Category Archives: Acne


Curology, fka Pocketderm, a Six Month Update

I’ve been using Curology, formerly known as Pocketderm, for six months now and felt I couldn’t put off doing this review any longer, so here we are!

In this post I have before and after photos for the three prescriptions I’ve gone through and some thoughts on what I think is good and bad about Curology.

What is Curology:


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. Their scope is very limited – they only deal with acne and anti-aging concerns, 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.

Does it Work?


Weeks 1 – 7 // 1% clinamycin, 4% niacinamide, 4% azelaic acid

I apologize these are not the best photos – I had no plans of posting pictures of my acne-ridden face on the internet when I was taking them. Please note that picture 1 is not my skin at its worst. Months of BHA usage and AHA usage had gone a long way in getting my cystic acne under control and fade some of the worst post-inflammatory hyperpigmentation.


Photo 2 looks worse than photo 1, but IRL my acne was about equally bad. Photo 1 just has really terrible lighting.

That said, I did not have a lot of luck with my first prescription. I have inflammatory acne and the main active ingredients here, niacinamide and azelaic acid, are supposed to have anti-inflammatory effects. Unfortunately, I saw little change in my skin. The hyperpigmentation I had on my face was still fading at a frustratingly slow speed and I was still getting some pretty large breakouts that resulted in even more hyperpigmentation. I kept messaging my provider and asking when I should be seeing results, and her consistent response was give it 6 weeks. After 6 weeks and I was still breaking out at my pre-Curology rate, she changed up my prescription to include tretinoin.


Weeks 8 – 12 // 1% clinamycin, 8% azelaic acid, .018% tretinoin

Version 2

YES IT WORKS! The first 1-2 weeks were hard. Because tretinoin can be super irritating, I had to stop using AHAs and BHAs completely, which initially resulted in more breakouts. As the tretinoin did its work, the breakouts not only slowed, but became increasingly less common! Not only that, but the dark pigmentation I have all over my cheeks from previous breakouts were fading at a record rate! About a month after starting this new prescription, my skin was at a point where I previously did not think possible just a few weeks before.

The downside of this prescription, as mentioned earlier, is that it was extremely harsh on my skin. My skin was shedding at an insane rate, which I’ve previously talked about here. Not only that, but my skin became uncharacteristically sensitive. EVERYTHING I tried to put on my skin, from cleansers to toners to moisturizers, made it burn. After talking to my dermatologist, I decided to only use the prescription every three days. At this frequency, the cream was still as effective against my acne but it was no longer fading my pigmentation as quickly as before. I figured I would rather live with slightly slower-disappearing hyperpigmentation than constant flaking, so that is ok.


Weeks 13 – present // 4% azelaic acid, .017% tretinoin, .25% zinc pyrithione:

Version 3

After a month with my second prescription, my dermatologist adjusted my prescription to have less azelaic acid and slightly less tretinoin due to the terrible flaking I was still getting. She also threw in zinc pyrithione, which is an ingredient commonly used in anti-dandruff shampoos but it also effective in reducing fungal (gross, sorry) acne. This is the prescription I am currently on! So far as I can tell, it is equal in effectiveness to prescription 2, slightly less harsh, but has a better consistency (prescription 2 had a strange texture). I use it every 2 or 3 days, depending on how sensitive my skin feels. I still get acne occassionally, but they are very shallow breakouts that clear up in a day or two.

The Good:

Having a medical professional to email back and forth is really awesome! I think I sent my practitioner and email every time there was a change in my skin, just to ask if the change was normal and whether it was a good change or bad change. As someone who had previously been trying to “solve” my acne by blindly following advice I found on the internet, this was a huge step up.

Also, obviously, Curology works, or at least it does for me. My skin is still not 100%, but I am so incredibly happy with it! I can go out and buy groceries without wearing foundation or concealer, which 6 months ago I NEVER would have even thought of doing. Also, when my first prescription wasn’t giving me results, my doctor gave me a clear time line of when I could try something stronger and she stuck to that timeline. That to me demonstrates great accountability.

The Ugly and the Bad

As mentioned earlier, some of the prescriptions I received were very, very harsh on my skin. The constant skin shedding led to a few very stressful weeks at work where I was constantly ducking in and out of the bathroom to try to brush off any visible dead skin on my face. I work in a fairly formal environment and was a little surprised that no one reprimanded me for how terrible my skin looked at that time.

