SKIN UPDATE #4: Switching From Adapalene (Differin) to Tretinoin (Retin-A), Taking Spironolactone, Acne Scar Revision?

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 of how my skin has been. 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

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 in my routine and had the most 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.

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

5% Dapsone, Spironolactone and 0.04% Tretinoin

After discussing 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 the 0.04% Tret, I asked the derm if it was actually “lowering” the dose since most studies compare 0.3% Adapalene to 0.05% Tretinoin; She said 0.04% Tretinon is still stronger than Adapalene so it should have a better effect for acne prevention and of course, preventative aging benefits!

I’m really hoping that 5% Dapsone, 0.04% Tret and Spironolactone together will show greater improvement in my skin clarity and health, especially on my cheat days :3


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.


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.


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

SKIN UPDATE #3: 1+ Year using Differin

Wow, it’s been 1 year since I started using 0.3% Adapalene! Crazy how fast time passes when you get older heheheh….

If you haven’t already, please be sure to read my previous skin updates so you understand what I talk about in this post and other actives I use that I do not mention here.
Skin Update [#1] December 2018: Acne + Scars
Skin Update [#2]: August 2019: My Skin’s Progress so Far!

Breakdown of what I’ve been doing to my skin since my last Skin Update August 2019:

  • Got too cheeky and started eating eating crappy food and drinking sugary drinks, thus getting breakouts so big that 10% Azelaic Acid couldn’t handle it 🙂
  • Have repurchased a 5% Benzoyl Peroxide wash which does the job very quickly. However…
  • Contemplated why I stopped using 5% Dapsone, and realized that the moment I had a mild side effect (redness) I freaked out. I began the purchasing spiral to find an OTC product to help with breakouts, when I could’ve just continued using Dapsone.

ACNE

My cystic breakouts have been on and off. As mentioned in my recap, I’ve been eating shitty food lately, and both my boyfriend and I know the triggers (refined sugar). Since the holidays, I have been cutting back on sugary snacks and drinks. Reflecting back on older photos, my acne is definitely is more under control than it has been in years. Here are some posts for reference when I started 0.1% Adapalene. You’ll notice dark red marks and lots of hormonal breakouts along my jaw:
2018 Skincare Routines
Some By Mi Review

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From this year of using many actives (do as I say, not as I do lol), I found that Benzoyl Peroxide in wash form (Benzagel 5 Acne Wash) and my 5% Dapsone gel prescription have been the most effective at treating inflamed acne lesions quickly and making my skin smoother from bumps. I’ll continue using both, mostly 5% Dapsone on my face 2 times a day (as advised) and use the BP wash for emergencies.


PIGMENTATION

Due to the increase in some breakouts, my chin in particular has more red/purple marks than usual. However I don’t find it to bother me much, since Differin really helps to diminish them quickly, alongside an SPF50+ sunscreen. I also find Azelaic Acid has been great in speeding up their healing process. Incorporating it into my routine definitely makes my complexion brighter, more even tone, and assist with fading any pigmentation.

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I actually prefer it over Vitamin C serums, which have never shown (in my experience) to help with red acne marks. I currently am near the end of Paula’s Choice 10% Azelaic Acid Booster in my collection, and I don’t plan on getting the unprescribed 15% Finacea any time soon. The PC one while nice is quite expensive and it is difficult to find unprescribed Finacea, even if I look on eBay. I think I need to be patient and either a) ask my Derm about prescribed AA, or b) wait for F.C. from SimpleSkincareScience to launch his AA serum!


ATROPHIC SCARS

And now the big update! Please watch my Youtube video showcasing my scars after a finishing a whole tube of 0.3% Adapalene (over 1 year). I couldn’t for the life of me replicate the exact angle and lighting of my face and it looked different with every photo. The video will give a better idea.

Like I have mentioned here or there, every time I see family and friends, they always compliment how much smoother my skin looks. Usually awful lighting was the teller of all tales for my complexion, and I even notice that my skin looks so much smoother! Although my skin isn’t 100% smooth (I don’t think it will ever be to be honest), the texture has definitely improved for the better with continued use of Differin.


