A Journey with Retinoids.
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Wed Nov 28, 2012 9:10 am

Hello everyone.

I've often found helpful information in this forum and so wanted to join and get involved in some discussion. I'd really like to talk myself through this journey I'm on and maybe someone will get something useful out of it or have a question I can answer, or maybe not!

I'm a male and 26 years old. I don't suffer with Acne, however I do suffer with slight O.C.D. when it comes to skincare (as I'm sure most of you do), because of what I went through as a teenager. When I hit my teens I developed Milial Cysts on my face and behind my ears - horrible things, similar looking to whiteheads but buried deep in the skin, creating an unpleasant bumpy surface texture... I did suffer from mild Acne too, but only really as much as many other teens do when they hit puberty - it gradually went away not long after I left high school.

At 16 I decided a Dermatologist was needed for these cysts - I was quickly put on a course of Roaccutane followed by laser surgery. I experienced quite awful skin dehydration during the Roaccutane phase - I'd started college at the time and I remember someone asking if I was wearing lipstick because they were so dry and red! I was relieved once I'd taken my last pill and the side-effects began to ware off, although I was lucky that I didn't suffer any of the more scary side-effects I'd been warned about. So, on to laser surgery... To say it was painful would be an understatement - it involved injecting each cyst with local anaesthetic followed by laser removal. I'm sure I remember the Dermatologist counting 96 injections/lasers, and seeing the smoke come from burning my skin/the smell was like something out of a horror film! Anyway after a few weeks of recovery and terrifying the general public with black marks all over my face, I was really pleased that I healed well and it had all paid off...

Now ten years on at 26, I'm working towards a more common goal - restoring smooth skin texture. If I dared mention to family/friends that I'm not happy with the condition of my skin they would most likely tell me I'm crazy and there's nothing wrong with it... Of course, I know different! I suspect, or hope, that most of us here are very aware of what our skin looks like to others (e.g. in certain light, at certain distances, etc.) compared to what we actually see ourselves close up, in a mirror, under revealing light - It's something I'm forever conscious of. It doesn't really hinder my lifestyle in any way but it's always there. Like for example if my face is close to a friend's face in broad daylight, I can guarantee that somewhere in my mind I'll be thinking, "No no no, they can see my skin, noooo!" I acknowledge that my skin isn't terrible, I don't suffer Acne, and there are people with much bigger fights on their hands, but it's all relative.

Anyway I think the condition of my skin is probably as a result of tanning excessively when I was younger. I have a few enlarged pores I can't bare the sight of (one being a good old fashioned ice pick scar), and I do still get the odd whitehead under my skin which I struggle to remove... I've been aware of Retin-A and the effects of it for a long time, but knowing what the short-term effects were it was never practical for me to use it. I'm currently in a position where I have some time off, so can live with the short-term dry/peeling/red skin.

So 3 weeks ago I visited my G.P. asking for Retin-A gel. Unfortunately here in the U.K. It has now been discontinued for whatever reason - Isotrex gel is offered as an alternative. Isotrex contains the active ingredient Isotretinoin, which is found in Roaccutane funnily enough, although topically it has very different effects much more similar to Tretinoin... So I've been using Isotrex gel 0.05% for around 3 weeks, every evening before bed, along with my much loved/trusted Aesop Oil Free Hydrating Serum during the day (side-note; most efficient moisturiser I've ever used). I think I'm now passing the skin irritation phase as I've been getting the burning sensation less and less on application. Skin has generally been slightly red over the last couple of weeks and I'm experiencing very slight peeling, but nothing I can't handle with Aesop Serum during the day...

The only serious issue I've had is a bit of a miracle/disaster scenario. I've had what I can only describe as a cyst on my forehead for probably a few years now. It was never visible, but to rub my hand over my forehead I could feel it as a slight bump. The skin over it has always been slightly dryer than the surrounding skin too... I've tried my hardest to extract it for a long long time, never being successful. However last week after having used the Isotrex for two weeks now, I realised I was able to squeeze it. So of course I did. I became so amazed that I was finally extracting it that I just kept squeezing the life out of it - a major triumph. What did not occur to me was that in the process, I was also completely destroying the skin around it, being so sensitive from the Isotrex. Within around 30 minutes of me having extracted the last leg of the cyst - blood had risen to the surface of my skin and I was left with a horrendous big wound! It's almost healed now but my goodness, if you're using any topical retinoids at all, please do not squeeze your skin, at all! Saying that though, I do feel like the wound was worth defeating the evil cyst once and for all...

