So I just though I'd post this to maybe encourage others trying out tretinoin cream.

I started tretinoin cream in August. At that point, I had been on spironolactone 100mg a day and I was routinely getting facials. I had moderate-severe comedonal acne all over my cheeks and mild comedone acne around my mouth and chin. My derm wanted to put me on accutane but since I didn't have any health insurance, it wasn't an option. The facials weren't really helping with my skin, so I broke down and agreed to try tretinoin cream per my derm's suggestion (and much to the dismay of my esthetician...).

Okay, so I started the tretinoin in August. At the same time, I was starting back to school... a 28 year old as an undergraduate engineering student, it was fairly hectic (still is!) to say the least. So anyhow, about 3 weeks in I started breaking out. Then I broke out some more. And... then some more. I had REALLY big red pimples all over my cheeks and it was pretty awful. I was super self conscious. It didn't help being around 19 year olds with better skin than me. And oh god, the peeling was awful. Some days I'd go to the bathroom and realize I looked like I had leprosy. It was pretty awful.

I came on here once or twice and read about tretinoin cream, and a lot of people were encouraging others to stick with it, that it took time. So I thought "Okay, I'll do that." -- I'm glad I did! I've been using tretinoin cream for 4.5 months now, and while I still have comedonal acne, it is SOOO much better. I am not having the terrible breakouts anymore, so that was obviously a purging incident, as it took place largely on my left cheek which is where I really struggle with the comedones. My right cheek is pretty much devoid of acne at this point. It feels so smooth, and it's such a wonderful feeling. Prior to this every time I washed my face it felt like I had pebbles under my skin. I hated that feeling.

My left cheek still has some comedones, but I would say 60% of them are gone and I expect it to improve as I'm still having some minor breakouts in an area where I had some really deep under the skin comedones (I had REALLY bad, stubborn comedonal acne).

I don't have flaking anymore. I use the tretinoin once a day at night, and usually 2x a week I will switch the tretinoin cream out with Aquaphor and let it moisturize overnight. I use Cetaphil to wash my face morning and night, and Cerave moisturizer in the morning.

Anyhow... that's my story. I encourage others who are having a hard time with tretinoin cream at first to just stick to it. Give it at least 3 months; that was about when I started seeing a change in my skin.

Good luck everyone!