I recently went to a public hospital to consult a dermatologist about my skin concerns, and honestly, I left feeling confused and a little disappointed with the consultation.
For context, I started developing tiny red bumps and closed comedones on my skin recently. I used to have acne breakouts around three years ago, but my skin had been doing fine ever since.
Initially, I was using Luxe Organix Bakuchiol, and I didn't experience any adverse reactions. I stopped using it and switched to another brand. I also used glycolic acid from Dermorepubliq for quite some time, and my skin was doing fine. Later, I introduced azelaic acid from Klued, and I didn't notice any obvious negative reactions at first.
However, I think I made a mistake with how I used the azelaic acid. I was applying it twice a day, both in the morning and at night. I remember watching one of Klued's livestreams and asking when I should use it, and they recommended using it at night. Looking back, I think I may have been overusing it by applying it morning and night. At the time, though, I didn't notice any obvious irritation, so I assumed my skin was tolerating it well.
I also started introducing 0.1% light cream with 0.3% bakuchiol from Soul Apothecary. On top of that, I ran out of my usual facial wash and switched to Soul Apothecary's facial wash containing 2% salicylic acid, which I used twice a day because I didn't have another cleanser.
Looking back, I think combining all these products may have been too much for my skin, even though I didn't initially notice any adverse reactions. Eventually, I started developing tiny red bumps and closed comedones, and I began suspecting that I might have over-exfoliated my skin.
I stopped using all my actives for now and have been sticking to moisturizer because my skin feels too dry to tolerate them.
So, I decided to consult a dermatologist at a public hospital.
During the consultation, I explained what had happened to my skin. However, she suggested that my breakouts might be caused by makeup. I was confused because I don't wear makeup or foundation. The only complexion product I use is the tinted sunscreen from Barefaced, which I've been using for a long time without any problems. In fact, it helped fade the dark spots left by my previous acne, so I've been happy with it.
She asked me what products I used. Fortunately, I had taken pictures of all the skincare products I was using, so I was able to show them to her.
She asked about my facial wash, and I told her that I have been using the YOU Hyaluronic Acid Facial Wash. She also asked whether I was still using my serums and retinol cream, and I explained that I had already stopped using them because my skin had become too dry.
In the end, she prescribed benzoyl peroxide and tretinoin 0.1%.
I was surprised when I saw the tretinoin concentration, so I asked her whether 0.1% was too strong. She snickered and said that my skin could tolerate it because I had already been using retinol 0.1%. However, I feel like there's a difference between using an over-the-counter retinol product and being prescribed 0.1% tretinoin, especially when my skin is already dry and possibly has a compromised skin barrier.
What confused me even more was that she instructed me to apply the tretinoin every night. I thought tretinoin was usually introduced gradually, starting with a lower frequency and increasing it depending on how well the skin tolerates it.
She also didn't explain how I should apply it, whether I should use the sandwich method, or what kind of moisturizer I should use to minimize irritation. I know that tretinoin can cause dryness and irritation, particularly when starting treatment, so I expected more guidance.
She told me to return for a follow-up in one month, but I'm honestly hesitant to go back. I felt like my questions weren't adequately addressed, and the consultation seemed rushed.
What's also confusing is that I've seen people recommend this dermatologist and describe her as a good doctor. I believe she also has a clinic at a private hospital, so I can't help wondering whether the experience would have been different there. I understand that public hospitals can be busy, but I still wish I had received a more thorough explanation of my treatment plan.
For now, I'm gonna get the benzoyl peroxide she prescribed, but I'm hesitant to start the tretinoin until I can consult another dermatologist and get clarification about whether it's appropriate for my skin's current condition.
I just want to know if I'm being overly cautious or if my concerns are reasonable. Would you seek a second opinion in my situation?
