Dear ASG,

It sounds as if you are using the Retin-A appropriately. However, if the red spots all over your face appeared after you started using the Retin-A then it may be drying and irritating your skin. It's very important to treat acne effectively without causing skin redness and flakiness; otherwise you just switch one problem (breakouts) for another (skin irritation). New research studies show the vital importance of your skin as a protective barrier. When this barrier is disrupted by skin irritation, your skin is not able to function properly. Besides skin redness and inflammation, this can even cause more breakouts. I suggest you ask your dermatologist about alternatives to Retin-A that will be as effective to treat your breakouts but that will not cause you to develop red spots. I find the Tretin-X kit very helpful for my patients. The kit contains tretinoin, the same active prescription ingredient that is in Retin-A, along with a cleanser and moisturizer containing antioxidant green tea extract and coQ10. The cleanser and moisturizer optimize your skin's protective barrier and soothe inflammation so that the tretinoin works to the maximum for your acne with a much lower risk of skin irritation. An added bonus is that the antioxidant green tea extract and coQ10 in the cleanser and moisturizer help to destroy free radicals, which are harmful chemicals produced by your body that are thought to be the cause of premature aging. You will receive the cleanser and moisturizer free of charge when you fill your prescription in the pharmacy, so another advantage of the Tretin-X kit is that you don't have to spend extra money on your skincare regime. Your dermatologist should be able to provide you with a rebate coupon for your prescription copay, so that you can usually get the whole Tretin-X acne kit (tretinoin cream plus cleanser plus moisturizer) from your pharmacy at no cost.

Hope this helps!

Dr. Hema