You guys may have noticed that this blog has been neglected for a few weeks now. This is not because I’ve given up on skincare or blogging, but simply because both my skin and its care routine are under-going some changes right now. Namely, after a lot of pussyfooting around the idea of prescription skincare, I signed up for Curology (previously Pocketderm) and after TWO MONTHS they finally put me on tretinoin. Woot!

This means two things:

The routine I’ve been using for the past couple of months? It needs an update. It is severely lacking in moisturizing agents because summer has been strangely kind to my dry skin. Also, just like the doctor ordered, I’m off of AHAs and BHAs. Tretinoin has made my skin uncharacteristically sensitive so I imagine it’s going to take some time before I can reintroduce them. This has been a difficult adjustment, to say the least. Without BHAs keeping my acne in check, I’ve been dealing with more breakouts and longer lasting breakouts, operating on the faith that Curology / Pocketderm would take care of it, with mixed results.

What is Curology and My Experience So Far

Curology is an internet dermatologist service that treats acne and aging. You are assigned a dermatologist and communicate with him or her purely through the built in Curology messaging service and by uploading photos. The scope of what they do is obviously very limited compared to an in-person dermatologist (you’re still going to need a real dermatologist for any skin cancer concerns or services such as cryotherapy) but where they win is accessibility. You can communicate with your doctor at any hours of the day by sending messages and, from my experience, you will receive a response quickly.

I realize I haven’t really mentioned my experience with Curology / Pocketderm very much up until now. There’s a good reason for this: my first prescription really didn’t do much.

I started using Pocketderm in July and my first prescription composed of 1% clinamycin, 4% niacinamide, and 4% azelaic acid. At the 7-8 week mark, my doctor took out the niacinamide, doubled the azelaic acid content to 8%, and added .018% tretinoin. I don’t know if 7-8 weeks is the usual amount of waiting time to get a stronger prescription, but I imagine my constant pestering, photo uploading, and question asking of my doctor might have something to do with it. My doctor, to her credit, was very patient and thorough in all of her correspondances with me. Even though my first prescription did not perform as I had hoped, I still think Pocketderm is worth every penny because having a doctor to freely email with skincare questions is really awesome. Who knew I had fungal acne and inflammatory lesions on my face? WebMD can’t diagnose that sh*t.

I received my upgraded Pocketderm cream three weeks ago. My doctor suggested I start using it every three days while using the old prescription on my days off. After two weeks, I finally bumped up my frequency to every other day.

It’s too early to tell how effective this new prescription will be, but it’s definitely doing something. My face feels raw and even products that have been firmly established in my routine are now causing redness. It’s a little unnerving, but I’m excited to see what happens!

Btw, you can try one month of Curology for free by using my invite here. After that, it’s $19.95 a month.

FLAKE-POCALYPSE Begins

With my first Curology prescription, there was virtually no change to my skin. I had no sensitivity (even though I kept using AHAs and BHAs in my routine), no changes in dryness, and also no changes in my acne. Two days into my new prescription, my skin started peeling off at an alarming rate!

My skin was peeling in the way that skin peels a few days after a terrible sunburn. The parts of my skin that weren’t mid-flake looked like scales. This isn’t your normal dry-skin flakiness, this was my face shedding an entire layer of skin. The area around my nose and mouth looked the worst but the flakiness extended all the way up my cheeks.

Three weeks in, I have my flakiness mostly under control. It’s still an ongoing issue, but no longer a cause for social awkwardness! Here are the anti-flaking rules I’ve been following that have made all the difference:

Rules for Keeping Flaking at a Minimum:

1.) Forget ALL Chemical Exfoliants – No AHAs, No BHAs, and No LAAs

My assigned dermatologist had instructed I put a pause on using AHAs and BHAs because my skin may be too sensitive as it adjusts to tretinoins. However, another reason to avoid chemical exfoliants is because they make the flakiness so much worse. A few days into tretinoin, my skin was feeling sensitive enough that I thought reducing l-Ascorbic Acid (LAA) usage might be a good idea. This didn’t help with my new sensitivity issues, but it did reduce the flakiness I was getting by a significant amount. Even though it’s not as effective as an AHA or BHA, LAA does exfoliate at a low enough pH. It seems obvious in retrospect, but when your skin is flaking off at an alarming rate, it probably doesn’t need the assistance of additional chemical exfoliants.

