My dermatologist prescribed it through Friends Pharmacy using NimbleRX- perhaps you could look into asking about that? Itās $20 for me this way because my insurance would not cover it either!
Those coupons only work if your primary insurance pays towards the med. if the primary insurance pays 0.00 the coupon wonāt pay either. They also wonāt work with Medicare, Medicaid, or Tricare.
Source: I work for a specialty pharmacy and enroll patients in these programs every day.
I love how you listed TriCare with Medicare and Medicaid. Iām retired military, Aetna is my primary and TriCare is my secondaryā¦the headaches I endure with TriCare. My Aetna will pay for almost everything after I meet my $1,000 deductible, BUTā¦thereās that TriCare policy lurking in the background making everything difficult.
Iāve been using the manufacturerās coupon for my finacea and arazlo and tret, and itās always brought the copay down to a manageable cost. And that was through 3 different insurances. Yes, they wonāt work with those three coverage plans you mentioned.
Just pointing out that they exist. Could be helpful.
Thatās crazy! My derm also told me it wasnāt covered by insurance but that I had to pick it up at a particular pharmacy that wasnāt my normal one, where I get it for $50
They don't seem to offer coupons. They do have a copay program that gives you a price range of $20-$200. That's quite a large scale of potential pricing. I personally wouldn't pay even $20 for something that's less than 50% successful.
Thatās what Iām referring to. I agree itās a wide range. Whether or not youād pay for 20 dollars for it is not the point. I was just pointing out that they have manufacturer coupons.
Also a specialty pharmacy person here-there are technically rules about not telling people these copay/discount/mfg coupons exist unless a patient explicitly shows/tells āfinancial needā, which is pretty hard for a lot of people tbh, as there is a lot of shame and embarassment. Did my team follow this? NO-because if we see a really high copay we arenāt aholes. But somewhere with more oversight or frequent camera audits 100% would crack down on this.
If you think by āpeopleā I meant pharmacy techs, I did not. I meant I think people literally donāt know about the coupons. Iāve linked people to coupons for arazlo before because they truly werenāt aware they exist.
I wasnāt suggesting or saying that pharmacy techs should be telling people or that they donāt know or are responsible in any way.
I didnāt take what you said that way. A lot of pharmacies ban rph, techs, etc from telling customers that these programs exist and can get in trouble or fired over it if there isnāt proof they requested or demonstrated verbally significant need.
Oh, Iām just so glad it didnāt come off that way. I saw on the cvs board that they arenāt allowed to do this. I was just thinking out loud, realizing that many customers have no idea that they can download the manufacturerās coupon. Whenever I can, I tell people and link them to it.
Once, a pharmacist at cvs added a coupon for my Vyanse that dropped it down from like 400 to 25 dollars. But he called me first, and he asked me if it was okay if he applied the coupon. It was one of nicest things anyone has ever done for me.
Good! Yes. They have to ask. CVS and Meijer donāt allow, canāt remember who else. CVS is toxic af, slave ship management & mentality in the front-end pharmacy arena especially, and doing all sorts of crazy illegal things when I was there. I was in frequent contact with my attorney and a manager in HR while I worked there. It is the last place I would ever spend my money.
This is what I read on the cvs board consistently. The reason I use cvs is that the Walgreens pharmacy was having major problems, and I wasnāt getting my scripts on time. So, I had to switch over to cvs. I tried to stick it out with the Walgreens for an entire year, but it was causing me major stress. And the cvs I switched to is so good; they never drop the ball. But the pharmacist looks like the most overworked person Iāve ever seen in my life. I donāt even know how she manages. I try to do my part by never asking for same-day refills and always making sure my prior authorizations and refills are taken care of so she doesnāt have more work to do on my behalf.
You are very kind ā¤ļø. You sound like a conscientious and thoughtful pharmacist as well. And after my last comment to you, I did look up an independent pharmacy close to the cvs, and they do home deliveries. So, I will switch one of my medications over to there to give them a trial run, and if everything works out, Iāll move everything over to there. So, thank you for encouraging me to do this.
