Choosing acne treatments with a dermatologist: factors, side effects, and combos

[Joseph.W]

I've been dealing with persistent moderate acne on my jawline and cheeks for years, and after countless over-the-counter products failed, I finally saw a dermatologist who presented me with several prescription acne treatment options, including topical retinoids, oral antibiotics, and even hormonal therapy. I'm feeling overwhelmed by the choices and concerned about potential side effects like dryness, antibiotic resistance, or long-term commitments. For others who have navigated this with a dermatologist, what factors did you consider when choosing a treatment path, and how did you manage the initial adjustment period, especially with retinoids? I'm also curious about the real-world effectiveness of combining treatments versus using them sequentially.

[Aurora70]

You're not alone. I found that starting a retinoid at a low frequency and pairing with a good moisturizer made the adjustment manageable. The idea is to tolerate it long enough (8–12 weeks) to see results, then escalate if your skin allows.

[Jonathan.M]

Key factors to discuss with your dermatologist: your skin type (oily, dry), photosensitivity, pregnancy plans, history with antibiotics, and whether you have hormonal concerns. A lot of people do well with a combination approach (retinoid plus benzoyl peroxide or a topical antibiotic) rather than trying one product at a time.

[Mia.G]

Retinoid dryness tips: cleanse gently, apply moisturizer after a short wait, and avoid scrubs or other irritants. Start with every other night or a few nights a week, then increase as tolerated. If you notice redness or peeling, cut back and reintroduce slowly. Sunscreen daily is non-negotiable because retinoids increase sun sensitivity.

[Charles61]

Combination vs sequential: in real life, many find faster improvement with combination therapy, but it requires careful monitoring for irritation. If your dermatologist approves, you might keep a reduced regimen and escalate only if needed. Sequential can be gentler on the skin but slower to show results.

[Gary62]

Hormonal therapy: if you’re a suitable candidate (e.g., certain ages, not pregnant, not trying to become pregnant), hormonal options like certain OCPs or spironolactone can be very effective for hormonal acne. It requires medical oversight and discussing risks and benefits with your doctor, especially if you have blood pressure or kidney concerns.

[Nora59]

Tracking progress: take photos weekly, count active lesions, note dryness and irritation, and keep a simple diary of any triggers. Schedule a follow-up in about 8–12 weeks to adjust. For products, keep track of usage and expiration.