What was even worse than the flaking for me were the sensitivity issues. There were a few days where my skin was burning so intensely that it was almost unbearable. I couldn’t clean or moisturize my face without it burning and turning bright red. Even products designed for super sensitive skin irritated my skin and I was terrified that this was how my skin would be forever.

The other issue I had with Curology is some of the responses I received to my questions were obviously canned responses. They were relevant, very informative canned responses, so this is not a major issues at all, but just something I thought worthy of pointing out.

Should You Try Curology?

If you have acne, give Curology a try. It might not work, but I’d say odds are good and at the very least you have a medical professional on your team helping you get to the bottom of your acne.

If I could go back and change ONE thing about my experience with Curology, it would be that I wish I had signed up earlier, because not only would I be that many months ahead in my recovery, but I also would have that many months less of pigmentation issues from acne.

How to Sign Up

You can get a month of Curology for free by using a referral link. When I signed up, the free month included a 3 month (30ml) prescription, but I think its been reduced to a 1 month (10ml) prescription now. If you want to sign up, here is an entire page of stranger’s links you can use, or you can look for mine in the sidebar.

And if you do give Curology a try, please please let me know how it goes!


How to Survive Tretinoin without Molting – a Dry Skinned Girl’s Guide to Curology (fka Pocketderm)!

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 post made me do it.

This post made me do it. When I mentioned my indecisiveness to OP, to which she responded:
Please, please go for it. For me, it took about 2 months of skin like the first 3 pictures before I went for it. If I’d gone for it sooner, that’s 2 more months of happiness I would’ve gotten.
This struck a chord. It’s easy to write off acne as something cosmetic, silly, and vain, but truth is acne had taken a toll on my happiness. To look in a mirror and see an unfamiliar, acne-ridden face is bad, but having to face the world with that face without being able to explain it to other people ate away at my confidence in a way not many things have.

This means two things:

  1. 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.
  2. 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

Prescription 1 and prescription 2, hanging out with the new vanityrex mascot!

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. 


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 on tret. Source.

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

Konjac sponges are so difficult to photograph. :(

Konjac sponges are so difficult to photograph. 😦

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!

Full review coming, but take a look at that ingredient list!

Full review coming, but take a look at that ingredient list! Purchased from eBay. Also available on Koreadepart.

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!

caolion mucin's cream water

Purchased from eBay.

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?

DHC Salicylic

DHC Salicylic Face Milk Review also a Reexamination of Salicylic Acid’s Effective pH Range


Remember my review on Chica y Chico’s Beta Salic 2.0? Well (knocks on wood), since I started using it, I have not had a single recurrence of cystic acne. I do still get closed comedones, but even those are less frequent. Needless to say, BHAs are totally my jam right now. They’re the security blanket ingredient of my skincare routine and my second deserted-island skincare essential, after sunscreen of course. The reason I wanted to swap out Beta Salic 2.0 with something new? I wanted something STRONGER. DHC Salicylic Face Milk ReviewI also wanted something without glycolic acid. I’m currently using a lactic acid toner, which has been a bit harsh recently, and I thought removing glycolic acid, even in small quantities, may help.

But back to salicylic acid. Products in Korea are limited to containing only .5% salicylic acid. A lot of brands deal with this restriction by using betaine salicylate, a mild complex of salicylic acid, instead. This means to get my grabby hands on stronger BHA products out there, I have to look outside Korea. I have had my eye on this salicylic face milk from DHC for some time and since I was running out of BS2.0, finally decided to order it!


I bought this as part of a Rakuten haul. It is also available in the states with a markup on DHC’s website or on Amazon. I cannot actually confirm with 100% certainty that the Japanese version and the US version are the same. Japan does not require products to label active ingredients (this goes with vitamin C products and sunscreen active ingredients as well) and the US DHC customer service team was pretty much worthless when I repeatedly asked, sending me the link to‎ three times. However, the ingredient lists are identical so chances are good that the two are and for the purposes of this review I am going to assume they are.


Comes in a small, flat, blue tube with a small spout. DHC Salicylic Face Milk The product itself has a light cream texture. Its thinner than beta salic 2.0, but not quite what I would consider milky.


