A few days ago, Google photos sent me a throwback picture of myself from over a year ago. It was a picture I took of my skin right after waking up, I still had my hair bonnet on, and I looked rough, to say the least.
But, I remember looking at that picture and going, “It’s working! This stuff is actually working!”
I was a few weeks into my new acne regimen, and it gave me so much hope for the skin issues I’d dealt with for over a decade.
One of the main reasons I started this blog was to share product reviews and parts of my skincare journey. I’ve been very hesitant to make posts about my acne, but I think it’s important that I share this to encourage anyone dealing with acne. I know the toll that it can take on your mental health and self-esteem.
After 11 years of spending lots of money on skincare products that didn’t do jack for my skin, I finally had enough and went to a dermatologist.
Disclaimer: I am not a healthcare professional, neither do I have formal training in skincare. While I can answer general questions based on my experience, I cannot decide what’s best for your skin. Please direct all concerns to a qualified healthcare professional and refer to your drug’s package insert.
THE DERMATOLOGIST VISIT
After examining my skin, the dermatologist said my acne was both a hormonal and bacterial issue. I also had a lot of congestion due to slow skin cell turnover. This slow turnover meant that dead skin, dirt, and bacteria were getting trapped because my skin wasn’t shedding fast enough. This was pretty much causing my acne and texture issues.
So, she prescribed Doxycycline Monohydrate (an antibiotic) and 0.1% Tretinoin (some people know this as Retin-A). These drugs are only available via prescription by a healthcare provider (in the U.S), but I think Tretinoin may be available over the counter in other countries.
The goal was for doxycycline to attack my acne from within and for Tretinoin to help with shedding the old, not-so-great skin.
Based on my dermatologist’s assessment, we created a plan to be on doxycycline for 3 months while simultaneously using Tretinoin. After 3 months, I’d stop doxy, and she would reassess my skin. Since Doxycycline is an antibiotic, it’s not recommended to take it for extended periods of time due to bacterial resistance. My derm also recommended that I use the Acne-Free Cleansing set while on this regimen.
Here’s a breakdown of my experience with the individual skin treatments:
DOXYCYCLINE (PILL)
Doxycycline is a broad-spectrum antibiotic currently used to treat various bacterial infections, including those that cause acne or rosacea.
For the most part, I had a good experience with this pill and didn’t have any of the side effects that some people experience. I attribute this to religiously following all the safety precautions and never doing anything I wasn’t supposed to do while on it.
Speaking of things I couldn’t do, here’s a laundry list of them:
- Couldn’t take my medicine within a few hours of eating dairy products
- Couldn’t hang out in the sun willy nilly
- Couldn’t lay down until an hour after taking my pill
- Couldn’t drink alcohol
- Couldn’t swallow the medicine dry, needed a full glass of water
I know this seems like a lot, but there are very logical reasons why you can’t do them:
- Dairy can interfere with your body’s ability to absorb doxycycline.
- Doxycycline can cause your skin to be sensitive to sunlight, in other words, you can burn more easily.
- Laying down can cause the pill to reflux back into your food pipe and irritate it.
- You should never drink alcohol on any type of antibiotic.
- If you’re one of the psychopaths who can take a pill without water, you’ve met your match. You have to take this pill with a full glass of water to prevent irritation of your food pipe.
For the most part, if you slip and do one of these, you won’t really be set back. I mostly struggled with dairy, as I took my pill around breakfast time, and my breakfast sometimes included dairy. So, I would wait for an extra hour before taking the pill.
Also important to note is that antibiotics like doxycycline can interfere with oral contraceptives. In other words, your birth control pill probably will not work at its max while on doxy. So make sure you’re either taking extra steps or are ready to have a baby. If you choose the latter, this drug can cause developmental issues for babies, so please talk to your doctor.
TRETINOIN (CREAM)
Tretinoin is a vitamin A derivative or retinoid. When applied to the skin, it can treat acne and other skin conditions. Some people may know this as Retin-A, Retin-X, or Renova. It works by speeding up skin cell turnover, meaning older, dead skin cells are cleared off faster, and newer cells rise to the surface. It also helps to regulate excessive oil production that often causes breakouts.
