Monday, March 5, 2012

Dermatologic Treatment: My Experience and Tips

Remember how I asked whether you wanted to hear about my experience at a dermatologist? It seems that you were generally interested, and on top of that, I've been getting a lot of wonderful comments asking about my skincare and the foundation I'm using, so I've felt it's only appropriate to try and explain what's been going on with my skin recently. Fetch yourselves a cup of tea (non-caffeinated, of course!), it's going to be a long and rambly one.

I visited my dermatologist's office in mid-January, following more and more serious flare-ups of eczema on my hands (btw, I'm not going to mention the names of my doctor or the specific medications I was prescribed; but if you're local, shoot me an email and I'd be happy to recommend her practice). I was treated for the same problem before but my condition worsened a lot this year, so I was looking for some advice and also thought I could just ask about the acne on my face; at least I'd be able to hear another point of view. In this post, I'm going to discuss the treatment I was prescribed for acne, but if you still want to hear about how I'm dealing with eczema, I can write a separate post about that too :)

To give you more background information, my current doctor is the third dermatologist that has treated me for acne. When I was a teenager, my aunt who is a dermatologist prescribed me different things over the course of a couple years that generally did not work and that I wouldn't touch with a pole right now. Then as a student, I visited another doctor and that treatment didn't do a whole lot of good for me either: I was put on oral antibiotic (tetracycline) that didn't work and had a bunch of topical creams that left me red, peeling and with the same breakouts as before. At this point, I vowed never to go back to a dermatologist again and try to get a handle on my acne on my own; but to be honest, that wasn't working either. Ok, back to the story!

First of all, my dermatologist's office feels very inviting: all the front desk staff and nurses are friendly, knowledgeable and helpful, and the space has a nice vibe to it as well. The doctor herself is efficient, energetic and all her suggestions seem thought-out and reasonable. When I asked about the acne on my face, her first reaction was: 'Oh really, but your acne is so mild!'. She wasn't dismissing my problem, that was her honest evaluation; it made me really happy to hear that, because I had often felt in the past that I was exaggerating the problem in my head. Following that, she decided on putting me on a very low dose of a different oral antibiotic (minocycline) that she said could also help with my eczema. She also gave me two topical creams: a combination antibiotic (clindamycin) and tretinoin (form of vit. A, a retinoid) for the evening and an antibacterial cream containing dapsone for the morning. The nurse gave me little samples of all the medication to start me on the treatment right away, as well as an acne information sheet and a lot of coupons to take with me to the pharmacy.

In all honesty, boy I'm glad she gave me those coupons - I had no idea prescription medication could be so expensive! I have a pretty good insurance, but let's just say that if I didn't have neither the insurance nor the coupons, one of the topical creams would have cost me $500. What?! Even the pharmacist commented they gave me really expensive stuff.

I started using my medications right away and... I noticed IMMEDIATE results. I was trying not to expect much, but the effect was just miraculous! I stopped breaking out instantly and the breakouts I had started to heal very fast. The first two weeks, I used the gel with tretinoin every three nights, then every two nights, and then every night - I had very bad experiences with tretinoin before so I wanted to make sure I gave my skin some time to get used to it. This time, I only experienced very minimal peeling around my nose and on my chin, and that was it.

I'm over 6 weeks into the treatment and MY. SKIN. IS. CLEAR. I cannot believe it myself! I'm still dealing with hyperpigmentation and scarring, and as of right now, I have ONE small red bump on my chin that's disappearing already. The texture of my skin is a lot better too - I only have very few tiny bumps/clogged pores left and my pores are tighter/cleaner overall. I'm jumping for joy, ladies! I haven't had such good skin since I was 13 - I've had to deal with acne half of my life! I went in for a check-up 4 weeks into the treatment (more for eczema than acne, but obviously they still had a look at my face) and the doctor was very happy with the results too.

You might be thinking 'Yeah, Monika, I'm happy for you, but how does all of this help my skin?'. Well, here's a couple things I've learnt through my acne struggle and treatment that you may want to know if you're considering giving a dermatologic treatment a try.

1. The first treatment plan may not work. I've tried a fair share of prescription acne medication before having a lot of success with the current ones - so it might take time before you find medication that's effective for YOU. It's important to have a doctor who's willing to experiment and change the treatment according to your body's response. The cheat sheet I was given stated: 'There's a lot of different acne medications on the market so it might be a while before we try something that works for you but we will find it and your acne WILL get better! Don't give up hope!'. I think it's a very important message that none of my previous doctors thought of conveying to me. Practically, it means that after initial 12 weeks of treatment, you should go for a follow-up visit, and if your medication is not working, the doctor should suggest a new course of treatment.

2. If you're prescribed a retinoid, start small. The concentration of tretinoin in my medication is 0.025% - a miniscule amount! But it works, and it works without making my skin angry, red and flaky. Also, start by using it only couple times a week; remember to use a very small amount, just a dab whenever you need and spread evenly. I was also told to wait 10-15 minutes before the application and after I cleanse my face to avoid irritation and not to use the cream for about a week if I plan on having my brows waxed or a laser treatment, as it could simply rip the skin. Retinoids work as exfoliating agents, so make sure you're not overexfoliating, for example by using your Clarisonic/PMD/physical scrubs too often on top of the medication. If you're still peeling badly, ask the doctor about switching to a lower concentration.

3. Wear sunscreen! Both retinoids and oral antibiotics increase your skin's photosensitivity, so don't even think about going out without a layer of sun protection! Also, sun rays make hyperpigmentation marks even worse, so really, you'd be shooting yourself in the foot.

4. Hydrate your skin. Both antibiotics and retinoids can dehydrate your skin pretty badly - and mine was dehydrated to start with. Drink a lot of water, use hydrating skincare products, maybe even invest in an air humidifier; I'll be writing a separate post on how I combat dehydration, so stay tuned.

5. Supplement your diet. One of the drawbacks of oral antibiotics is that they often kill the good bacteria as well as the bad bacteria, so supplement with probiotics pills - or eat a lot of yoghurt, or even drink kombucha! Also, try to get into the habit of taking fish oil/ evening primrose oil capsules, as they help the skin from the inside a lot as well.

Pfff, I think that's it for now! I hope this post has been at least somewhat helpful - please leave your experiences and any questions you might have in the comments below, I'd love to know what you think!


  1. I'm so happy for you that you found something that works!

  2. thank you for your great post... it's so great that your trial and error has finally paid off :)

    So far I've been to two different dermatologist as well, and both times I ended up being worse off than I started with.... maybe third time is the charm :)

  3. I read this at work the other day but couldn't comment. But I'm so glad you posted it! I have an issue that I need to see a dermatologist about but the secondary thing I'll inquire about is persistent acne. (It's gotten a lot better with less picking, Clarisonic and AHA topical treatments but still.) My first dermatologist was a total b***h and it turned me off of derm visits for a long time. Your advice is perfectly timed. Thank you, Monika!

  4. I was wondering if you could tell me or maybe give me some clues as to what type of products you were prescribed.

    I visited my dermatologist today and was prescribed Aczone and Epiduo. Have you had any experience with either of those?

    Thank you!! Your skin looks amazzzzing!

    1. I'm using Aczone as well - I find it really good for calming down redness and inflammation in the blemishes, but in terms of actually preventing any spots, I really think the antibiotic pill is my savior. If you have any specific questions, feel free to shoot me an email!