Retinoid update: how I got rid of my acne discoloration

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Alright ladies & gents, let’s talk skincare here for a little bit. Waaaaay back in the day before it ever even occurred to me to have a blog, I made a post on reddit about post-inflammatory hyperpigmentation (AKA dark spots or flat acne scars) & how to treat it because at the time it was the bane of my existence. The process of writing that up was actually one of the things that inspired me to start a blog in the first place, so I ended up posting it right here too. Surprisingly enough it actually still gets a fair bit of traffic, and a couple weeks ago a reader asked for an update on my progress with retinoids. Ask and you shall receive!

That particular post was over 3 years ago (geez oh man, it doesn’t feel like it’s been that long!) so here’s some backstory for newcomers: back in the day I had major problem skin. And I don’t mean ‘oh no, two zits before my wedding’ problem (though that did happen). I mean huge, hurts-to-move-my-face, requires-cortisone-injections cysts. After a change in birth control plus basically every acne treatment known to western medicine it’s finally cleared up, but the aftermath included some surprisingly minor pitted scarring and a lot of dark spots. The pitted scars are still a thing – maybe I’ll get around to getting them lasered eventually – but as far as discoloration I’m really happy with the progress on that.

But first – great news if you have acne/PIH

Up until recently most retinoids required a prescription in the US, meaning you had to not only pay for the medication itself but also a doctor’s visit/office copay. Tretinoin/Retin-A is still prescription-only, but adapalene/Differin (another type of retinoid) was pretty recently approved for over the counter use. Yay! You can pick it up for $30 or so at Target or Walgreens.

My routine

I really should have kept better track of everything I used, and when. After I finished up my course of accutane and got my doc’s approval I used the 40% lactic acid peels from Makeup Artist’s Choice a few times about a month apart, but other than that generic tretinoin cream has been the real hero in my war against PIH. I switch up my skincare products pretty often (what kind of beauty blogger would I be if I didn’t experiment?) but I do keep with some general categories with my daily routine and I’ve added some of my favorite products for each.

Morning:

• Water rinse with a microfiber cloth
• Hyaluronic acid serum (Nip + Fab Dragon’s Blood Hyluronic Shot)
• Light moisturizer (Paula’s Choice Skin Balancing Moisture Gel)
• Sunscreen (Elta MD UV Clear SPF 46 – also has niacinamide to help fade dark spots)

Night:

• Micellar water to remove makeup (Bioderm Sensibio, Sephora Collection Cleansing Water)
• Gentle cleanser (Paula’s Choice Resist Cleanser)
• Retinoid product, followed by ~15min wait (generic tretinoin, Differin would work here as well)
• Rich moisturizer (Eucerin Calming Creme, Elemis Pro-Collagen Oxygenating Night Cream)

That’s it! Well, other than the occasional sheet mask or random stuff I happen to be trialing. As a side note, I like the generic tretinoin cream much better than brand name Retin-A Micro – the gel base in Retin-A seems to dry my skin out a lot more and of course the generic is a lot cheaper.

Progress pics

After all, this is what you really clicked the link for, right? But I just want to stress again that this stuff takes time. It’s been just under three years since I got my skin cleared up enough to really work on the discoloration, and it took a solid year before I really was like “hell yeah, my skin looks awesome!” When you see your own face in the mirror multiple times a day, it can be hard to notice the improvement as it’s happening. Word of advice: take progress pictures. Even if the first few hurt your soul, you’ll thank yourself later. These days when I’m being way too critical about my skin – the tiny menstrual breakout, a hint of a wrinkle I hadn’t noticed before – I just go back to some old photos and think about how infinitely better it is now. It’s also a great way to monitor whether your skincare products are helping.

March 2014 – Right after I finished taking accutane & got the ok to start using topical retinoids again. No new breakouts, but still a lot of dark marks and redness.

January 2015 – A peek at what the other side looked like after almost a year.

September 2015 – After about a year and a half of using tretinoin pretty consistently.

January 2017 – I haven’t been quite as consistent with the tretinoin over the last year or so, but mostly all that’s left are the shadowy areas from pitted scarring and a little leftover redness from the odd hormonal spot. Still not a doll-like porcelain complexion but I never had that in the first place!

Needless to say, I’m absolutely thrilled that science didn’t fail me on this one! There were a lot of times that I thought nothing was happening, but this is one case where patience paid off. If you’re looking for something that works about faster, Silverkis’ World has a great post on her experience with laser treatment.

Have you come across any absolute must-haves for acne & scarring?

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