There are two major differences between this cream and beta salic 2.0: First of all, I mentioned that with beta salic 2.0, I only experienced minimal purging. With this face milk? Holy starfish! I had zits erupting on my face non-stop for about a week.

On one hand, I’m happy this stuff is working. On the other hand, I kept having to duck into the bathroom at work to make sure I didn’t have to reapply my makeup (again) to cover up the warzone that was my face. Thankfully, this purging calmed down greatly after the first couple of days and stopped altogether by the end of the second week.

The second difference is that there is a noticeable anti-inflammatory effect with this cream that I did not experience with beta salic 2.0. Minutes after applying this, my problem areas were noticeably less red.

dhc antiinflammatory

Photo on left taken immediately before applying DHC SFM. Photo on right taken 10 minutes after applying. There is obviously still a lot of redness in the right photo, but notice how the pinkness emanating from the problem spots is reduced.

I was concerned my dry skin would not be able to handle the increased BHA concentration, but I had no issues whatsoever! I think this is partly due to DHC SFM being well formulated and partially due to the fact I’ve been using a BHA (albiet a mild one) for more than two months before using this. Here are the ingredients, with cosdna acne triggers and irritants thusly indicated:


This is when things start to get interesting. After a month of using this milk, I finally got my hands on some pH testing strips. This item has a purported pH of 3.8 but the pH strips I have were telling a different story.

dhc salicylic face milk review ph test

Left most square suggests pH is around 5. Second from the left square suggests pH is around 4. Let’s just say 4.5?

Granted, these pH strips are not the most reliable way to measure pH, but I tested this cream a few times and consistently got a reading suggesting the pH is around 4.5. For a BHA, a pH of 4.5 is really high.

Screenshot from The Journal of Experimental Medicine, Volume 36. source

Screenshot from The Journal of Experimental Medicine, Volume 36. At a pH of 4.5, less than 5% of salicylic acid will be in free salicylate acid form, which is the form required to exfoliate skin. source

From everything I understood about BHAs, this product should not be exfoliating my skin in any significant way. Yet, the effects I was seeing with this product, particularly the purging, are difficult to attribute to anything else. This lead to some frantic googling and pubmed searching to find possible explanations, of which I have three!

Possible explanation #1:

There is one study that caught my eye (that RatzillaCosme actually tweeted about but I’m lame and not on twitter so I didn’t see it until now):

Salicylic acid at close to neutral pH (mostly in its neutralized form as salicylate, pH 6.50) exerted a corneodesmolytic activity as good as that of salicylic acid in an acidic vehicle (pH 3.12) after only two days of application… In conclusion, neutralized salicylic acid at a 1% concentration is a suitable exfoliant agent for subjects with sensitive skin.

For those of you who don’t know what corneodesmolytic activity is (because I sure as hell didn’t), I did some digging. According to Acne and it Therapy:

Corneodesmolytic… results in desquamation due to degradation of corneodesmosomes, which are proteinaceous complexes that effectively rivet corneocytes together.

Uhhhhhhh ok so some translation is in order! Here’s the dumbed down version:

Corneodesmolytic… results in [the shedding of the outermost membrane of skin] due to degradation of [proteins that hold [epidermis skin cellstogether], which are proteinaceous complexes that effectively rivet [epidermis skin cells] together.

In short, I’m pretty certain corneodesmolytic is science jargon for exfoliation (or at least a certain type of exfoliation), which means the study is effectively claiming salicylic acid at a pH of 6.5 exfoliates as well as salicylic acid at 3.12. This is just one study but it seems like a compelling reason to reconsider the requirement that salicylic acid products need to possess a pH under 4.

Possible Explanation #2

A simpler explanation is basic math. Salicylic acid is recommended for use in concentrations of .5% of 2%. The upper limit of the range is 4X the lower limit, so perhaps the high amount of salicylic acid in this product allows for it to still be effective at a higher pH.

At a pH of 4.5, 2.87% of salicylic acid will be in free-acid form. For this product, this means 2% X 2.87% or .057% of this face milk is free salicylate acid.

So, we can calculate what % of the hydroxy acid needs to be in free acid form in a hypothetical .5% concentration BHA product to effectively have the same amount of free acid as our DHC product as thus: .057% / .5% = 11.48%. Using the same chart, we can see that a pH of 3.5 corresponds to 22.79% of salicylic acid being in free acid form and a pH of 4 corresponds to 8.54% free acid. 11.48% lands between 22.79% and 8.54%, being obviously closer to 8.54.

