u/Aromatic_Draft_1311

Beeb 4 years on tret, still dealing with cystic acne, hormonal shift made it worse.

I use tret every night (maybe this is part of the probem

??)

Want to try azelaic acid and sulfur before jumping to spironolactone. Looking for experiences similar to mind/ other reccs )

I4 years ago with tret, started at 0.025% and worked my way up to 1%, where I’ve been for the majority of the time. I added clindamycin/benzoyl peroxide somewhere around the 2 to 3 year mark.

Tret has for sure improved for my overall skin texture and definitely speeds up the healing process for cystic acne and scarring, but the cystic acne itself and sometimes other acne never fully went away like I see so many people report. It’s still happening. Texture also could be better.

About 4 months ago things got significantly worse. I suspect a hormonal shift due to some medication changes (non derm). My derm is recommending spironolactone for the hormonal component, which makes sense in theory. And I am open to it !

Here’s the thing: my body is really sensitive to medications, so before I jump to spiro I want to make sure I’m not missing something in my routine first. I’d rather know what’s doing what before adding a systemic medication into the mix. I’m especially curious about trying azelaic acid, sulfur, or potentially both together. I see them hyped constantly here for texture and acne improvement and I haven’t explored either yet.

I also deal with contact dermatitis and some dryness around my period, not every cycle, so I’m cautious about adding anything too irritating.

Current routine:

AM: La Roche-Posay gentle cleanser, clindamycin/benzoyl peroxide, vitamin C (CEO Riley) , EltaMD tinted sunscreen.

PM: La Roche-Posay gentle cleanser, tretinoin 1%, CeraVe moisturizer, La Roche-Posay Cicaplast on dry patches as needed.

Questions:

1. Has azelaic acid, sulfur, or both together made a real difference for persistent hormonal/cystic acne on top of tret and cindomyecin

2. Is there anything else you’d try before going to spiro, especially if you’re medication sensitive?

3. Where would you slot AA and/or sulfur into a routine like mine without overloading it?

4. At what point did you decide topicals weren’t enough and spiro was necessary?

Hi I am getting my eyebrows threaded for the first time in an hour anyone with sensitive / acne prone skin figure out a way to manage reactions?

I am going to take two Pepcid two Allegra (for histamine / autoimmune purposes ) something I typically take daily

Has anyone used cindomyecin / benzoyl peroxide immediately after?

Or is it best to just cleanse and moisturize after?

My derm said it’s fine to continue skin care as usual however I want to be extra careful and hear from others who are acne prone