Mid Week Live Q&A PLUS all things Retinoids

[@DRVenard]

Please don't apologize! We're very appreciative of any time you give to us 😁Many of us do realize that this is NOT your full time job. You have a life and a practice. We will be here when you are. Hope all of the @Doctorly family has a wonderful Christmas and New year💗🎄❄️❄️

[@boomboom6577]

I second this so much. I am so very grateful for this time and energy Dr. Max gives to these live streams. ❤️❤️❤️

[@isagoldfield7393]

👏👏👏👏👏

[@violet4481]

The sheer dedication.. the timestamps are amazing. The doctorly community is truly blessed. Thank you Dr. Maxfield.

[@traceymeadows7900]

Thank you Dr. Maxfield for taking your personal time to keep us informed on how to take care of our skin. Love you and Dr. Shah together y’all are informative and hilarious at the same time.

[@gilllondon8617]

I was prescribed Accutane in the 80s and there was no counselling beyond “don’t get pregnant” I experienced the dry lips and skin but it was truly transformative and I believe that anyone with serious acne should have the opportunity to take it.

[@keileen8357]

Yes but I will add, that people who have a history of depression and other mental disorders should be cautious as with any drug. I haven't been mentally the same since and I had lost half of my hair and was in the range of having premature arthritis from this. Yes it helps but just please keep in mind that is it potent and it is serious..

[@keileen8357]

Also it isn't a cure all for some and might have to take it twice. It's also isn't a given for hormonal acne either, which was unfortunately my case.

[@vkng_drag0n982]

I work at a dermatology lab, and I never knew there's so many different skin conditions. Since then, I have started learning with you and other quemist and dermatologyst and my skin is looking better than ever.

[@rachelhoward7889]

I am so grateful for this channel! I enjoy every minute... Your videos are the root of my passion for skin care and decision to pursue nursing in dermatology. I catch myself smiling while watching your videos all the time!! I can’t express my appreciation for all your time ❤️❤️

[@dimafluturmihaela979]

Accutane is the only treatment that helped me to treat my severe cystic acnee. I wasn't concerned about depression as I was already depressed because of it.

[@anjaliiii689]

Same!!!!!!! 🥲🥲🥲

[@boomsalamii]

Same😂

[@preranagoswami87]

I know right 😄😊

[@justicepower1255]

Amen to that. I can relate.

[@maswiyat_i]

Currently on it. Nothing else worked for me. But ooo the dry lips. But yes it actually having a positive effect on my depression:)

[@munangiwamuthabi2972]

This Q&A has really helped to calm me down about everything I was hearing about accutane. Thank you 🙏🏾

[@sarahelkin2647]

Fun fact: Tretinoin (technically All-trans retinoic acid /ATRA) for 2 years was the tail end of my chemo regimen for leukemia (APL specifically) I never put it together until I saw this video! My skin looked great during that time though, even though I had no hair 😂

[@Doctorly]

One of the many more rare but amazing uses for retinoinds. Thanks for sharing and I'm glad you got through that!

[@omonpeters7748]

@@Doctorly good morning my favourite dermatologist, please can I use both differin adapalene and neutrogena rapid wrinkle repair cream together in my night routine? Like I mean, I cleanse my face with my gentle cleanser, then follow up with my adapalene and then lastly my neutrogena rapid wrinkle repair cream? Is it okay like this?

[@bloodhunterr]

Neurologist here. Vitamin A can cross the blood-brain barrier and can in theory cause CNS/psychiatric symptoms. As many other drugs do , like steroids for example. I can assure you much more people take them for years/ or do pulse therapies, unlike systemic retinoids. And only a minor percent of patients , which receive high doses over short periods of time(pulse therapy) have psychotic/depressive symptoms. Furthermore they tend to disappear after the course is done and rarely require medicating. People need to be educated and fear mongering around these topics should not be a thing. Like you said it's more likely that the depressive symptoms lessen because of the treatment.

[@somethingkindawonderful3034]

Thanks for your comment . Does retin a cross the blood brain barrier also and can cause cns and psychiatric symptoms ?