Now, this cream was a killer. When I say I’ve never been so dry in my life, I mean the Sahara had nothing on me.
When you get a prescription for this, your derm and pharmacist will warn you that it can cause dryness, so you need to be prepared for it. The only moisturizers I stuck to were the Cerave AM lotion & PM lotion, and the Neutrogena Hydroboost Gel Cream (read my review here). For sunscreen, I used the Neutrogena Hydroboost Sunscreen SPF 50 (read my review here).
While using Tretinoin, I also found that my sweat stung a lot! When I exercised or did any rigorous activities, my pores would literally burn. I typically relieved this by splashing some cold water or rubbing ice all over my face.
Tretinoin is quite tricky. Some people use it, don’t experience extreme dryness, and see results quickly, while others use it for months, go through many purging stages, and don’t see a change for a long while. I was one of the lucky ones, as my skin purge only lasted a few days, and I started seeing changes relatively quickly. If you start this treatment and feel discouraged, this thread on Reddit is very supportive, with many Redditors offering encouragement and advice.
If you’re new to the world of tretinoin, here are some helpful tips for first-timers:
- Do Not Apply Tret on Wet Skin. Applying on wet skin will cause it to be carried and absorbed into the skin too quickly. This will cause some serious irritation, especially if your skin isn’t used to tretinoin yet.
My routine was simply: Wash face, pat dry, wait at least 20 mins (yes, on uncomfortable dry skin) before applying Tret for the night.
- Sensitive skin or skin feeling “rawer” than usual? Apply a layer of moisturizer, then apply tret on top. This will act as somewhat of a buffer for your skin’s absorption of tretinoin. Better yet, just skip tret altogether until your skin feels better.
- In the beginning, stick to mild face washes and moisturizers. This means go for the fragrance-free, non-comedogenic stuff, as these often will not cause further irritation. As you progress, you can add others things.
My skin is pretty tolerant to harsh actives, so I started off simple, and by week 2, added a benzoyl peroxide face wash and cream (recommended by my derm).
Some of my personal recommendations that are simple and do the job are the Cetaphil Daily Facial Cleanser, and Fresh Soy Face Cleanser.
- Do Not Scrub! Do Not Physically Exfoliate! The tretinoin is already doing all that for you, so exfoliating even more will cause further irritation and leave your skin sensitive and exposed.
- Purging is normal and may make you look worse! Stick with it! There’s light at the end of this tunnel.
- Sunscreen is your best friend! Avoid the sun like the plague! But if you can’t, slather on sun protection.
This is not the time to go sunbathing on the beach or spend a whole day by the pool.
*Please remember to read the package insert that comes with your Tretinoin packaging.
Now, for what you’ve truly been waiting for, before and after pictures while on doxycycline and tretinoin. Be aware that I often took these photos right after waking up, so I still have my sleep bonnet on.
Also, in the spirit of full transparency, none of these photos have been retouched. This is 100% my skin’s true state. Keep scrolling to see the miracle!
I don’t know about you, but there’s a HUGE difference between days 1, 18 (purge), and 67. I mean, look at this side-by-side comparison again.
Before and After Tretinoin and Doxycycline
After day 67, I did a terrible job documenting my progress (without makeup). The only changes were a little more improvement in my skin’s texture, but by month 6, Tretinoin stopped having much of an effect on my skin. Since then I’ve switched to something else, which I will talk about in a different blog post.
I’ll be honest, I’ve had a lot of setbacks since then. I still get pimples, and some of my texture is back; however, I am 10000% sure that my acne would be nowhere near what it is today if I hadn’t used doxy and tretinoin.
I’m sharing this to encourage you. If you have acne and have been battling it for years, maybe it’s time to see a dermatologist. Many insurances may cover a portion of the visit and pay partially for the drugs but make sure you check with your insurance first.
Also, to keep costs low, ask your dermatologist if they can prescribe the generic version of whatever they decide to put you on. A generic version is a cheaper alternative to a “brand” name version of a drug or cream. It’ll still be as effective as the brand name.
I hope this encourages you that things can and will get better.
I’m rooting for everyone on this acne journey!
With love,
Meso