Tret newbie - dos & don'ts advice please

[happy2025]

After years of battling acne I have finally decided to take the plunge and start Tret. I've been with Dermatica for a while but they did not give me Tret. The old combination is no longer working so I have asked them for Tret,

The new formula is Tret 0.05%, niacinamide 4% & Clindamycin 1%. Is this too strong to start Tret? I've read here that most people start with 0.025% Tret. Not sure why I'm starting higher except that my acne is getting quite bad - maybe that's why?

Can you share your tips & tricks of how do I start without getting to a place where I'm scared to continue? Alternate days? Sandwich?

I have been using a high frequency wand at home (at a low setting) anyone know if it's safe to continue or should I stop that?

Update: it's all going great, skin is improving by leaps and bounds. Other than occasional light peeling in some areas, nothing to report. All the acne silences and scars fading. Great!

However!! This week a giant cystic acne has made an appearance. I am so sad. What should I do? Is it time to up from 0.05 to 0.1?

@happy2025 eeek that's annoying!
I would be inclined to stick on the same % for now.
It could be your skin purging. Really annoying when that happens but until it goes down I wouldn't aggrevate your skin with a higher % at this state.
Great to hear your making progress though x

@twiddlingthumbs69 - thank you, I'll hang on to hope then. Feeling a bit low as I'd reached a happy place of not obsessing about my skin/new acne. Looks like it's not over yet...

@happy2025 I know exactly how you feel. I went through the same. You're doing really well and as you can already see results, keep going. Don't forget to take selfies so you can see how far you're progressing. It's amazing how quickly I forgot what my skin looked like before, I have to keep checking my old photos. Not that I'm vain or anything 😂😂😂

@twiddlingthumbs69 - you are so right. I always take pictures of the bad, but not enough of the good. Please tell me you got to the end of the tunnel and you have stunning skin with no acne! Please.

Remember to do a patch test first, behind the ear is good

@happy2025 well I can't say I've got stunning skin, I'm 60 😂😂 BUT it's done amazing things for me. I no longer have acne and I don't have any flares/breakouts anymore.
I've been using tret for nearly a year now.
Just wish I'd known about it sooner instead of wasting money on OTC stuff.
I did break my skin barrier early on (might have mentioned that). I upped my % too quickly and I was so disappointed in myself. It's like I went back to square one.
I've now gone back to a lower % and it's fine now.
It's a long game really. I think to begin with you see really noticeable results and then it seems to plateau. Whether it actually does or you just get used to seeing your skin as it is, I'm not sure. Hence the progress photos.
I'm not a Derm but going by my experience, keep going on the % you're on. The last thing you want is a damaged barrier, believe me.
Give yourself til July, taking photos along the way, then make a judgement on whether to increase the dose.
You're doing great!!!! It can't not work, it's proven, but slow and steady is the way to go with this x

And if you have a reaction, its effective on hands. I use any of my leftover Monderma tret on sun damage.

I wouldn't say long-lasting. 6 months is typical, 12 at best. Oral roaccutane is the only medicine that effectively cures it, but cream clindamycin is a low-risk option with generally positive outcome.

Good to hear its improving. Give sometime with the same % and then upgrade. Little bit on and off's are normal.

Glad to hear! Keep us updated. I wouldn’t rush upping your dose, give your skin time

I started on tret recently and after a week of amazing glowy skin I also now have cystic acne on my cheeks and chin. My skin suddenly looks horrific 😢 Is this a normal reaction then? I wasn't sure if it might be the tret or the sunscreen they also sent with the trial.

I've been using retinol for years before I started the tret so it's not like my skin isn't used to actives. I'm currently on 0.06% prescription from Skin +me. Hoping it calms down soon!

I think you really have to be patient with tretinoin - a lot of people get purging for the first few weeks. It could take a few weeks to settle down, just give it some time and pare back your routine, maybe stop using the sunscreen they sent you and see how you get on.

I never got spots, but I got lots of peeling and redness for the first few weeks/ months.

@itsnothingoriginal - sorry to hear you are having a bumpy journey like me. I'm happy to report that other than the 1 cystic spot, things look calm. I would suggest you ask Skin&me to add Clindamycin (topical antibiotic) to your Tret if they haven't already. I think that's been a huge positive for me, so worth trying.

100% agreed. It takes time for tret to show its effect but its worth the wait.

Thanks all for the words of encouragement and the suggestion of the topical antibiotic @happy2025 I will request that with my next prescription. Glad you're getting on well with it!

You can use clindamycin for 3-4 months. It does help with cystic acne.

What strength do you recommend?

1% usually.

Thanks for sharing

Here is my formula

Excellent, and it expires in 90 days?

@pinkhimalayan - yes, this arrived in early Feb

Great

I've used tretinoin for 15 years. I STILL peel. Drives me mad but the benefits are so good. The fitness, evenness of colour and general overall improvement is real. But the peeling does my head in.
I sandwich, buffer, tried every second day. Lower strength. Everything but I still peel. It's a very fine layer not the huge thick flakes like at the start but it is very annoying and unsightly sone days close up. Makeup grabs the peeling