Differin help
July 31, 2012 9:15 PM   Subscribe

Acne-filter: I finally went to a dermatologist, who prescribed Differin for my adult acne. A few questions inside.

I've been using the Differin for one week now. (I'm on the 0.1% gel.) I know it's not supposed to work right away. I may be getting a slight initial breakout, but nothing too bad so far. I am only using a very small amount - less than a pea size for my entire face, once a day at night.

I am starting to get very dry skin. My face is starting to peel a bit, even with moisturizer. For those of you who have used Differin, I have a few questions:

- Was it successful for you? If so, how long did it take to work?

- Does the dry skin improve over time? I normally have oily skin. Does your skin get used to the medication so that it is less drying?

- Any tips for dealing with the dry skin? So far I'm just using my Clinique moisturizer, which helps a bit but not totally. Do you normally use a separate sunscreen, or a moisturizer & sunscreen combo? Any particular brands you would recommend?

[Relevant info about me: 34 year old woman, not on birth control (and not planning on it - I took bcp for about a decade, and no matter which brand I was on it never helped my acne). I have had acne since my teens, but it has gotten worse over the years. Usually just small pimples, but occasionally I get a cystic one that lasts forever and leaves a scar.]
posted by anonymous to Health & Fitness (10 answers total) 3 users marked this as a favorite
Differin was never good for me. I always used plain, old Retin A. But I did use Differin for a while and the dryness is usual, it does go away after about 2-3 weeks (same with Retin A), you can't do much about it, and I would use a separate sunscreen. Differin makes your skin VERY sensitive to the sun. I would use something like Peter Thomas Roth, or Alba if you have access to it. I like Alba. Aveda makes a good one, as does Tropic Sands.

Treat your skin very, very delicately now. The Differin does make it fragile. Some facial waxers will not work on you if they know you are using Differin/Retin A, for instance. So no scrubbing with a washcloth or mechanical brush, hard, gritty scrubs, etc. What Clinique are you using? The old yellow? Maybe move up to something a little more emollient. And use a creamy wash. Nothing $$$, but something a little more emollient there, as well.
posted by oflinkey at 9:36 PM on July 31, 2012 [1 favorite]

Differin did not work for me much. It didn't dry me out in most places - however it did dry out my eyes quite horribly, and my doctor prescribed an antiinflammatory cream for that.

If Differin is working for you now, that's great! No need to worry about isoretinoids. I had to go on isoretinoids and they dried out my skin like nothing else (well worth it, though).

These are the changes I made to my skin care routine when my skin got very dry (as opposed to being very oily):

- sensitive skin apricot scrub every day (I would only recommend this if you're skin has been dried to the point of flaking. if I go a day without scrubbing I can pretty much pull off an imprint of my face, which is gross)

- change soaps. I'm using cetaphil now, which is nice

- here's the big difference, though: double moisturizing. I started using Garnier moisture rescue. It feels so good going on! Usually, though, after that's sat on my skin for a few minutes (while I'm putting in my contacts or whatever) I will put on the moisturize I used to use (Biore dual action or something). (At night I use a Garnier creamy night moisturizer.)

I've been doing this for a few months and I suppose it has balanced out. Sometimes I forget to moisturize during the day. Lately I don't bother with the second moisturizer unless I'm going out a lot (the moisture rescue has no SPF). The only thing that really becomes a problem is when I don't exfoliate daily (but again, if you aren't peeling, you could probably skip that).

Also, do you go for facials? I found my aesthetician was very helpful with advice (she doesn't just try to push products on me, she actually helps establish a routine with whatever products I have access to, and she's always been great). Even if you don't normally get facials, perhaps you could treat yourself and see what the aesth. says.
posted by Lt. Bunny Wigglesworth at 12:09 AM on August 1, 2012

When I went on Differin I had two weeks of painfully dry red flaking skin. After that it was fine. Six months later I was able to stop all the treatments completely and now a few years later my skin is still nice and clear.

Be patient. It's worth it. Treat your skin nicely, avoid moisturizers with salicylic acid or harsh exfolients, and use gentle soap. It will suck for a bit. But it's worth it.
posted by olinerd at 12:17 AM on August 1, 2012

Any acne treatment can take up to two months to make a difference. After two months, if you see no improvement, it's not working for you. The exception to that is BCP, which (and no-one will tell you this) can take up to nine months to work.

Any topical treatment you use has to be left on untouched for at least 30 minutes, to give it a chance to bind to your skin. This is another thing that no-one will tell you.

I think you should use it as directed by your doctor, but, since I had a free hand in how I used mine - I used it one night a week for a month, every sixth night for the next month, every fifth night the month after that, and so on until I now use it every night or every other night.

