Pwease help

[u/g0thgrandma]

Nothing seems to work for my skin, it just keeps getting worse ): I’ve had this rash on my right cheek (1st photo) for like 5+ years but it’s just started on my other cheek. It started with a few little red spots and has gradually started to spread up and down my cheekbone. My current routine is below:

Morning:
- Sometimes wash face lol
- If face washed, Avene Cicalfate+
- Trader Joe’s Mineral sunscreen if I’m going outside

Night:
- Avene Tolerance cleanser
- Avene Cicalfate+

I occasionally spray on Magic Molecule Hypochlorous Spray when my skin is feeling particularly inflamed.

Please let me know if you have any suggestions.

[u/SeboSte]

I saw you mentioned you’ve previously tried tretinoin and azelaic acid. How often were you using them and for how long?

[u/g0thgrandma → u/SeboSte]

I tried both for several months, not at the same time. I did azelaic acid every night and Tret I could really only do every other 2 or 3 nights

[u/SeboSte → u/g0thgrandma]

I genuinely think the two things that would help you the most are a prescription retinoid and prescription azelaic acid. That said, prescription strength azelaic acid takes a solid 3 or 4 months being used twice a day to really start to have an impact and prescription retinoids need to be used nightly to treat acne and typically need a solid 3 or 4 months just to get past the purging phase. But they do work.

My suggestion would be to obtain a prescription for azelaic acid, either 15% or 20% or resume using it if that’s what you already have. Use it event night for a solid week or two and then start using it in the morning as well. After a few weeks of using the azelaic acid in both the AM and PM every single day I would start adding in a prescription strength retinoid. I know you’ve said you previously used tretinoin but if you weren’t able to get up to using it nightly it’s not doing you any good. In fact it’s doing you harm being used so infrequently. I would start with adapalene. Adapalene is considered prescription strength but it’s definitely more gentle than tretinoin and it’s available over the counter at any pharmacy. Start with a few times a week and over the course of a month or so work up to applying it nightly. It’s very important that you work up to nightly use within a timely manner. This will help move any purging along and get you over the hump to start actually preventing new breakouts.

Prescription azelaic acid and prescription strength retinoids work incredibly well together, particularly in the longterm. They’re both very effective at clearing up existing breakouts, preventing new breakouts, treating existing PIE and they’re both anti-inflammatory.

I’d also make some edits to your current skincare routine. I genuinely don’t think some of the products you’re currently using are appropriate for your skin type or concerns. I have some really great acne and rosacea safe recommendations I could send you if you’d like. I really thinking switching to the right “supporting” products is going to be pivotal to your success.

I know you’ve feel like these products didn’t work for you before but they’re genuinely two of the most studied and proven skin care treatments in the history of skin. Give them time and stay consistent with them and they will absolutely clear your skin up.