[@biguy47905]

The Doctorly videos are extremely educational and I have learned so much by following you and Dr. Shah. Thanks so much for taking the time to share your knowledge. May you and yours have a happy, healthy, safe and prosperous new year!

[@Tsampoukalou]

I really love this channel💙. Always feels like a friend is talking to us, so down to earth SO informative and- well I can't omit this : so easy on the eyes!😂 But seriously- very very much appreciated and thank you for sharing your knowledge with all of us !

[@vickibornefeld2409]

Thank you for taking a moment in this busy Christmas season to impart knowledge. Thank you so much

[@TheMjn43]

My son took it in high school it was life changing for him. He had multiple breakouts playing sports. He tried so many OTC finally had a dermatologist put him on it. 2 rounds that’s all he needed clear face

[@hazwani2496]

is sugary food trigger you son acne even he already completed the acne cycle?

[@ddb3126]

You guys should start a podcast so we can listen while doing things and we don’t need to keep the YT open. Just a thought. We love learning about the skin, hair and nails.

[@SayHelloToOblivion]

I missed the livestream! Darn! Happy anniversary and also very glad you are well again (I can’t imagine losing my voice for such a long period of time). I ordered a few products from The Ordinary based on some of your recommendations. Can’t wait for them to arrive. Thank you for these videos. ☺️

[@Doctorly]

I hope they work well for you and that you enjoy them!

[@esteruser8483]

Glad your feeling better! Happy Anniversary! I wish I didn't miss this earlier! Thank you so much for taking the time to do these videos! Love all your work! wish you were in Connecticut! Merry Christmas! Happy New Year!

[@helenacothran1069]

Happy Anniversary!! Thank you for the live stream and sharing your knowledge and time with us! Merry Christmas!!

[@yellowrose13]

I've been dealing with the Ipledge headache. In the nick of time I was able to get my accutane this week. I feel for anyone who has to be off it for a month. Don't underestimate how much acne affects mental health. I call it the modern-day leprosy of the Bible.

[@ashleighmartinez8448]

I'm really hoping this doesn't effect my ability to get my prescription. I'm going on it for a second time and my adult acne is worse than my teenage acne ever was and it needs to be gone asap! The depression related to acne is unreal...

[@val.teacup]

As a Bulgarian who has just started getting into skincare I noted the lack of Retinol products, but never knew it's banned. It does exist as an ingredient in some other products like the Uriage cremes for example. I am going for The Ordinary tho.

[@acoolducksloveryeahweexist]

Hey fellow Bulgarian, good luck to you

[@charlescoffey695]

Great you're back! Love your live streams!

[@elizabethb3994]

I developed cystic acne as a twenty-something and after many failed treatments, I took Accutane in 2005. It changed my life. To this day, I have clear skin. I was a little hesitant about taking it at the time, and to this day, I haven't told many people about it, but I am acknowledging it now. It saved my skin and my confidence.

[@miznaali7329]

Happy anniversary Dr. MAX

[@isagoldfield7393]

Thanks so much Dr. Maxfield. We appreciate you so much🌼💜🌸

[@lialovely6768]

Acutane is life changing! I’m on it now.

[@violondon8776]

Accutane has made my skin perfect. Best thing ever.

[@melody3b432]

Dr maxfield is so cute sometimes I just look at him and forget what he is saying 😁😁😁

[@mbarn]

Love that you’ve put time stamps on the saved version, thank you

[@adriennetravels]

I am so glad I am coming back to the states with my prescription from my Dermatologist in Nicaragua.

[@AutumnElaine]

Congratulations! 🎉❤😢🎉 Very much appreciate you!

[@j.indanight]

Hi, on accutane right now. It’s made my depression way worse. It definitely is a side effect

[@Grannysouth]

Thank you for providing such helpful information. I am just getting over an almost 3 week laryngitis. Glad we are both better!

[@Doctorly]

Me too!

[@jennifermajor5013]

Love y’all!!! So helpful and love watching you both on all platforms.

[@Dreamofjanae]

Hi Dr. Max! Missed you and happy anniversary ❤️

[@lharlow8044]

Dang it! I missed the live all so my husband could take me to the UT basketball game. Mrs. Maxwell, you’re a lucky lady.

