, vitamin C serums… Being super consistent with my skincare for years, I can still see wrinkles coming through on my forehead, my pores were sagging a bit which is a sign of collagen degradation, I still freckle when it’s summer time. It has only been in recent times I’ve been able to control my acne, and a big reason for it is both the use of this topical prescription as well as taking care of myself on the inside. After a year and a half of experimenting, I have finally managed to connect the way I eat to my skin health. Being disciplined in my eating habits plus these topicals help keep my skin clear and overall contribute to the graceful aging process.

Dapsone 2 Years Later

I started using it day and night everyday since January 2020 when I did my 1 year of Differin update. I felt like I could have saved myself a lot of time and money if I just stuck with what was prescribed to me and not freaked out so much about short term side effects. Dapsone is one of the gentlest prescription topicals I have used for my acne and it’s an unsung hero for sure.

  • It helps reduce inflammation around active acne,
  • I have been able to use it alongside other actives with no issues (tretinoin, AHAs, BHAs, Vitamin C),
  • there’s no irritation if I overapply,
  • it doesn’t make other skincare textures not work in my routine.

Now that my skin has been staying fairly clear, I reduced the usage and only use it at night when I use my tretinoin.


6 Months of Spironolactone

Spironolactone is an oral medication to help further assist with acne control. Originally prescribed as a diuretic to help lower blood pressure. How it works for acne is it also inhibits androgen production. Those of us with hormonal acne tend to be in excess of.

I had a bad breakout when I saw my dermatologist in the summer of 2020. Fed up with breakouts, I agreed to going on Spironolactone while continuing my topical treatments tretinoin and dapsone. The first 3 months I most definitely had side-effects, the worst being dizziness and spotting for an entire month. After this time had passed, I definitely noticed its benefits. When I ate too many carby foods, I still did not have a bad breakout. Maybe a small pimple that disappeared quickly. When it was my time of the month, same thing! Little to no breakouts. It was about 98-99% clear at that point.

I took Spiro consistently for another 3 months until I ran out and decided not to get a prescription refill. Deep down, I knew it was a bandaid to my lack of discipline with what I ate. As time passws, this fact bothered me a lot more. I finally figured out my gut health and how it has been effecting my skin. The Spiro just allowed me to be lazy and undisciplined. I also didn’t like the side effects when it came to hormonal changes.

In the past, I took birth control. Part of the reason I stopped taking it is to not be reliant on oral medication. I wanted control over my body. Spiro also effected my hormones, my period being the obvious indicator. If I was younger I wouldn’t care. But now that I’m in my 30s, hormonal health is very important for me. I know a few people who had difficulties conceiving and I was afraid that iIwould have that problem. Although the rewards of taking Spiro were good, for my situation the risks outweigh it.

Frankly I don’t miss it. I’m way more disciplined with my way of eating and lifestyle than the time when I started taking it. I also feel very free not relying on oral medication for my acne.


CO2 Fraxel Laser

YES, I finally did it! I got my first CO2 Fraxel Peel session to address my old atrophic acne scars. I started 3 professional microneedling sessions last year. It definitely lifted some of the scarring, improved my pores and gave a moment of plumpness to my skin. Still,I knew I needed something more heavy duty. Even the dermatologist who performed the procedure said prior that my scars are too old and therefore difficult. I documented my healing time over on my Youtube so be sure to check it out! Long story short, it hurt lol. Now that my skin has settled from the procedure, I find my skin definitely looks smoother. Scars look more lifted, pores look more minimal, and obviously overall skin texture has been refined. I have already completed a 2nd session and will probably get a 3rd in the new year.


And that’s all, folks! As always, I hope you find content like this helpful and informative.

xo, M

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