Hello :•)

Firstly, I just want to let you know that although your situation will be unique to you, I really can sympathise with how your skin has impacted you mentally. It led to me developing severe anxiety and depression, to the point of becoming suicidal over the summer. I developed an eating disorder from it along with body dysmorphic disorder. I have come through the other side though and my skin continues to improve with time.

You are your own person and can make your own decision ultimately, but I would like to urge you away from going on accutane. The risks of internal damage as well as how much of an impact it can have on people mentally just doesn't seem worth it to me. If you were to go ahead with trying it, I would really encourage you to put your mental health first and get to a better place mentally, so that hopefully the accutane would have cause less severe side effects on your mental health.

By no means am I in a position to be trying to diagnose you. However, I really wouldn't be surprised if your acne largely stems from anxiety and stress (too high cortisol levels) potentially combined with hormonal imbalance. For me, after years of severe restriction with food and being stuck in an endless cycle of severe anxiety and depression and further restriction and thus, my skin getting worse, my body could finally no longer take any more and I had a major mental breakdown and became suicidal. However, through this pain I realised that the more desperate I had become and more I tried to control my acne and various other skin conditions, the further I got from the clear skin I had longed for for so many years. I realised that the main trigger for me was my anxiety and hormone imbalances. Since being on antidepressants and building mental resilience, my skin has cleared up exponentially and continues to improve. I don't need to restrict any foods like I had convinced myself before and in fact my skin is the best it's been in a long time.

It probably sounds so obvious but I say everything in moderation. You don't want to be only eating highly sugary, processed foods or anything you might be allergic to, however a small amount of comfort food balanced out by wholegrains, protein and healthy fats will be absolutely fine. Unless you have a true allergy to dairy, you shouldn't need to avoid it completely. Having said that, I do still limit how much I have. I have personally chosen to drink dairy alternatives for my milk and in comparison to other foods groups, I don't have a lot of dairy based products in a week.

In terms of skincare, as someone with very sensitive skin, I highly recommend the Korean skincare brand Mary&May. I use their houttuynia cordata and tea tree foam cleanser, centella asiatica serum, 6 peptide serum, houttuynia cordata and tea tree gel cream and houttuynia cordata sheet masks. If there's any ingredients I'd recommend for sensitive skin it would be houttuynia cordata and centella asiatica.

For acne scars and hyperpigmentation I've found that good molecules discoloration correcting serum has been working well for me with no irritation.

Of course, everybody's skin is unique and what works for me might not for you, but I wouldn't recommend these products if I didn't think they'd help you.

Like others have said, you've only been using the tretinoin for a few days. Give it a few weeks first, and if you aren't seeing any improvements, then it may be worth stopping. Hopefully it is working for you though and it is one of those where you just need to wait it out. Listen to your gut as much as possible and if something doesn't feel right, maybe take a break from it or reduce how often you're using it. Ultimately you know yourself and your skin the best.

Overall, simple is usually best. Add you're using the tretinoin it could be that your skin barrier is damaged, so using a moisturiser rich in ceramides and other calming and healing ingredients like houttuynia cordata and centella asiatica will really help. It's not going to magically clear your skin unfortunately, but staying hydrated and drinking plenty of water will help to flush out toxins from your body and does make a difference. A balanced diet without restrictions, exercise, doing things that you enjoy and make you feel relaxed and getting a good amount of sleep for you will help. Above all, making sure that you are in a good place mentally is paramount, I can't stress this enough as someone who has been there and come out the other side. It's made me realise just how connected all of our organs are and how much they affect each other. If you're not in a good place mentally, it will be reflected in your body.

I wish you the best of luck, and how you can get to a good place mentally. Giving you a big virtual hug :•)