[@Doctorly]

Which UT? Tennessee or Texas?

[@lharlow8044]

Texas. They aren’t even ranked…..I had to look that up.

[@lexijones8414]

I took Accutane in 1994 twice (I needed two courses.) It worked. HOWEVER, I lost a ton of hair that never grew back, my joints hurt, and it affected me emotionally. BUT it worked. Back then they really scared you too. I did everything for years, literally years, and nothing worked, but accutane.

[@CaffeineGirly]

Like me n maxfield were chatting...it was so good ✨❤️

[@ashleighmartinez8448]

Love these fact based videos! Thanks for all your useful information:)

[@thea-listtv312]

OH BOY I LIKE WATCHING THIS GUY TALK I DUNNO WHY.

[@mauriciolhc]

Here in Brazil we can get tretinoin(0,25 0,5 and 1 mg) without prescription and it’s really affordable last than $10 USD

[@Eff_It]

That answers one of the reasons Brazilians are so beautiful.

[@PassionPno]

Same here in Malaysia. It's less than US$10 a tube.

[@herstory4768]

In india, the cheapest tret 0.025% retails for less than $1. So yeah, as a student, I'm super lucky.

[@noufalshmri6529]

Hello doctor, I am from the Middle East and I am one of your biggest fans. I want to ask you to provide us with an Arabic translation of the videos so that we can understand the explanation and not make it difficult. Thank you

[@theoriginallacey]

My son was on accutane as a senior in high school. It mad his acne considerably worse, then eradicated it completely. Now he has Crohn’s, and I often wonder if it’s related.

[@maryamh3302]

Thanks for the efforts you guys putting into your videos it’s really informative. I learn things i didn’t learn in school!!!

[@memphis1201]

So much good information here. Thanks Doc.!

[@JWSanchez]

Accutane is a miracle drug. Im 32 amd my adult acne went haywire after my last pregnancy. For almost a year my doc tried everything. Hormones were regular but my skin just bever returned to normal. accutane cleared my cystic acne and helped normalize by super oily skin. This is so disheartening because accutane helped me so much.

[@desertrose4597]

Doctor you're amazing! Thank you so much for your efforts to help us.

[@courtneyderouen]

Jenna Rubis, Jennifer Byerly, and HotandFlashy/Angie all are channels here on YT that are great to watch if you’re going to use Tretinoin or any retinoids. I use it and they’re routines helped me learn watch to watch for and how to start out working it into my routine.

[@michellekelly2937]

I have very sensitive skin, and I'm able to use the Paula's Choice Intensive Wrinkle Repair Retinol Serum on my neck with no irritation or redness.

[@Pandalf82]

Congratulations on your Anniversary!

[@heckyesitsjess84]

Thank you so much for the free education. I am very thankful.

[@laurajean9999]

As you eluded, the “virtual” service you provide to the wider world of dermatology may be exposure to what persons “don’t know they don’t know”.

[@blastedgrandma1625]

Channel is so informative! Thank you for that but I was wondering if you can stress we do a morning routine and a night your favorite items

[@rae9072]

I’d love an update to the rosacea deep dive video! Please😭

[@michelekoupai]

it is interesting when you read the literature on other countries and why certain medications are/are not available here vs. there...

[@janetrodriguez5445]

So educational! Love it!!!

[@miamine3019]

There are so many online shops selling retinol in Bulgaria. I have seen also Tretinoin selling without prescription.

[@myrzamarilyslassus956]

You guys are the best.

[@JohnSmithh644]

Love your sharing such important information! These are all the things i want to learn when I go to the dermatologist, but instead my dermatologist just sells me hundred dollar otc products

[@justicepower1255]