2.) Get A Konjac Sponge STAT

While chemical exfoliation is a definite no-go, gentle physical exfoliation can make a world of difference by preemptively removing loose skin before it starts to flake! Konjac sponges are the gentlest, least irritating way to physically exfoliate the skin. Gommage exfoliators such as the ever-popular Cure Natural Aqua Gel would probably work as well, but konjac sponges are cheaper, easier to use, and pose no risk of comedogenesis! I stock up on Konjac sponges when I place orders with Koreadepart. They are also available on amazon.

3.) DO NOT TOUCH Your Skin

It is really difficult to notice flakiness on your skin and not to brush it away, but trust me touching will only make things worse! Every time I touch my skin, more flakiness will magically appear, even if my skin looked stable before the touching. I now avoid looking too closely in mirrors when I am not at home and bring makeup remover wipes with me everywhere, so if I mess up and trigger more flaking, I can at least wipe the mess away and reapply makeup to patch things up.

4.) Is Your Current Moisturizer Satisfying All Your Needs? It’s Time To Get Serious About Hydration!

Moisturizing seems like a no brainer, but this is the time to ditch poor and mid-level performing moisturizers. As someone with dry skin, I can write an entire treatise on why most moisturizers suck, but that’s for another day. The point is you need a moisturizer that works. You aren’t necessarily looking for something super heavy – the dryness issues from tretinoin are internal so the goal here is different than say, protecting your skin from Chicago winters, but you do want something that can seal in hydration. My current go-to moisturizing products are the Neogen Dermatology Dual Layer Ceramide Oil and Caolion Mucin’s Cream Water.

The Neogen ceramide oil is bottle full of half essence and half oil. To use, you shake the bottle and then use the dripper cap to extract the product. The instructions say to use 4 drops, but I fill the entire dripper and use it all. Despite its high oil content, it does not leave my face feeling heavy, sticky, or greasy nor does it leave my face looking shiny. In fact, it dries matte. It also layers beautifully with other products and seals in moisture like a champ! I use this in the mornings after applying toner and essence and before sunscreen. No emulsion or other hydration steps needed!

Caolion Mucin’s Cream Water is a newer addition to my routine but it is one of the 5 snail creams I’ve been testing against each other (with the help of my water / oil analyzer!) and the one that moisturizes best by far. This cream is not heavy but it does leave a tacky (but not sticky) feeling on my skin, one that almost feels like a makeup primer. It feels more protective but less reparative than the Neogen ceramide oil, and I haven’t been using it as much right now but I imagine it will become my go-to moisturizer when things get colder and windier!

When my skin is feeling especially dry, my go-to remedy has been sheet masks, but not just any sheet masks, horse fat sheet masks! Fiddy, the ultimate fairy snail mother, sent me with two Guerisson hydrogels and I immediately fell in love and purchased a bunch more plus some other horse masks that looked promising! On my skin, horse oil is pretty much magic. It hydrates / maintains hydration and makes my skin baby soft, all without feeling like I have anything on my face at all!

At the end of the day, there’s still a good amount of loose dead skin on my face, which becomes painfully obvious when I’m oil cleansing and I can feel it peel off and bunch up in the oil. When this first started happening, I excitedly thought that maybe I was getting grits, but alas, it’s just skin. It’s pretty gross but as long as it isn’t super visible throughout the day, I’m pretty happy!

Has anyone else had issues with flakiness after starting tretinoin? What are your tips for dealing with it?