FINAL THOUGHTS + MY PLAN

Although it’s a lengthy process, I’m happy that my skin has been overall improving for the better since starting 0.3% Adapalene. This plus other actives has also given me more mental freedom, and I see myself (literally and figuratively) in a more positive light. The quality of my skin has been a constant focal point in my thoughts for years, and I finally have the clarity to not care about how I look without a face full of makeup.

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I already picked up another prescription of Differin, so I will continue to use it. It seems that more evidence is popping up that it can also help with photoaging, so hopefully this will also contribute to my skin’s quality in that aspect. In addition, I will continue to use 5% Dapsone morning and night even if I am lesion free (it’s supposed to help prevent as well), and book an appointment with my derm if I ever have concerns.

Now that I have finally used up a full tube of Differin, I am going to FINALLY start microneedling again to speed up the healing process of my atrophic scars and to help prevent my subtle fine lines from getting worse. I know I mentioned this in my last skin update, but I decided to just see what topicals solely did for my scars.


As always, I hope you found my post helpful and informative.

xo, M

Skin Update [#2]: August 2019: My Skin’s Progress so Far!

I forgot to schedule this because my mind drifted during the Long Labour Day weekend 🙂

It has been around 9 months since starting 0.3% Adapalene, so it’s about time I do a skin update and show you my skin’s progress!

Be sure to read my first one so you’re up to date: Skin Update [#1] December 2018: Acne + Scars


Here’s a breakdown of what I’ve been doing since my last update in December 2018:

  • Still have not used a microneedling device since November when I reviewed the Banisher 2.0.
  • No professional facials done, just stuck with topical products I purchased.
  • Using Differin almost every night since I got it end of November 2018.
  • Aczone was good up until the 4 month mark, then I switched to Finacea (AA). I noticed Aczone would dry out my skin and make it look darker and red.
  • Upped my chemical exfoliators to 2 times a week – still using Krave Beauty’s Kale-lalu-yAHA and Paula’s Choice Skin Perfecting 2% BHA Liquid.
  • Have been attempting to apply minimum SPF50 PA++++/PPD 16 up to 2mg/cm2 of sunscreen on exposed areas.

BEFORE / AFTERS

NOTE:

  • It’s really hard to match exact lighting and angle!
  • I also added the same photos with increased the shadows and highlights to emphasize the texture – even then it’s hard to truly depict what’s happening on my face
  • Ignore that cut on the bottom part of my face – I shaved and cut myself (yes I’ve been shaving my face! it’s quite magical)
  • TIMEFRAME: November 27, 2018 – July 13, 2019
michxmash-before-afters
Top: Befores, Bottom: Afters
michxmash-before-afters-2
Emphasized shadow and contrast. Top: befores, Bottom: Afters

ATROPHIC SCARS

In general, they look like the got smaller, and my face generally looks smoother. At first I thought I really wasn’t getting a good angle for the photos; but maybe, just maybe… they actually look that much better! My mom said my skin looks smoother every time she sees me, that has to count for something lol.

PIGMENTATION

I find a lot of the pigmentation I had lingering lightened up ever since I introduced AA and applied proper amounts of higher UVA protecting sunscreens to my routine, and a general boost in my skin’s health.

ACNE

I definitely don’t get as many breakouts since last year, and they are well under control. When I do experience a bad breakout, the connection is from eating too much processed food and drinking very sugary drinks. I find the actives I use in my routine however really help rid any active breakouts quickly, and I don’t find myself stressing over cystic spots as much as I used to.

OVERALL SKIN CONDITION

  • Clearer – acne is under control, pigmentation does not last for months
  • She is slow, but there have been some improvements with my atrophic scars
  • Feels fairly normal since we’re in summer, but still prone to dryness
  • I find my skin gets sensitive to products that I used prior without issue

And that’s it for my 2nd Skin Update! It’s by no means perfect, but I’m happy it’s getting better. Healing old scars as mine with topicals can only do so much, and I’ve accepted that, but at least there’s SOME improvement!

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ACTION PLAN

  • Continue with what I’m using, sticking with Differin
  • Use micro-needle again to boost the process
  • May look into the vampire facial, or other professional treatments to help speed the process for my atrophic scars. It’s so expensive doe ;_;
  • I like my skincare routine at the moment ko, so I’ll be sticking with what I’m currently doing and share it in good time!