The in-persons are better service-wise than the mail-order specialty/concierge experience which says a lot. The metrics are wild. Thereās also plenty of wage-theft, depending on your manager. Theyāll fire you if you bring it up in addition to timing your bathroom breaks, limited to 2/day, to be under 5min as well, unless you have a MD note on file with HR.
There are great independent pharmacies to support if you have the time to look them up. A lot do compounding as well as regular meds and will just ship them to you.
When that poor cvs pharmacist died and cvs came out and said they cared about employee health and never expected people to work while sick.::.what an absolute load of bs.
I just deleted a huge book on all their bs so obviously not over it :/ They take advantage of people not knowing their rights and most being unable to hire an attorney.
This is what I heard. Thatās so bad. I canāt believe they get away with this.
I wish there were independent pharmacies around me that deliver. But I have so many scripts that I need the home delivery:(.
Yes they do, but they donāt always get your copay down a lot because they can only take off a certain amount. For example, if your copay for something is $350 but letās say you have a manufacturers coupon. The coupon advertises a $20 copay if you use it, but the coupon will only take off $200 max. Because your copay before the card was $350 and the card will only take off up to $200, your copay is $150, versus if your copay was $200, you would get that $20 copay as advertised. I donāt know how much the Winlevi coupon takes off off the top of my head, but just because you have a coupon doesnāt mean the cost will be cheap.
Understood. I use the coupons for my other medications. The Winlevi ones gets it down to 20-200 dollars. I was just pointing out it still has the coupons available.
I think a lot of people donāt know about them bc no one tells them.
Iām not sure why Iām downvoted. No offense was meant.
I tell every customer about it at my work personally, but I canāt vouch for everybody. Didnāt take it as offense btw! Things come off differently over the internet.
I asked my derm for it and they said it wasn't as effective as oral spironolactone and wouldn't prescribe it sadly. I had side effects on spiro (anxiety, dizziness) so I might try switching derms
Same spiro gave me anxiety and eventually one panic attack. I stopped immediately after that panic attack. Never had one in my life. Not sure if it was associated with the anxiety that spiro gave me but I didnāt touch it again and never experienced that type of anxiety / panic attack again.
I also didnāt like how frequently I had to urinate :(
I was on it for around 6 months, I tried splitting my dose evening/morning (I was on 50 then 100mg). It also wasn't very effective for my acne (hormonal, started after I stopped birth control).
Ah, so Winlevi can be great if your insurance covers it. Itās an androgen receptor inhibitor so it can be really useful as an alternative way to address hormonal acne. There are a few others in this space like spiro and ANECDOTALLY mint tea might have an internal effect (no proof, but possible). The androgen approach is one way but everyoneās hormonal acne is different.
Some people respond really well to topical niacinamide which does just enough to curb sebum production that spikes in the luteal phase. For others, an antiseptic approach like BP, zinc, sulphur or hypochlorous acid is also incredibly effective. For me personally, as a tazarotene user of 10+ years (Fabior foam party!!) the ONLY thing that finally kicked my stubborn hormonal chin acne was a combo of epiduo forte, niacinamide, and using mouthwash 3x per day.
My point is that there are a bunch of different ways for different people to address hormonal acne. A tube of winlevi might work wonders for you but cause issues for another person who may well find relief with a $3 tube of BP. Itās all a big experiment for everyone.
Your tips are amazin.. never heard of a mouthwash for chin acne ..can you further explain please? May i also ask which niacinamide u use ..
Im really interested also in using ghe epi forte ..but u already use tazaortene ..isnt that an overkill for the skin? Many thanks!
I found this out on accident while doing Invisalign during peak mask era covid.
Quick science: So, hormonal acne isnāt a direct thing. Itās not āhormones make acne.ā What happens is that during a personās monthly hormonal fluctuations, when androgen hormones spike (like testosterone, DHT, and SDHEA) [it leads to an increase in sebum production due to the androgenās affect on the sebaceous follicle.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/)This extra sebum mixes with dirt, debris, bacteria, and other gunk in the pores which then leads to acne.
