As someone who dealt with severe cystic acne, I understand your pain all too well.
I don't know how long you have been using the tret, but it tends to have a purging period of around three months before it makes any significant progress.
My main progress was from taking Accutane. When you use harsh retinoids and creams like benzyl, it can end up damaging your skin barrier instead of helping much. Acne is so incredibly frustrating, but at a cellular level, it starts from your gut health and hormone levels. The underlying cause will be different for everyone, but the best advice I can give you is to make changes very slowly. It takes time to see changes in our skin, and if you try too much at once, you'll never know what worked or didn't work.
It’s really easy to get overwhelmed with everything on the market, influencers telling you what to buy, pushing expensive products bc “you need the best.” Nah. Here are the products I currently use to maintain clear skin.
Figure out your skin type: oily, dry, or combo. Keep in mind, you can have oily skin because your moisture barrier is broken down. Dry skin can create excess oils, trying to make it less dry.
For reference, basic ingredients to avoid would be sulfates and perfumes, but to be very specific, get the app onskin to scan products and it tells you in dummy terms if a product is good or bad with a rating and description of what the ingredients are.
Now all you need is a cleanser for your skin type: (use this in the AM/PM)
My personal favorite is Youth to the People- Superfood cleanser. You can buy 8oz for $39. I go in once with this in the am and once in the pm as it takes off my makeup, dirt, sunscreen, everything.
For a lower price range, I recommend La Roche Posay or The Ordinary, and they have pretty standard ingredients. They range from $9-$20.
Moisturizer: (AM/PM)-
I love the La Roche Posay Toleriane Double Repair moisturizer. I've used a lot of different Sephora moisturizers, but my skin is sensitive and acne-prone, and this does what it needs to do. If you have oily skin, you can opt for a gel moisturizer, or a cream-based one if you're dry. thick or thin, based on skin type, when you’ll be using it, SPF is a MUST, so either find a moisturizer that has at least SPF 15 or add in some sunscreen.
Sunscreen: (AM)-
I've tried many sunscreens in my lifetime, but the best sunscreen is the one that you will put on every single day. I use the La Roche Posay Kids one. This gives your skin a nice glow and prevents sun damage and aging associated with that.
mineral spf: there are two types of spf, mineral and chemical. mineral SPF is zinc-based SPF that stays on the top layer of your skin instead of absorbing. There isnt enough research on chemical SPF, they DO know that your skin absorbs it, but don't know if it causes long-term damage. safest to stick with a mineral SPF with a high zinc level (high is about any over 13) and strong coverage ( 30-50 ), my favorite: caudalie spf 50
Topicals- tretinoin is great for reducing acne scars, so you're doing well there. I use a Winlevy cream that was prescribed to me.
DIET:
I personally think sugar is a huge one; we don’t realize how much sugar is in the foods we eat. Even something like yogurt can have a ton of it. Obviously, eating yogurt is better than drinking a soda, but often we do both, not realizing that the yogurt is contributing to our daily sugar intake. Hormones are also a significant factor. Although diet affects hormones, and if your hormones are already out of whack due to being young, eating garbage all the time is only bound to cause more imbalances.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565837/
https://pubmed.ncbi.nlm.nih.gov/27061046/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257617/
https://ijdvl.com/role-of-insulin-resistance-and-diet-in-acne/
Some articles, if you're curious.
See if you can change your diet, take an allergy test, research any foods that could contribute to sensitivity, and see if you can get Accutane.
Good luck, man.
