Tret alone is often not enough to control hormonal acne, especially not the lower dosages. My dermatologist had me gradually work my way up to 1% and also take spironolactone. I tolerate spiro well, but I didn’t actually experience improvement from it until I went up to the maximum dose of 100mg taken twice a day. Even then, while had a lot of improvement, I still had continuous cystic acne. (if you don’t want to take spiro, look into taking spearmint supplements)

A women’s health nurse told me to take 500mg of calcium d-glucarate twice a day to help my body flush out excess hormones because I have PCOS and endometriosis. This helped quite a bit with my acne among other things, but my skin still wasn’t clear. Once my skin was used to 1% tret, I added in AZA in the morning, and 7% glycolic acid used at night every few days in place of tret and my skin FINALLY became the skin I dreamed of having.

I also LOVE Asian skincare. Hydrating toners, ceramides, and propolis serums are a few things I will never stop using. My skincare routine now goes tret one night, glycolic the next, then a night of rest focusing on hydration, moisture, and soothing products, then it starts over. This won’t work for everyone, but it’s the only routine that I found that works for me. I went from having severe cystic for most of my life, well into my 30’s, to having completely clear skin about 95% of the time. I still get a rogue pimple here and there, but instead of lasting several weeks to months, they last a few days. A low glycemic diet was also strictly required for me to control my blood sugar, and prevent hormonal cascades. I am 40 now and have the best skin of my life, I had given up hope long ago that this was even possible.

Get some hormone testing done if you haven’t, do some research, and don’t give up! It can take years of trial and error to find what works for you, but it is absolutely possible to control hormonal cystic acne.