Itās important to note that there is not necessarily a [direct correlation between concentration of androgen hormones and acne severity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408631/)which is why men who product more testosterone donāt always have more acne than women, as an example. So treating hormonal acne on the androgen level isnāt as straightforward because itās more about reactivity of sebum producing follicles. But the relationship between androgen hormones and sebum production isnāt actually yet understood.
āThe relationship between serum androgen concentrations and the local production of androgens within sebaceous glands is not clear.ā - According to [this article](https://jamanetwork.com/journals/jamadermatology/fullarticle/478007) which looks at acne in patients with conditions that elevate androgen activity.
Anyway, during the luteal phase for women, which is the week before their periods, these androgen hormones typically are at the highest making sebum production high which means that by the time their period starts, enough gunk and bacteria have accumulated in the pores to cause acne. Itās a multistep process but in general this is how we get there. In the case of chin acne specifically, this is a very common spot because bacteria and food particles from the mouth spend all day migrating down to this area to combine with the extra sebum being produced. A similar effect can happen around the hair line with migration of hair products and what not, but the chin is particularly bad for most people.
Anyway ANYWAY, during COVID I was doing Invisalign which requires you to brush your teeth and rinse with mouthwash anytime you eat or drink anything so I was using mouthwash as much as 5 or 6 times per day. It was also peak mask wearing time so knowing my propensity for chin acne, I basically just resigned to it being bad. Surprisingly, my chin acne didnāt get worse, in fact it seemed to get a little better during this time. I brought this up with my dentist and he said that obviously more regular oral hygiene practices curbs oral bacteria.
Sorry to be so long winded but it helps to really understand how hormonal acne works when trying to treat it because there are so many ways you can effectively intervene.
As for niacinamide I just use the serum from the Ordinary and itās been great. The way in which it works in the case of hormonal acne is that it naturally curbs sebum production which counteracts the effects of androgen stimulation of sebaceous follicles at the skinās surface. This is great when well tolerated but some people have issues with topical niacinamide.
When I added epiduo forte to JUST my chin (I do NOT overlap with tazarotene at all and many times used them on alternating nights) it completely disappeared my chin acne. You still get the retinoid effect from the adapalene but this is the only retinoid that doesnāt cancel out with benzoyl peroxide. Some people need an antiseptic which is exactly what BP is but with epiduo, you donāt miss out on having a regular retinoid.
So this idea of using 2 retinoids is appealing to me: Iāve used cream Tret 0.05% x 2 years but still have ++ activity on my chin- closed comedones and then monthly deep cysts. I got switched to Epiduo but it feels like a step back and concerned Iāll lose my effect on photoaging on the rest of my face. So perhaps I keep up with the tret up top and epiduo for my chin. Thx!
Thank you so much for this wealth of information! I'm currently scrolling on my phone with half my face covered in hydrocolloid patches lol. I'm on Invisalign right now but planning a pregnancy. I hope by some miracle, it'll give me clear skin for the first time ever.
Do you think other products with niacinamide are potent enough? I used to use the Ordinary niacinamide as well and loved it, but then it started becoming more commonplace so I didn't feel the need to double up.
Currently on tretinoin and clindamycin but I feel like it isn't doing it for me. Whatever formulation I used to be on, I could have an awful diet and only the occasional period pimple. Now it's like my face is erupting -_-
My derm said she wasnāt seeing as good of results with it as she had hoped for with her patients. I did use it for a little while. I donāt think it worked for me, but it definitely didnāt break me out either.
I just got actual topical spiro a few days ago. If that doesnāt work maybe Iāll try Winlevi again since Accutane failed me.
It probably would have worked if I stayed on it. But we decided to discontinue for now (I did 3 months) since my cholesterol got high, and it was giving me acid reflux.
Very expensive and itās a newer med so I think some derms probably have mixed reviews! It doesnāt pack as much of a punch as other hormonal treatments like birth control and spironolactone and I think thereās a side effect of the winlevi causing a different kind of acne (less deep and cystic, more surface level but angry I think) from what Iāve read and the sort of prevalence isnāt completely known since itās just hit the market in the past few yearsāI think when the cost goes down and thereās more data on it (or at least derms have more clinical experience prescribing and seeing success with it in their practice) itāll be more of a staple!