Hi Doc, I'm currently on my 2nd treatment of Isotretinoin at 60mg and alternating with 80mg every other day. I'm in month 4 but my skin is already smooth like butter. My dermatologist said I need to finish my 6 months to avoid it coming back again. You see, I was on the medication in 2019-2020 and my acne went away but came back this year in September 2022. Started my isotretinoin this September 2022 on 20mg, October 40mg, November 60mg December 80mg and have 2 months to go. Only side effects I have are dry lips, joint pain, backache, dry throat, drowsiness, headache, loss of appetite, but not all at the same time. Love this medicine. Is it ok for me to use a face retinol in my skincare routine seeing as I'm on Isotretinoin? I'm just trying to get rid of the black spots left from my acne with the Cerave Resurfacing Retinol Serum. I know Isotretinoin is a gamechanger for me anyway even though it is my second treatment. I can deal with the side effects. I saw a woman nose bleeding so much from this medication.....it looked like a murder scene on CSI. I'm lucky to never ever get nose bleeds from Isotretinoin. Like I said this medication was a gamechanger for me.

[@Onyxamber]

Thank you for this! Would you suggest stopping Tretinoin if you have facial eczema?

[@IvanLing]

amazing content as always

[@gingertunstall7739]

I have used 0.1% tretinoin nightly for more than 35 years and my skin looks plumper and younger than my peers. I am 74 now and my thumbnail photo was taken 2 years ago. I have had no Botox or fillers because I have an autoimmune issue that makes injectables questionable.

[@shawnasomers9127]

You look fantastic Ginger! You inspire me to take better care of my skin! 😀

[@sleepifiy2096]

That's it! That is why i quit using tretinoin. There was research done and its conclusion had that many of them got some kind of respiratory problems or auto immune diseases.

[@ohokie4558]

@@sleepifiy2096 Hey yo bruh,read the comment again but this time with ur eyes open 😺

[@freshmacarons]

Thank you so much and the time stamps help!

[@anonymousperson4970]

I was on accutane during my last semester of university and it worked wonders to clear my skin. 3 years later to today, and I still struggle with acne but more manageable and I have a good (maybe great) skin care routine -- but why am i still struggling with acne at 27? Ive also come to notice that my skin flares up the most when I am experiencing higher levels of anxiety / stress... so frustrating. ( panoxyl 10% BP, 0.05 retin - A prescription, neutrogena hylauronic acid gel fragrance free and a fragrance free no BS moisturizer and Elta MD physical sunscreen. I also have a prescription for clindamycin BP gel when I need it) I sure hope this acne goes away as i continue to age

[@sharondelshad1749]

I love 💘 u dr Maxwell....HAPPY HOLIDAYS FOR YOU AND DR SHA 🎆🎇✨

[@primordialmeow7249]

Dr: Your RN here thinks you really shine in solo vids using your "patient teaching" mode. More q&a vids like this.

[@missOhdrey]

I'm on my 4th Accutane treatment (in 11 years). Side effects come and go but it's still the most effective acne medication out there. I know many people who only needed one treatment.

[@mariewiefel4542]

I love your videos! Can you look at Anteage products, stem cells and growth factors in skincare? It’s pretty expensive, is the science there?

[@nisey088]

Thanks for the time stamps!!!!!!!!

[@rivrox17]

I drink at least 4L of water a day and take fish oil with about 2.5g each of EPA and DHA, and my time on epuris (a brand of isotretinoin in canada) has been a breeze. Only noticeable "dryness" has been no need to wash my hair and dryness on the backs of my hands (which resolved itself quite quickly now my hands are soft as heck). I use vaseline lip balm all the time so my lips are not dry at all. I truly believe water and fish oil are CRUCIAL for isotretinoin use!!!

[@setapart9853]

I like watching your videos, so informative, can you do a video on how to remove moles on the face.

[@Doctorly]

We actually have shot a video about how moles are removed and I think it's like 3rd in line in our list to release. But spoiler, not a good idea at home

[@lubnan08]

Great information!!! THANKS!!!

[@rhondajansenvanvuuren392]

My oldest son (now 18) was prescribed Oratane as a Fifteen year old. It cured his acne. My younger son who has a history and is prescribed meds for depression and anxiety-was advised by his treating psychiatrist not to take Oratane. His acne is cystic Though. I spoke to my derm about it and he seemed frustrated by what the psychiatrist said and does not agree. I am unsure what to do?

[@vamptowngirl6922]

Try tretinoin. It's topical

[@a.t5140]

I also struggled to find retinoid in Bulgaria but recently it is available in Douglas for example.

