CASE CLINIC: Acne Progression, Texture & Treatment Fatigue

A Reddit user recently shared their skin journey after starting tretinoin and spironolactone for persistent acne, congestion, post-inflammatory pigmentation, and overall skin texture concerns.

While they’ve seen progress over time, they’re still navigating:
• lingering breakouts
• barrier sensitivity
• texture irregularities
• post-acne marks
• treatment frustration and inconsistency concerns

It’s sparking a really interesting conversation around treatment expectations, skin cycling, patience with prescription therapies, and knowing when professional guidance may be needed 👀

If this client walked into your treatment room today…

🔍 What would you assess first?
🧴 Would you focus on barrier repair, acne management, pigmentation, or all three?
⚡ How would you approach professional treatments alongside tretinoin use?
📅 What would realistic expectation-setting look like for this client?

We’d also love to see more professional voices represented in skincare conversations online 💬

If you’d like to join the Reddit discussion and offer supportive professional insight, you can find the thread here:
https://www.reddit.com/r/tretinoin/comments/1tja0li/skin_progression_on_tretinoin_and_spironolactone/

Then come back and share how YOU would approach this case professionally 👇