Aside from all this, during the 3 weeks I've been using the Isotrex gel 0.05% I couldn't help but think about Retin-A gel 0.1%. My skin is not usually sensitive, actually quite the opposite, and I am a sucker for always wanting something stronger... It's a strange almost masochistic (!) condition where if it stings and hurts, It feels good in the sense that I feel like it's doing something?! If no one relates to this then I will admit myself to a mental asylum ASAP...

Anyway, curiosity got the better of me so I went ahead and ordered a couple tubes of Shalaks A-Ret gel 0.1% from ADC. Got it in the mail the other day and immediately started using it instead of the Isotrex. Last night was my second night. It's got quite a lovely texture to it, warm and dewy, reminds me a little of Elizabeth Arden's famous Eight Hour Cream. Also to my surprise, the first night I applied it, there was no real burning sensation to my skin - it actually felt quite relieving compared to the Isotrex gel (I'm assuming because of an oil base as opposed to Isotrex's ethanol base). Last night on application there was definitely a little more of a burning sensation than the first night, so I suspect that it may get worse over the next week or so... I'm bracing myself and will soldier on.

My thoughts so far are regarding the Isotrex/A-Ret... I'm wondering if they are similar to the point that switching to the A-Ret suddenly is still continuing the work the Isotrex has done in the last 3 weeks, or are they different enough that the A-Ret is working differently and so I'm effectively starting from scratch again?

We shall see.

Any input appreciated/welcome.

free skin care · Wed Nov 28, 2012 3:34 pm

Hi there,

I certainly understand how you feel. most of us on here are always striving to improve our skin texture, firmness etc. I get compliments now and then about my skin, but let me tell you I see so many things I can fix...a bit OCD, but not to the point where it interferes with daily life either.

Heres a link which I talk about using isotrex and retina-a http://www.essentialdayspa.com/forum/viewthread.php?tid=47486

I'm not sure if the info will help you but its just my thoughts on it. I'm from Australia so we don't have retina-a here either. But we do have Stieva-A, howevever its a cream base. I'm not sure if its available to you or if you like the idea of a cream base, otherwise as you have done, to order overseas, many have done here too. I'm just a bit weary of ordering overseas, but thats just me. Very Happy

The only gel we can get here too would be the isotrex. The main reason I stuck with treinoin (steiva a) as opposed to isotrex (isotretinoin) is because there's more data to back up the first. My dr had told me isotrex was more for acne, but I have read they both work in a similar way but isotretinoin is a more synthetic version of tretinoin....well as my dr explained to me anyways. I didn't notice anything bad happen to my skin from switching, but like anything start slow, even though your skin is used to isotrex I still personally did that...just to be sure. Maybe even alternate till you run out of one.
Good luck Smile

Wed Nov 28, 2012 5:41 pm

Thanks for that link, some insightful info there... Funnily enough my G.P. also told me to apply the Isotrex twice a day! I can't imagine what state my skin would be in if I were applying it that frequently... Scary thought.

I'm with you on there being more data regarding tretinoin VS. isotretinoin... I think maybe that's what led me to end up ordering A-Ret despite already having Isotrex. There is simply so much more info/reviews/proven effectiveness that it made me question what my G.P. had given me... However the link you posted in the other thread has some interesting info regarding Isotrex being more effective... Hmm. It has me stumped!

Anyway I'm glad to have found someone else who made the switch from isotretinoin to tretinoin! So you didn't really notice effects of making the switch? The only difference I've noticed is that the lack of ethanol in the A-Ret has been quite a relief... I guess it begs the question of how effective the oil base is at absorption but I suppose it would be different for everyone...

free skin care · Wed Nov 28, 2012 5:53 pm

Yes I agree. The one thing that I like about using my StievaA is that I can layer my moisturisers or oils over it. At first I was doing it about an hour after, but now I'm actually mixing it with my moisturiser and I actually find my skin can tolerate it every night. I'm even staring to use my topical C about an hour prior to my retinoids. I cant believe that I can do this nightly now and my skin doesnt gt all flaky and peel.

Even though the retinoid is buffered a bit my skin likes it much better and I can use my other stuff. So you're right everyone reacts to things differently and its all about seeing what works for you.

I have no idea why these drs would recommend isotrex twice a day.If it works like a retinoid then it would make your skin so sensitive to light. Ugh!! Rolling Eyes

Thu Nov 29, 2012 12:25 am

I've used Retin A for wrinkles and it really helped me to get rid of them.

Thu Dec 06, 2012 11:59 pm

I want to use retino-A with hydroquinone to treat melasma, or deep pigmentation of my face. The area around my eyes look dark and its texture has become very rough.
Should I use these chemicals around my eyes too? Will that help? Or, will that make the area around my eyes even worse? please advise.

free skin care · Fri Dec 07, 2012 12:26 pm

tarrysimpsom wrote:

I've used Retin A for wrinkles and it really helped me to get rid of them.

