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This isn’t a flex, but I never had an issue with acne.

Throughout my teens and early adulthood, my skin has been virtually blemish-free, with an occasional pimple here or there. So imagine waking up one morning to find your entire face with not only blemishes, but deep, angry, cystic spots that refuse to go away. That’s exactly what happened at the beginning of April. We now know that cystic acne occurs for several reasons but mainly a perfect storm when you overproduce oil, shed skin cells way too quickly, and have bacteria fester all over the combination.

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Pictured: Dear Brightly’s Night Shift Tailored Tretinoin Serum

Feeling overwhelmed with anguish, I researched until I came across something that I should have used all along: tretinoin, a prescription retinoic acid. Most of you have probably heard of over-the-counter Vitamin A, aka retinol, which helps skin cell turnover. But tretinoin is prescription-only, and much more potent—20x more, according to some NIH studies.

Having nowhere else to turn to – I certainly was not going to go into a physical dermatology office – I sought out the help of Dear Brightly, an online service that provides tailored topical tretinoin and dosage support. FYI, tretinoin is not only great for photoaging and premature skin aging, but yes, for acne as well!

The company was founded by Amy Chiu and Alda Luong, who say they created Dear Brightly because of her own frustrations when it came to skincare and OTC retinoids or tretinoin (which needs an Rx). While in her mid-20’s, she found her skin was changing and she began experiencing things like hormonal acne, sun spots, and uneven skin. But it was trying to find a dermatologist for Amy – and the hassles of going into a clinic – that made her realize how inconvenient it was (not to mention expensive), just to get an appointment.

“The experience was inconvenient, inaccessible, and costly. The commercially available retinoids felt medicinal, and the instructions were pretty scary and hard to read (font is so small!),” she recalled. This experience led her to create Dear Brightly to make the entire process much more seamless.

The service has you upload your photos, gets a real-live dermatologist to look over your condition, and sends you a tretinoin that helps with your skin type. I received one that had 0.015% tretinoin and weeks later received a stronger strength. In days I received a new bottle, and it was pretty seamless. Note that every patient gets a dosage based on one’s unique skin and skin profile, and dermatologists will either give a ramp up or upgrade you to Dear Brightly’s highest strength. But before getting to my results, let’s delve into what tretinoin actually is!

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Pictured: Dear Brightly’s Night Shift Tailored Tretinoin Serum

So what is tretinoin?

According to Dr. Krishna from Dear Brightly, it’s a vitamin A derivative that helps acne in multiple ways. “Tretinoin improves fine lines and wrinkles by increasing collagen production and improves skin tone and texture by lightly exfoliating the skin and reducing oil production,” she tells me. “It’s a great choice for anyone looking for an all-rounder product focused on photoaging prevention and treatment.”

How does tretinoin work?

According to the good doc, tretinoin has several important functions that “make it an excellent choice for acne, photoaging, and hyperpigmentation (i.e. dark spots).” It works by exfoliating dry, dead skin cells and reducing oil. This not only prevents breakouts, but calms your skin. “Further, in the deeper levels of the skin, it reduces oil production from oil glands and most importantly, activates collagen production,” says Dr. Krishna. “Collagen provides firmness to the skin and reduces the appearance of fine lines and wrinkles. Tretinoin has been studied for over fifty years and science has shown that consistent use can reverse sun damage and improve overall skin health.”

How far can you go?

All skin is different, so you do have to take tretinoin slowly. For some, using it every night is effective. For others, it might be too strong and leave your face feeling angry. It all has to do with how well your skin tolerates the products. At first, I tried this every other day – about three times a week – then upped my usage to every day.

Skin purging is real.

I’ll admit, I was bracing for the worst. I’d done my research scrolling through endless Reddit accounts with posts talking about a so-called “skin purge.” It’s an experience where your skin breaks out even worse than before and where you begin to regret using tretinoin at all. I experienced the same, and after two weeks, my cysts began surfacing to a head. This is all normal, says Dr. Krishna. It’s not that your skin is getting worse, she explains, it’s just that because of quicker skin cell turnover, the cysts deep inside are rapidly coming to the surface. “Tretinoin isn’t causing more acne, but getting rid of acne,” she confirms.

My results

Dear Brightly’s formula has a velvet-soft texture, which is far from the sticky goops found in others. It’s also great because since people have different skin, there’s a “ramp up” structure where you can up your dose of tretinoin according to how your skin reacts/gets used to it. Meaning that yes, results will vary. But Dr. Krishna says you can expect your skin to have noticeable differences after 4-6 weeks. I used Dear Brightly’s Night Shift. “This is from the initial exfoliation and oil decrease,” she explains. “Microscopic changes are occurring as early at 4-6 weeks but around 8-12 weeks you’ll see major improvements in tone, texture and firmness.”

After two weeks my skin purged, but after a month, I did see small initial changes.

My first month

Ya’ll, I’m not gonna lie: Month 1 was difficult. Not only was I experiencing deep anxiety and perhaps undiagnosed depression, I woke up with stress lumped in my stomach. To top it off, I felt the tretinoin wasn’t working. In turn, my complexion broke out in even bigger cysts and angrier skin. Working the Dear Brightly tretinoin from every other day to every day, I waited and emailed Dear Brightly. “Is this working?!” I messaged impatiently, but they assured me the results come with time and to stay consistent through my initial purge.

Month 5

Ya’ll!!! It’s been a JOURNEY AND BACK. I’m alive. My skin is back to normal. Yes, major benefits take time – but you really can’t expect overnight results. You have to take it as it is. Here’s a picture of my skin (unretouched or refiltered) that I just took yesterday.

To get started on your own skin transformation, go to Dear Brightly! Starts at $59 for a two-month trial (and they cover your initial consult!).