It’s always nerve-wracking sharing my skin like this, but I really hope these updates help you out, especially if you’re going through the same skin struggles as I am!

xo, M

Skin Update [#1] December 2018: Acne + Scars

It has been ~6 months since I stopped dermarolling and started using OTC Differin 0.1% Adapalene. I have done quite a few things for my skin since then, and I thought I’d do a Skin Update if you were curious about my progress and my current approach to achieving healthy skin! As seen in the title and main image, these will be the main focus of this update.

Before we continue, please be sure you’re caught up with the following, that way you have a better understanding about my skin and my approach to this post!
I’m Finally Sharing my Current Skincare Routines 2018
My Morning (AM) Skincare Routine 2018
My Nighttime (PM) Skincare Routine 2018
REVIEW: Banish Acne Scars Banish Starter Kit

RECAP:
– Did 4 at-home dermarolling sessions with the Banish Kit. Stopped microneedling in general because I had no control over my acne breakouts. (March – April 2018)
– After microneedling, used OTC Differin for ~6 months. (May 2018)
– Sun not as strong, reintroduced chemical exfoliators back into my routine. BHA in the AM only on days when I workout, and AHA every other night. (September 2018)
– Tried Banisher 2.0 and did another 2 microneedling sessions. (Novermber 2018)
– Saw a dermatologist after 10 years of not seeing any skin professional; Got prescribed Aczone Gel 5% Dapsone + Differin 0.3% Adapalene to heal acne lesions and prevent breakouts. She was okay with my at-home microneedling. (November 2018)
– Created a more focused skincare routine in consideration of the new prescriptions. (Decmber 2018)
– Spoke with a Medical Esthetician about a PRP (Vampire) Facial. (December 2018)


Acne

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Differin 0.1% Adapalene for 6 months
After using OTC Differin 0.1% Adapalene for 6 months, here’s what I have noticed:
– Skin is subtly smoother, but not by a lot
– Quickly reduced pain caused by active acne
– Helped acne to quickly heal
– Red acne marks fade faster

Overall, OTC Differin was a great introduction into my skincare routine. Any skin professional will tell you Vitamin A is the most superior ingredient for improving acne and anti-aging, and this one is easily available for Americans (*shakes fists of jealousy*). However, after half a year of use, my skin plateaued. By that I mean it was working okay, but not great – not significant. Quite frankly, I really disliked how I was still breaking out into large, painful cysts. Definitely a sign to me that 0.1% was only doing so much.

Dermatologist Visit
My family doctor booked me an appointment to see a dermatologist about a few spots I noticed on my body (FYI: no skin cancer, yay!), so when I went in for the visit I also expressed concern about my persisting acne breakouts after YEARS of trying to get it under control (antibiotics, birth control, previous prescriptions, cleaned up diet).

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The derm prescribed me Aczone Gel 5% Dapsone to help heal current inflamed acne lesions (painful AF cysts) and non-inflamed acne lesions (blackheads and whiteheads), and upped the Differin to 0.3% Adapalene to better prevent blocked pores as well as treat inflamed skin. I’ve currently been using Aczone in the day and Differin at night (since Nov. 27th), and I, as well as family members and BF, have already seen a difference. Current inflamed acne lesions subsided a lot, and I find my skin way more even tone and smoother than usual *no placebo effect, plz*.


Scarring

I’ve hoped for years topicals could help me with my acne. I’ve been trying this for 5 years. Half a decade. And only recently I decided to incorporate Vitamin A into my routine and speak to a professional. I feel like a dummy, but at least I’m still in my 20s and I got over my fear of prescriptions (due to my poor routines years prior) and understand my skin concerns enough to address them with a professional.

As I previously mentioned, Differin 0.1% Adapalene made my skin appear subtly smoother, but frankly, there was no significant change. In attempts to take a Before/After photo (the Before photo being my last picture in my dermarolling post) I found it not only difficult to remember the exact lighting angle I used, but also my atrophic scarring didn’t look THAT different. On top of that, I am still breaking out so you can see red marks despite previous ones healing fast, as well as active acne *le sigh*.