Yes, mine too. Melasma is fading and Retin A has also helped to shrink the pores on my nose. I use it every second night. I find that the area around my mouth/side of nose can get flaky sometimes, but if this happens I apply vitamin e oil for an hour or so in the morning and the flakiness goes away - happens mainly in the wintertime.

Fri Dec 07, 2012 2:52 pm

I've been using Isotrex for about 6 weeks now. I really don't think 3 is long enough a period to assess whether you should move to something else or not, but that's just my opinion! I've only just started using it every second night after having a disaster using it every night for the first week, taking one off, and then applying it every third night for 3 weeks or so. If i hadn't tried everything else before, and not thoroughly read up about retinoids etc, i may have given up by now. It's made a difference to my skin, but my problem was acne and stubborn closed comedones. I am weary of the ethanol content, but you need to use so little of the gel that the irritation and side effects are almost nil. Regarding its effectiveness, i'm crossing my fingers that as the weeks go on the improvements will become more noticeable and apparent. I'm still getting the odd little breakout, but only in areas where i've had resurgent acne over the past few months and i'm hoping this is essentially purging it completely. The breakouts don't seem to last long either.

Unlike you i don't like it when my skin stings and hurts! I don't see that as a good sign at all. If i get any stinging while using the retinoid i usually hold off for an extra night.

I think i will update my Isotrex thread in a few weeks in case it helps anyone else that finds their way here from using the gel.

Sun Dec 09, 2012 5:38 am

lindsay123 wrote:

I've been using Isotrex for about 6 weeks now. I really don't think 3 is long enough a period to assess whether you should move to something else or not, but that's just my opinion! I've only just started using it every second night after having a disaster using it every night for the first week, taking one off, and then applying it every third night for 3 weeks or so. If i hadn't tried everything else before, and not thoroughly read up about retinoids etc, i may have given up by now. It's made a difference to my skin, but my problem was acne and stubborn closed comedones. I am weary of the ethanol content, but you need to use so little of the gel that the irritation and side effects are almost nil. Regarding its effectiveness, i'm crossing my fingers that as the weeks go on the improvements will become more noticeable and apparent. I'm still getting the odd little breakout, but only in areas where i've had resurgent acne over the past few months and i'm hoping this is essentially purging it completely. The breakouts don't seem to last long either.

Unlike you i don't like it when my skin stings and hurts! I don't see that as a good sign at all. If i get any stinging while using the retinoid i usually hold off for an extra night.

I think i will update my Isotrex thread in a few weeks in case it helps anyone else that finds their way here from using the gel.

Lindsay, you're absolutely right - 3 weeks is not at all enough time to make an assessment and jump ship. I think it was just a case of me already having had my heart set on Retin-A gel, only to discover it had just been discontinued... I don't doubt Isotrex's effectiveness and I'm sure if I'd stuck with it I wouldn't have regretted it. In the 3 weeks I used it I also didn't experience any harsh redness or flaking - only slightly, enough that my moisturiser could keep at bay, and of course the slight burning sensation on application...

As an update to using the Retin-A, in my first post I was up to two nights of using it and feeling good about the switch... The day after my third night however (last Thursday), things took quite a turn!!! My face gradually became more and more red, raw and sore as the day went on. To make matters more eventful I was out at a party that night (caked in concealer which made me feel even more uncomfortable!), and consumed a lot of alcohol. It was something I was concerned about because of dehydration potentially making my skin worse, and by Friday, along with a hangover, I resembled a burn victim... I'd clearly gone overboard applying it and my face was in pain - went to my local Pharmacy and they told me I'd given my self what was essentially a strong chemical peel!!! So I was advised to lay off the Retin-A for a couple days and use Aqueous cream to calm the skin down.

Aqueous cream by the way, is a lifesaver. It can be used as a cleanser when mixed with water, and heavily moisturises the skin when applied dry. It brought my face back to life within a couple days and by the beginning of this week I was ready to get back on the Retin-A gel... My skin definitely seems to be adjusting/tolerating it more as that red, sore, rawness has become gradually less throughout the week, so I'm glad I decided to stick with it... Peeling seems to be occurring more now - I'm really hoping my moisturiser will be able to handle it whenever I'm in social situations, as it's oil-free...

In hindsight I think if I'd started off using it every other night instead of every night, this process probably would have been a lot less hassle. It's only the fact that I'm away from work for a little while that I've been able to tolerate looking temporarily like a monster... I also probably shouldn't have been applying as much as I was - I'm gradually reigning it in now as I'm learning only a very small amount will still be effective. You really don't need to lather it on!

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