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This isn’t a flex, but I never had an issue with acne.

For my teens and my adult years, my skin has been virtually blemish-free, with an occasional pimple here or there. My parents tell me that it’s all due to their golden genes – how their flawless complexions never had a single zit.

So imagine waking up one morning to find your entire face with not only blemishes but deep, angry, cystic ones that refuse to go away. That’s exactly what happened at the beginning of April. We now know that cystic acne occurs for several reasons but mainly a perfect storm when you overproduce oil, shed skin cells way too quickly, and have bacteria fester all over the combination. There are many studies that say how diet, hormones or stress can lead to inflammation, where your oil glands produce even more sebum to the detriment of your complexion.

It made complete sense. I was going through so much mental anguish and coping with a perfect storm of anxiety. My maternal grandmother, who I was extremely close with, passed away at the beginning of March just as COVID-19 was being spread across the world. I was forced to watch her being buried just as our country began to close its doors. The coronavirus changed everything and I woke up every morning thinking I had the virus or pacing back and forth between thoughts that my parents, sister, or nephew could get it. But the coronavirus wasn’t the biggest of my worries. The rise of anti-Asian crimes sweeping the world, with thousands of people being assaulted just for being Asian, took its biggest toll. Not only did I feel helpless in my own skin, I began thinking irrationally about what would happen to my parents if they went to the grocery store. Would they be harassed? Would someone say something awful? Would my parents be physically attacked?

All of this came to a crescendo on May 25, when the nation witnessed the senseless killing of George Floyd by the hands of police officers. Already tense as a country from the virus, we were all thrown into fighting for Black lives and understanding how we, too, could be complicit in the structures upholding white supremacy. Not only did this take a toll on the lives of so many people, I, too, found myself spiraling with anxiety, depression, and constant stress.

(Photo by David Yi/ Very Good Light)

It’s no wonder my acne only worsened over time. What’s so nefarious about acne of the cystic kind is that there truly isn’t a remedy for it. For one, you can’t get rid of it overnight since it’s so deep, and trying to pop them only causes scarring. Although over-the-counter remedies like benzoyl peroxide or salicylic acid works to some degree, it’s not strong enough to truly zap cysts until they’re gone. At least, this was my experience with the countless cysts that continued sprouting.

Feeling overwhelmed with anguish, I researched until I came across something that I should have used all along: tretinoin, a prescription retinoic acid. Most of you have probably heard of over-the-counter Vitamin A, aka retinol, which helps skin cell turnover. But tretinoin is prescription-only, given that it is much more potent.

Having nowhere else to turn to – I certainly was not going to go into a physical dermatology office – I sought out the help of Dear Brightly, an online service that provides tailored topical tretinoin for individuals. FYI tretinoin is not only great for photoaging and premature skin aging, but yes, for acne as well.

The entire company was founded by Amy Chiu and Alda Luong, who say they created Dear Brightly because of her own frustrations when it came to skincare and OTC retinoids or tretinoin (which needs an Rx). While in her mid-20’s she found how her skin was changing. From hormonal acne, sun spots, uneven skin. But it was trying to find a dermatologist for Amy – and the hassles to going into a clinic – that made her realize how inconvenient it was (not to mention expensive), just to find an appointment.

“All in all, the entire experience wasn’t ideal,” she recalls. “It was inconvenient, inaccessible, costly, and the commercially available retinoids felt medicinal and the instructions were pretty scary and hard to read (font is so small!).

Which is why she created Dear Brightly to make the entire process much more seamless.

The service has you upload your photos, gets a real-live dermatologist to look over your condition, and sends you a tretinoin that helps with your skin type. I received one that had 0.015% tretinoin and weeks later received a stronger strength. In days I received a new bottle and it was pretty seamless. Note that every patient gets a dosage based on one’s unique skin and skin profile and dermatologists will either give a ramp up or to Dear Brightly’s highest strength. But before getting to my results, let’s delve into what tretinoin actually is!

(Photo by David Yi/ Very Good Light)

So what is tretinoin?

According to Dr. Krishna, from Dear Brightly, it’s a vitamin A derivative that helps acne in multiple ways. “Tretinoin improves fine lines and wrinkles by increasing collagen production and improves skin tone and texture by lightly exfoliating the skin and reducing oil production,” she tells me. “It’s a great choice for anyone looking for an all-rounder product focused on photoaging prevention and treatment.”