I’ve seen Chemist @kindofstephen post a study on 0.3% Adapalene helping with acne scarring just before I got prescribed Differin 0.3% Adapalene; After reading the study, I am more enthusiastic about my higher prescription and the potential results.

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Reintroduced Acids
Before I saw the derm, I began using chemical exfoliants in my routine once the sun became less strong and we started moving into the fall. I’m currently using Paula’s Choice Skin Perfecting 2% BHA Liquid in the morning only on days I workout. In the PM I was using Krave Beauty’s Kale-lalu-yAHA, a 5.25% Glycolic Acid toner *, but now rotate it 1-3x a week due to prescription use. PC’s BHA Liquid makes my face lovely and smooth every time I use it, but AHAs seem to always be my bestie when it comes to scarring. I’ve been using KB’S toner for just under 2 months now and I already notice my face looking smoother. I think I’ll keep using the AHA all year round just because it’s probably the only topicals easily available that I notice makes a difference in my skin. Also I don’t think I’ve ever talked about this, but I got 2 free BHA Peels done by George Brown College Students in downtown Toronto last year (2017) because it was free.

At-Home Microneedling
If you read and watched my brand review on Dear, Klairs, I did mention that I started microneedling again. I had the opportunity to review Banish’s new Banisher 2.0 * and have done 2 microneedling sessions since receiving it. These were done before my derm visit, so now that I have new prescriptions to get used to I won’t be using the Banisher 2.0 for another month or so until I get a better understanding on what’s happening with my skin.

original vs. 2.0

Considering a Professional for Microneedling
I told the derm I’ve done 6 microneedling sessions total with 0.5mm titanium needles and she was okay with that. Actually, she said microneedling or Fraxal laser were my best options for getting rid of my scars completely since topicals can’t do it themselves *le sigh*. My boyfriend’s mom (Medical Esthetician) discussed the Vampire Facial (PRP) with me and suggested to have the facial done through her friend who is an RN. I’m planning to meet her soon for a consultation. I also asked my sister (who’s now in Seoul working) to scope out the prices for PRP. In the meantime, at least the at-home 0.5mm dermastamp will assist in the appearance!


My Current Skin Goals & Routine

After all I have just said and done, my skin goals have not changed much. Acne Control, Hydration, and Barrier Protection are still my top priorities for maintaining and achieving healthier skin! Instead of using so many products like my previous routines, I want to achieve these goals by attempting a more minimal approach *key word: attempting*.

I’ve also been watching way more skin professionals online, including dermatologists, so I have a better idea (and patience in general) on how to incorporate the prescriptions in a routine with products I like to use. I’m going to try my hardest to keep an efficient daily routine, and leave the fun stuff for bath time or lazy times. I’d say my approach is inspired Dr. Davin Lim’s Vitamin ABC’s, but it seems like my routines always had them!
Vitamin A – Differin 0.1% Adapalene to 0.3%.
Vitamin B – Niacinamide (B3) is da besttttt.
Vitamin C – Using a derivative at the moment, but will try to focus more on L-Ascorbic Acid with future products.

TBH, I’m having a hard time with the C. I currently am using Dermalogica’s Biolumin-C Serum * and in November I received the Banish Oil * when testing out the Banisher 2.0 *. I just find the effects I usually get from Vitamin C (even skin tone, brightening, glowing, reduced hyperpigmentation), are also coming from/being assisted by the other Vitamins, and I don’t know if there’s really a purpose for the C. Or maybe, they all just work best together, which is why I haven’t noticed anything individual! I’ve heard great things about Melano CC Essence and have ordered it from DokoDemo along with a couple of other items. I’ve also been curious about Drunk Elephant’s C-Firma, but we all know that shiz is esspenssive. Skincare peeps, what do you think?

Now that topical prescriptions have been introduced to my routine, I want to make sure what I use with it has effective ingredients and helps offset any dryness or irritation I may expect.  I will share my updated skincare routine once I have comfortable used all the products.


And that’s that for my skin update! I hope you found it informative, especially if we’re on the same healthy skin journey! Stay tuned for an updated skincare routine with Aczone and Differin!

xo, M