[@lolgeselle]

What is your best suggestion / routine for hormonal acne on the chin??? Cleanser and moisturizer (I will be using differin as well)

[@hrhsophiathefirst4060]

Hi there, topicals have very little effect on hormonal acne but based on my derm's suggestions benzoyl peroxide wash, leave on skin for 5 mins three times a week, vitamin A product and a rich ceramide, triglyceride moisturizer. I do the benzoyl at night and a salicylic in the morning. Once a week I use lactic acid with no other products then top with moisturizer. For my hormonal acne I am on a 100mg spironolactone prescription which pretty much halted it.

[@anissa4334]

A KZbin channel called “ the honest channel “ talked about research around the long term use of retin A and why it may be beneficial to use it in short burst like 3 months and take a break etc., interesting study. I just switched back to adapalene because my pores looked more visible in my second year of Tretinoin.

[@josieshepherd2483]

What are 5 best retinol for anti aging that is not prescription?

[@SueZiegler-Greenleaf]

What about Accutane and ED in males? Ive read that it affects 30 percent of males and often permanent.

[@lindseycraig1023]

Merry Christmas from menorca!

[@cw3354]

He's so handsome!

[@kulverstuke1233]

Thats so informative

[@WaitingForTheSubway]

Uhmmmm..I did NOT know that benzoyl peroxide deactivates tretinoin!! I usually use tretinoin from curology AND benzoyl peroxide at night for acne. Then I use vitamin c and sunscreen in the morning. (Because you for sure can’t use benzoyl peroxide with vitamin c). So should I swap the vitamin c and the benzoyl peroxide? I have cystic acne, and I use all the hard-hitting acne ingredients.

[@Soso-ok8jz]

Acutane was the only medication that worked on my daughter. I wish we didn’t have to go thru other ways first before get to it for pit scars to form.

[@smiah7898]

I feel like I’m one of the very few people who had no results with accutane. Amazing skin whilst on it, skin back to full oiliness and therefore constant breakouts when off it. I’ve done two courses now and my skin has reverted back both times. I have taken the correct dosage for my weight and still have no real long term benefits despite being diligent with my skincare. I believe my oiliness is just too much for any medication to control. It may be hormonal but I also tried spironolactone with no success.

[@zahraahh61]

It maybe due to poor diet

[@smiah7898]

@@zahraahh61 it isn’t.

[@diva1675]

Aw man, i missed this? I told my aesthetician and dermatologist about you guys! I had some questions about light therapy for my vitiligo and what skincare i can use without burning myself. Vitamin C mask was a no! -learned the hard way.

[@cathywald4521]

I'm 65 & have developed a rash on my legs & arms that was diagnosed after skin biopsies as granuloma annulare. Over time, my skin Dr. has prescribed oral antibiotics, oral steroids, oral allergy pills & topical ointments containing steroids, the most recent being 0.03% Tacrolimus. Unfortunately, none of the foregoing have had much of an effect as far as improvement goes; in fact, the rash seems to be spreading. I was told that my rash is benign & I don't know what caused it to develop in the first place. Do you have any thoughts, suggestions, advice, etc. on any of this? Thanks!

[@Doctorly]

Unfortunately I can't offer any direct diagnostic or treatment advice but granuloma annulare can be very difficult. And like you mentioned, it often comes on randomly and although it's benign it can be so discouraging and nothing treats it consistently, especially when wide spread.

[@cathywald4521]

@@Doctorly Thanks for responding, Doc! I didn't expect that you could offer diagnostic or treatment advice but I wanted to touch base with you just to see what, if anything, you had to say about my problem.😊

[@KinniMoo]

I hate how some drugs are demonized more due to popularity than a difference in the side effect dangers. Unfortunately, due a wreck, age, and bad life decisions when it comes to exercise and nutrition, I take more than my share of meds. If I read all of the information that comes with my meds, I probably would throw it all away. I am all for requirements to tell patients about interactions and possible side effects but most of the ones listed are very unlikely so to publicize them in a way that makes it seems like they are likely. OTC Retinol is not for pregnant women but we don’t have to go through steps like we do with some other things. To discourage people from using something that are probably will treat not only severe acne, but also likely help them mentally because we all know kids can be cruel and they also live with the scars afterwards. I was caused pizza face and I only had slightly more than what I would consider normal teenage acne. Thank you for clearing up the reality. By picking a good dr, you can trust that you will get the info you need.

