Purging or skin barrier problems?
I'm late 30s, been dealing with hormonal acne issues off and on since around 2019. Never had acne problems as a teenager. It all started in my 30s and got the worst around mid-2020 and 2021. I tried BP for several years and it cleared my skin but then I started getting hyperpigmentation issues. Finally went to a dermatologist last year and she prescribed me Tret in September. Told me to sandwich it, start out 2 days a week, then 3, every 2-3 days, then eventually daily. She told me not to worry about adding any other products, that Tret and moisturizer was all I would need.
I took a long time to adjust to it and build up to daily use. I only in the past couple months started working up to using it daily, because my skin would purge and break out like crazy and make me even more self conscious and embarrassed with the white pustules. In the last month, I finally started seeing consistently clearer skin! But then my face would look really, really dry and peeling. So I started to skip Tret altogether 1-2 days before restarting to let my skin breathe.
Well, this week turned into a nightmare. I skipped Tret on Sunday and Monday due to the peeling. I had clear skin on Monday. Restarted daily Tret on Tuesday. Woke up to a ton of white heads Thursday, and then today on Friday...my entire face was nothing but white pustules this morning. Forehead, temples, cheeks. I have some breakouts on my neck, but nothing on my nose and barely anything on my chin. But it's tiny white bump after tiny white bump EVERYWHERE else on my face. The worst its EVER been. I'm so embarrassed and self conscious that I'm covering my face at work with a hat and a mask.
My question: is this still considered "purging"? Or is my skin barrier probably all messed up? I use a pea-sized amount but now I'm wondering if maybe I need to use less? It's so frustrating to go from almost perfect skin and seeing it clear and my hyperpigmentation fading to...this. Feels like a huge step backward for me.
Usual daily routine....
Morning: Rinse face with water. Toner. Moisturize. SPF. BB Cream occasionally. No makeup.
Night: Double cleanse. Toner. Moisturizer. Wait 30 mins. Tret.
Help? lol