Happy 2017 everyone! These are my empties from November and December of 2016:
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?
PRESCRIPTION # 1
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.
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
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:
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.
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!
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.
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?