When speaking about acne treatments you can’t forget the royal family of it, I mean the retinoids. All retinoids are derived from vitamin A; however, there are different types, amongst which the most common ones are retinol, tretinoin, adapalene for topical use and isotretinoin orally.
Acne is something of a family thing in my case, on both sides someone has a persistent problem with it, and we have oily T-zones. So it was no surprise for anyone when my acne started to appear. I first got acne when I was about 12 or 13 years old, pretty early to be honest. However, it was pretty easy to manage. As it was mainly bacterial a couple of trips to a dermatologist, and some topical antibiotics resolved the issue. After that, I used Skinoren for maintenance, and I was pretty okay, I still had oily skin and a sport there and here. Not a big deal. However, my acne got worse when I was in my final year of secondary school, around the time of my finals. I suspect it was due to the high amount of stress revolving around finishing secondary school, and after all most people supposedly have to go through acne until the age of 25. Of course, it was saddening who wants to wake up with a face full of spots.
I’d tried to deal with the problem by myself for about half a year, but I did not want to pass my university years with acne. I decided to go to a dermatologist and ask for retinoids. I knew Skinoren, and antibiotic creams wouldn’t fix the problem this time. I was pretty determined to get rid of the problem, so I asked for tretinoin. My doctor wasn’t too sure about tretinoin at first, and instead, she offered me Differin (it has adapalene as the active ingredient), which actually helped to a certain degree. My acne subsidised and the difference was noticeable. However, it wasn’t what I had expected. I was still getting a lot of spots, I had quite oily skin, and my pores were getting clogged pretty easily. After using Differin for about six months (on a nightly basis), I asked again for tretinoin, which the doctor prescribed to me at the end. Tretinoin took much shorter to show results, though I used it for a more extended period. Unfortunately, it’s available on prescription only. I am not surprised it’s a real-deal medicine. It is harsh and might be discouraging at first, the purge was much stronger (compared to Differin), and persistent dryness was simply annoying. It was worth it, though.
Some advice, which may sound cliche, but it’s very much true. A small amount goes a long way, for all retinoids, a pea-sized amount is all you need. Don’t overdo it; you will just unnecessarily irritate your skin. Bare through the first month and purge, it’s going to last for a while, but it’s worth it. Limit your skincare, don’t use too many products at once and aim for products with as few irritants as possible, I mean fragrance, essential oils, dyes, etc. You can use products with alcohol (solvent alcohol). I didn’t have much problem using sunscreens with alcohol, but they stung a bit. Lastly, be consistent once you commit to a retinoid stick to it for at least three months to see results. I would say give it six, and then judge if you want to continue or not.
As I have said, Differin is available over the counter in the US. I am sure that, if you don’t have access to a dermatologist, your GP will prescribe you Differin if s/he finds it necessary. I would say it’s definitely worth to try Differin. Probably if I’d kept using it longer, it wouldn’t have helped more. However, I was desperate for quick results, and I’d wanted to get rid of acne as soon as possible. Although I am done with my retinoid treatment, I still get spots, but it’s something about my genetics. I’ve embraced it, and I know I cannot change it. I encourage you to do the same, look around your family, and see if your skin is also likely to be oily and acne-prone naturally. You can’t change your genes, but you can help your face when needed. A spot here and there once in a while is normal, especially after eating something that triggers new breakouts, like sugar in my case. There’s nothing wrong with oily skin either, just embrace it and enjoy fewer wrinkles when you’re older.
While speaking about retinoids, I think I need to raise my concerns in regards to isotretinoin which is taken orally, a brand name known as Roaccutane (there are also several others). I know that many people see great results with it. However, it does not guarantee that you won’t see a relapse. It’s a powerful medicine which affects your entire body; unfortunately, in a negative way for your internal organs. It basically dries everything out. Not to mention other side effects. Sometimes when I see what kind of acne patients are prescribed isotretinoin, I am shocked because they in no way qualify for it. I don’t know if there’s money involved in doctors’ pockets or not, but I once fell a victim of a dermatologist in my teens. The doctor hadn’t told much information to my parents or me and hadn’t done any test before prescribing it to me. I used it for a month until I bumped into a different doctor who explained to me what the medicine really was. It wasn’t a planned visit; I just had a bad reaction to Roaccutane.
I highly encourage you to exhaust all of the other possible options before going for isotretinoin. I mean lifestyle, diet and routine changes. Diet and lifestyle have an immense impact on your health, and when it comes to acne, I won’t tell you to cut certain foods out. Contrarily, enjoy cheese and have a can of coke or a piece of cake once in a while, but don’t drink a can of coke and have a cake each day and don’t put cheese on everything you eat. Be moderate and eat a balanced diet that’s all. You may also want to consider supplements, zinc and omegas (I prefer borage and evening primrose oils), which might be helpful.
Try different tropicals such as salicylic acid, azelaic acid, tretinoin or adapalene, or benzoyl peroxide. Also, other ones if your doctor considers them suitable. There are so many options on the market right now, that isotretinoin should really be treated as the last resort, not as a second or third visit solution for doctors. If your acne seems pretty mild where you get regularly sized spots on your face, and maybe a few on your body, and the doctor pushes too much for you to get isotretinoin, then there’s something fishy. Be aware of that. I understand that some people need isotretinoin because of the severity of acne, but it is not a big percentage of all acne cases, honestly. I also understand that people want to get rid of acne as soon as possible, but isotretinoin is not worth it.
Ingredients: 0.1% w/w of adapalene and the other ingredients are carbomer 940, propylene glycol (E1520), poloxamer 182, disodium edetate, methylparahydroxybenzoate (E218), phenoxyethanol, sodium hydroxide and purified water. (medicines.org.uk)
You can get Differin from the US from Amazon.com for about €10, plus delivery costs, however, I am sure your GP would prescribe it to you if you can’t see a specialist.
A small clarification: I do not encourage buying prescribed medicine from unknown online sources or elsewhere. Get your medicine from a doctor. However, as in the case of azelaic acid or adapalene, they are not necessarily the strongest, and you can get them over the counter in certain regions, which, I think, makes them safe for people from other parts of the world to use as well.
PS. I’ve never used retinoids like retinol found in regular products, which you can get everywhere without a prescription so I can’t comment on those. However, there are a few OTC retinoid-based products for acne treatment, which you may want to look into.
Update 09/01/2019: Happy news people. Now we can get adapalene on Amazon Italy and
Amazon Germany. It’s not Differin, but Proactiv’s adapalene serum. It should work the same as Differin, so if you aren’t able to see a specialist, it’s a good way to get your hands on prescription strength retinoid. Adapalene is not approved to be used in OTC medicine in Europe, so it shouldn’t really be sold by Amazon, but they push their American stocks through. Better for us, really.