Nine Weeks of Retinol Purge and a $190 Dermatologist Bill

Thirty-one bumps. I counted them at 6:45 on a morning in late March, day 12 of a new retinoid, tipped toward the mirror in my office bathroom with the fluorescent tube buzzing overhead, tapping each one with a fingertip so I would not double-count. The light in that room forgives nothing. Jawline, chin, the lower half of both cheeks, and a cluster of nine under my left ear that had not existed in February.

The calendar made it worse. A panel talk was set for April 16 in front of maybe 200 people, an anniversary dinner followed on May 2 with $600 photographers, and my face was shedding and breaking out at the same time. My whole budget for the experiment had been $13.99, the price of the Differin tube at the Walgreens on Sixth Street, and at 36 years old I was not prepared for the tube to fight back. The cheap part was the slight part.

The detail that kept me goin' was printed on the carton. Second-to-last line. Warnings panel. The purge, whatever the tube wanted to call it, apparently had a paper trail, and I had quit the treatment once before reading to the bottom of my own box.

day 9, the drawer

Day 9 was when I quit the first time. I had stopped counting bumps and began counting days, which is a worse habit, and the tube went into the drawer under the sink next to a crusty Bare Minerals concealer from 2021. That night I read the carton end to end, mostly outta spite. One line, in type the same size as the batch number: acne may appear worse during the first weeks of treatment. It had cost me a week of confidence to find, and it was the only sentence on that box that had ever applied to me.

week three, the jawline mutiny

April 2 was the peak. I have the photos, forty-one bumps on the count, up from thirty-one, with two of them cystic and deep enough to feel when I raised an eyebrow. I wore my hair down to a spring board meeting like a teenager hiding evidence, and my sister-in-law the nurse talked me off the ceiling that Sunday with one question: did I want the skin I had in February, or the skin the tube promised by July. Restarting after three nights off was the hardest part of the entire process, harder than the bumps.

the $190 sixteen minutes

Sixteen minutes, $190. Dr. Imani Osei at Lakewood Dermatology saw me on May 6, self-pay, cuz my plan treats dermatology like a luxury good. She looked at the jawline for about forty seconds, asked four questions, and said the word purge out loud like a diagnosis, which is what it is. Her fix was not a prescription and not a product. It was a schedule: apply the Differin, leave it on thirty minutes, wash it off, moisturize, every third night for two weeks. She drew the whole thing on a sticky note from her desk and said the words short contact therapy like she was handing me a key.

the timer on the sink edge

The sticky note went on my mirror and the phone timer did the rest. Thirty minutes of wear, lukewarm rinse, then Vanicream from the same Walgreens run, $12.97 for the tub. The tub will outlive me. Every third night became every other night by week 7, the cystic ones stopped being new by week 8, and the count in my phone notes went forty-one, thirty-six, twenty-nine, twenty-two, a stock chart I was finally glad to read.

forehead first, jawline last

The forehead cleared first, around week 9, then both cheeks, and the jawline held out like it had a personal stake in the matter. Week 11 the under-ear cluster finally flattened. What replaced the bumps was smooth in a way my skin had not been since my twenties, with the pores on my nose visibly tighter in the Sunday photos, and the texture payoff everybody promises turned out to be real. It just showed up six weeks later than anyone on the internet admits.

the May 2 dinner, week 8

The anniversary dinner fell at week 8 exactly. Dead center of the ugly middle, and I went with heavy powder and eleven visible marks while $600 photographers shot everythin' wide. I look puffy in every photo from that night. I have kept two of 'em on purpose, cuz week 8 is the honest midpoint of this story, the before to everything that came after. The April 16 panel had gone the same way: blazer, slides, confidence, and a jawline I refused to look at in the hotel ballroom mirror.

week 14, zero

Week 14 landed on a Tuesday in early June, and the count came up zero. Not one bump, jawline included, under the same fluorescent tube at 6:45 in the morning, same mirror, same fingertip method. Total spend by then: $13.99 for the tube, $12.97 for the moisturizer, $190 for sixteen minutes with Dr. Osei, and one month of nerve I nearly lost at day 9. The Differin tube still holds a third of its 15 grams. Some mornings I count out of habit. The count stays at zero.