How does tretinoin work?

According to the good doc, tretinoin has several important functions that “make it an excellent choice for acne, photoaging, and hyperpigmentation (ie dark spots).” It works by exfoliating dry, dead skin cells and reducing oil. This not only prevents breakouts, but calms your skin. “Further, in the deeper levels of the skin, it reduces oil production from oil glands and most importantly, activates collagen production,” says Dr. Krishna. “Collagen provides firmness to the skin and reduces the appearance of fine lines and wrinkles. Tretinoin has been studied for over fifty years and science has shown that consistent use can reverse sun damage and improve overall skin health.”

How far can you go?

All skin is different and so you do have to take tretinoin slowly. For some, using it every night is effective. For others, it might be too strong and leave your face feeling angry. It all has to do with how well your skin tolerates the products. At first, I tried this every other day – about three times a week – then upped my usage to every day.

Skin purging is real.

I’ll admit I was bracing for the worst. I’d done my research scrolling through endless Reddit accounts with posts talking about a so-called “skin purge.” It’s an experience where your skin breaks out even worse than before and where you begin to regret using tretinoin at all. I experienced the same and after two weeks, my cysts began surfacing to a head. This is all normal, says Dr. Krishna. It’s not that your skin is getting worse, she explains, it’s just that because of quicker skin cell turnover, the cysts deep inside are rapidly coming to the surface. “This is all normal,” she says. “Existing acne buildup comes to the surface all at once, rather here and there over a prolonged period of time. This happens because as tretinoin is reducing oil, it draws any existing oil to the surface of the skin, where it gets trapped in the pores and produces blackheads and whiteheads. Tretinoin isn’t causing more acne, but getting rid of acne.”

My results

Dear Brightly’s formula has a velvet-soft texture, which is far from the sticky goops found in others. It’s also great because since people have different skin, there’s a “ramp up” structure where you can up your dose of tretinoin according to how your skin reacts/gets used to it. Meaning that yes,results will vary. But Dr. Krishna says you can expect you skin to have noticeable differences after 4-6 weeks. I used Dear Brightly’s Night Shift. “This is from the initial exfoliation and oil decrease,” she explains. “Microscopic changes are occurring as early at 4-6 weeks but around 8-12 weeks you’ll see major improvements in tone, texture and firmness.”

After two weeks my skin purged but after a month, I did see small changes.

Month 1

Ya’ll, I’m not gonna lie: Month 1 was difficult. Not only was I experience deep anxiety and perhaps undiagnosed depression, I woke up with stress lumped in my stomach. To top it off I felt the tretinoin wasn’t working. In turn, my complexion broke out in even biggest cysts and angrier skin. Working the Dear Brightly tretinoin from every other day to every day, I waited and emailed Amy. “Is this working?!” I emailed impatiently. “Just wait,” she replied.

Month 2

In week 5 I thought my life would change – but skin purging did not pass. I started stress eating and I think the late night Pringles probably didn’t help. With a swollen face, I think I saw a few more breakouts until week 8 – when they stopped growing in. Still, with a pretty painful face, I press forward with the tretinoin, waiting for my glow up to come.

Month 3

Surely enough, yep – the cysts went away. I was beginning to doubt Amy but I was finally able to breathe, let loose, and watch as the cysts stopped sprouting to the surface. In week 9 I started to see my skin start to mellow out, the breakouts drying and my skin becoming a little more even in skintone.

Month 4

Guys! I made it through the worst of it. This month, I saw my skin evening out – even starting to look fairly normal again. All that remained behind were scars. But apparently using tretinoin on a daily basis helps hyperpigmentation, which is another reason to keep this going.

Month 5

Ya’ll!!! It’s been a JOURNEY AND BACK. I’m alive. My skin is back to normal. Yes, it only took five months – but you really can’t expect overnight results. You have to take it as it is. Here’s my skin (unretouched or refiltered) I just took yesterday. While tretinoin is powerful I still do have breakouts here and there. Dear Brightly has helped. But so has breathing, meditating and understanding my relationship with stress as well.

To get started on your own skin transformation, go to Dear Brightly! Starts at $59 for a two-month trial.