This means our 2% salicylic milk with a pH of 4.5 effectively has the same amount of free salicylate acid as a .5% salicylic acid product with a pH between 3.5 and 4 but closer to 4. If you think about it this way, the pH is still higher than optimal, but within a more acceptable range. Cosrx’s very popular BHA product, after all, has a pH of 4.0.

Possible Explanation #3

As mentioned earlier, pH strips are not super accurate. Salicylic Face Milk also contains a few oils, which may or may not complicate how well the strips work. If anyone else has this product and wants to give a pH test a go, I’d love to hear what the results are!

Back to the product. I like this product and I think it’s effective, despite its higher pH, but it’s not perfect. First, it smells a little bit like tiger balm to me (menthol-like). I think this is due to one of the extracts (probably Perilla Ocymoides Leaf Extract). I grew up with Tiger Balm and find it strangely comforting, but its definitely an acquired smell. Also, I like to use my acids in the morning and as the weather has gotten warmer, I suspect this product is making my face greasy. This face milk is not oily but leaves a bit of a film. For whatever reason, if I use this at night, I don’t notice the film, but in the mornings I have to be careful about how much I apply. This brings me to my third complaint. The instructions advise to apply the salicylic milk all over your face and to do so one to three times a day. Three times is definitely excessive and seems like it could easily lead to over-exfoliation. I would instead use this once a day at maximum and if using in the mornings, only use as a spot treatment or on problem areas to prevent excess greasiness or skin flakiness.

I have been using this product since mid-June and my face is noticeably less bumpy and inflammed. It seems stronger and slightly more effective at getting my breakouts under control than BS2.0, but I don’t think I like it better. Regardless, BHAs definitely have earned a firm spot in my routine. Even though I still have acne, BHAs have taken my face from pus-volcano-covered-mess-that-makes-me-never-want-to-leave-the-house to blemished-but-with-makeup-I-can-be-a-functional-human-being. When I first started breaking out, I became more self-conscious and ashamed of my physical appearance than I’ve ever been in my life. BHAs have not (yet) restored my blemish-free face, but it cleared things up enough to restore my self-confidence.


Gentle (no flaking or increased sensitivity) yet effective (hello purging) BHA with impressive anti-inflammatory properties but possibly questionable pH. If you’re looking for an Asian BHA product with more than .5% salicylic acid, this is a fantastic candidate!


  • non-drying
  • effective
  • anti-inflammatory


  • higher pH
  • menthol-like fragrance
  • feels filmy in warmer weather
  • DHC’s instructions seem very ill-advised

DHC Salicylic Face Milk

My Struggles with Double Cleansing – Review of Innisfree Apple Juicy Cleansing Oil and Yes to Cucumbers Gentle Milk Cleanser

Double cleansing is such an important keystone of an Asian Beauty routine but for the longest time, it just wasn’t working out for me. Oil cleaning was giving me acne and foam cleaning was drying my skin out. Go figure.

My first attempts at oil cleansing involved using Banila & Co’s Clean it Zero to double clean. This gave me comedones. My second attempt was using pure 100% mineral oil for OCM. This gave me cystic acne and comedones. Long story short, I eventually figured out products with mineral oil make me breakout. I feel like an anti-vaxxer saying anything negative about mineral oil so I want to clarify that I fully believe the science shows mineral oil as being very, very unlikely to be comedogenic on human skin. In fact, it was because I believed this science so much that it took me a ridiculously long time to recognize mineral oil might just be the culprit.

Continue reading

LHJ Tea Tree 90 Essence

I avoided this essence for a long time because my previous experience with tea tree oil was in the form of a cleanser that was stinky and too harsh on my already parched skin. However, three months ago the now famous Banila & Co Clean it Zero cleanser brought on an acne storm the likes of which I’ve never experienced. I got through puberty with maybe a dozen zits and so the last couple of months have been a belated but zealous education in all things acne.

My skin is 90% back to its usual trouble-free self (shout out to C20 OST!), but a stubborn patch of closed comedones still occupies my right cheek. I’ve read enough to know I should probably be using α-hydroxy acids (AHAs), but between my vitamin C and retinal treatments, I wanted something simpler and decided to give this essence a go.


The Essence Continue reading