[@Doctorly]

Thank you so much for sharing your thoughts. I greatly appreciate that and couldn't agree with you more.

[@jc4626]

Hi Dr. Maxfield, Have you ever heard about megadosing Vitamin B5 Pantothenic acid? I have seen tons of videos on it and it might not have the crazy side effects of Acutane. Please let me know your insight? and thank you for your awesome videos!

[@jicokristobalcuadro2784]

Hi there. Quick question. Is it okay to use rejuvenating products while on isotretinoin medication of 10mg twice a week? Hoping to get an answer from these Doctors. Thanks!

[@sc9683]

Hi Dr 😊 Are you able to tell me how many days / weeks I can actually go without using tretinoin at all before I begin losing the tolerance I am building? How quickly does your skin forget?

[@eliziafajardo5249]

QUESTION!!!!! Have you ever looked into Good Molecules? I feel like it's similar to The Ordinary, but my skin takes better to Good Molecules than The Ordinary. But no one talks about it. 🤔

[@Sfren5336]

I've had dry skin which peels in winters naturally. But this winter, i've been using topical retinoids and have actually seen more oily skin (never seen that before, even in extreme heat). How is this happening? I always had whiteheads which are gone. Is this excess oiliness due to my pores unclogging?

[@micafisher3191]

I would looooooove a video on microbiome research because I've been using some probiotic products and I'm not sure if they really work (although it feels like they do?). And I've heard that retinoids could disrupt your microbiome. Thanks!

[@heidizeiler1269]

Thank you for sharing. I have been on tretinion 0.05% cream for over 2 yrs. Even after that amount of time im still having peeling around my nose and chin area. I have considered switching to differin since there are less side effects. Any suggestions on how to transition or should I continue both on alternate nights? Any feedback would be greatly appreciated. I am 48 mainly using for anti-aging but now that I'm wearing contacts (lol) I can see increased acne/hyperpigmentation under the skin. Also are there certain products best combined with differin?

[@rosalindaj5902]

I've been using tretinoin for more than 6months and I'm still breaking out when using it but it clears slowly my dark spot and slowly clear my skin,sometimes I want to quit using it. Do you think I'm allergic to it or it just takes time?

[@carlosurbina8252]

I’ve been on 7 months. Sometimes it seems like it’s working. Other times it seems it’s the cause of my issues. I was told by my derm to use nightly. I’ll keep using at least till my prescriptions run out. I would prefer tazorac. I used it as a teen and saw amazing results. Tretinoin gives me a nice glow and keeps me young but does nothing for breakouts or blackheads so far.

[@hrhsophiathefirst4060]

I have seen great success with a benzoyl peroxide wash in addition to the tretinoin, as recommended by the Maxfield as well. I use 3 times a week and let it sit on the face for 5 minutes.

[@rosalindaj5902]

@@hrhsophiathefirst4060 I'm using the Oxy cleanser with 10% benzoyl peroxide,it does help

[@pnwsaylorcolumbia8572]

I had to had to get on birth control before my dermatologist would give it to me. If I missed my depo shot I had to take a pregnancy test to ensure I wasn’t pregnant before taking the meds. I was 18 and was on it for 7 months; longer than he expected. I’m 44 now. I still get a doozy pimple now and again. I lost some hair too while on accutane. I gained weight but that could have been the birth control.

[@halyses34]

Thank you for the time stamps

[@candisk7368]

Such amazing information. I have a question about milia and how best to combat it. I 40 and need to use an eye cream for wrinkle prevention and also for hydration. When I do I get milia. Would using a retinoid based eye cream in conjunction with a hydrating one help? Alternating them every other day? Thank you ❤️

[@debbiethomas1524]

How do you feel about Estee’ Lauder skincare products

[@joanshealy1662]

Is store brand adapalene work as well as brand name differin?