I always moisturize after washing and before applying the Differin, leaving the moisturizer on for 15 minutes. I use Cetaphil Daily Advance Ultra Hydrating Lotion as it makes the difference between looking like a crabapple and looking like a baby's bottom.

I personally think Differin does very little or nothing for my acne - but I have my prescription and I ain't gonna waste it; I use it for anti-aging purposes. My go-to topical acne treatment is 2.5% benzoyl peroxide.
posted by tel3path at 2:51 AM on August 1, 2012 [1 favorite]

Mixing a few drops of organic jojoba oil in with your moisturizer is good for dryness. If you're flaking, jojoba oil also makes an amazing gentle exfoliator--before cleansing, put a fair amount in your palms (maybe 15 drops?) and gently rub it into your face for a minute or two. Wet your hands and keep gently massaging your face. You'll feel all the flakes coming off in your hands. Then just wash your face as usual. Do this a couple times a week (although I do it every day because I use it as a makeup remover).
posted by désoeuvrée at 3:26 AM on August 1, 2012

I'm on Differin (the 0.1%), and it took around two months to work properly. It reduced my acne to start with, but started being much more effective from month three onwards. I have oily skin too, and I never used to need to moisturize much.

When I started using Differin my skin got really dry, and I had a lot of peeling, flaking and general roughness. My skin seemed to get used to the Differin after that two month mark. I really switched up my skincare routine, so it could be that its just that my new routine takes care of the dryness and the flaking.

A gentle cleanser kept my skin from drying out more- I use Philosophy's Purity, but I've heard Cetaphil is as good or better.

Exfoliation -
Exfoliating properly fought the flakes and made my moisturizer absorb better.
I use the Dermalogica Microfoliant, but any exfoliator is good. The thing that made the most difference in fixing the dryness was getting first the Olay Pro-X face brush, and later the Clarisonic Mia. I like the Mia more, but the Olay brush is also good. Applying moisturizer after using one of these helps it penetrate deeper, at least on my skin, and both work to get rid of flakes when combined with gentle cleansers.

Using a tinted bb cream really made life easier in the mornings. The one I use (Too faced Beauty Balm) moisturizes,has sunscreen, and evens out my complexion. In the evening, a heavy serum (Shiseido White Lucent) makes a perfect night moisturizer.
posted by MFZ at 3:38 AM on August 1, 2012 [1 favorite]

I also had drying with Differin that did eventually improve, especially compared to the salicylic acid that I had been using before. But, just to check, are you using a gentle skin cleanser like Cetaphil along with the Differin? I LOVE Cetaphil. It's gentle and I feel like it gets my skin clean so that the prescription cream can do its thing.

If you are using a Clearasil or Neutrogena facewash with saliciylic acid in it, it could be overly drying with your medication on top of it.

Best wishes to you!

(And just in case you find in a couple months that Differin isn't working for you, I love Finacea! Had a bad initial breakout about a month in from the medication bringing acne to the surface and treating it, but now have better skin than I have had in years.)
posted by shortyJBot at 4:44 AM on August 1, 2012 [1 favorite]

I used Differin for a few months in combination with some other medication which I've forgotten the name of, but it was applied to my face with a roll-on type applicator. I think I used both for a few months, and the dryness was unbearable (I was living in a desert climate at the time, though, and my skin was already really dry). A comment upthread reminded me of how dry it got around my eyes, it was horrible. I figured my mild-to-moderate acne looked better than bright red dry scaly patches and stopped using both medications. (I had been using Cetaphil cleanser and Cetaphil cream moisturizer, and not even the cream could counteract the effects of the meds.) I've since been following the general advice from acne.org about making sure you're moisturizing all the time, and my face is decent these days.
posted by jabes at 7:03 AM on August 1, 2012

What do you use to wash your face? Does it have benzoyl peroxide or salicylic acid in it? I found that when my face would get really dry (not using Differin, but other topical treatments and was specifically told to wash with benzoyl peroxide wash), I'd only wash once a day or once every other day with it and that helped. I'd wash with Cetaphil on the off days. Switching to a lower concentration of benzoyl peroxide helped too. If you are washing with hot water, try cool-lukewarm water. I think that's supposed to be better for not drying out your skin.
posted by radioaction at 7:10 AM on August 1, 2012

I was on Differen for about 6 months and never got past the dry, flaky (and bright red) skin. I switched to the 2.5% benzoyl peroxide regimen described at acne.org and had much better results (less dryness and healthier-looking skin tone). I have been following the regimen more or less strictly for about 10 years.

But I continued to get breakouts of cystic acne in the winter with both Differen and benzoyl peroxide until (at the advice of a barber!) I cut out dairy from my diet. When I occasionally slip and eat pizza (it's almost always pizza), the cysts invariably return. But IANAD and of course, YMMV.
posted by RandallStanhope at 9:33 AM on August 1, 2012 [1 favorite]

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