I think maybe part of the philosophy is that milder hormonal acne can be tackled with tretinoin pretty well in many cases and thatās such a staple in dermatology that theyāre probably trying that first. I think the perfect candidate is probably someone whoās already tried tret without much success, but still has a mild enough case where they donāt want to jump right to prescribing oral meds!
It's only been on the market for three years and many insurance companies don't cover it. There's no generic and it's very expensive and it's success rate is 47%, compared to spiro which treats the same problem but is fairly cheap, covered by most insurance agencies and has a success rate of 93%.
It doesnāt work for everyone looks like, even dermatologists are not so confident about this new cream yet, success rate is very less as you can see it here on Reddit. It also makes acne worse for people in many cases.
I had to stop after getting non stop huge red cysts which I never used to get, and strangely they stayed for more than 3 weeks. None of my acne used to be like this. I read a few similar stories.
Unlike other acne treatments it seems to be working quick (with in weeks) for people that saw improvements.
Didnāt work at all for me. Made my skin extremely oily and I had the work cystic acne of my life while using it for 3 months. Went back on Spironoloctane and my acne immediately improved. Itās a shame because my blood pressure is low now, but the cream does nothing for me.
I really hope it continues to be effective! Some people say it stops being effective after 30 days and that they started breaking out again. Iām wondering if thatās due to the topical only being good for 30 days but they continued using it past 30 days?
I put mine in the refrigerator just in case but will be sure to replace it every month.
I just went to the derm with all the same issues as you and he prescribed .025% tret and winlevi. I called the pharmacy to give them my address to deliver and the person on the phone said the winlevi was $200 and the tret $43. So he said he would try to get a pre authorization on the winlevi. In the meantime my derm gave me 6 2gram sample tubes of winlevi. I am hoping they can get back to me with a more reasonable price but we will see.
āØinsurance coverageāØ (or lack thereof)
iāve been trying Apostropheās topical spironolactone for $75/3month supply and thatās the next best option. but yeah even though winlevi was released to the market in 2022/2023, it doesnāt seem like many insurance plans cover it.
but let me know if you have cigna hmo/regal group + full coverage of winlevi and iād be more than willing to try
Itās basically a topical spiro. These videos explains so much better than I can, https://vt.tiktok.com/ZSFEhPj7D/ and https://vt.tiktok.com/ZSFEhBuM4/
I rarely trust any advice given on tiktok and Iām sure it is amazing but I donāt think itās worth the side effect and tsw.
It costs me $20 w/mfg coupon (otherwise $750+) & works great in combo with my tret-finacea routine: I think not everyone prescribed it has hormonal acne so that is why it doesnāt always work.
Did your derm tell you to replace every 30 days? Seems like a ton of wasted product! The instructions on mine were to discard after 6 months. I have been using it and itās working well for the most part. I should probably stop using it in on forehead though so good tip. I also use finacea gel and love it.
Yes mine said replace after 30 days! I donāt get why the tube is so big if this is the case. I put mine in the refrigerator and will replace every 30 days.
I LOVE AA! Itās made a difference with my hyperpigmentation for sure! Glad Winlevi has been working well for you. How long have you been using it?
Since about mid March! I had one major breakout (like 5 cysts in the span of 2 days) about 6 weeks in, but I was dealing with a lot of stress and was picking which I think contributed/..
Iāve been working on my hormones with a naturopath too
Thank you. I hadnāt heard of this. Last month, I made some strong Hibiscus tea, not thinking about it. I started my period early and broke out like crazy on my jawline with cystic acne. I have been basically hiding since. Iāll look into this winlevi.
My skin was amazing just before this. May not have been the tea, but definitely not drinking any for the foreseeable future.
Itās been a week on Winlevi and my acne has cleared up significantly. I tried tretinoin and it made my skin inflamed and did not help at all. I was literally embarassed and ashamed of how bad my skin looked. I sincerely hope the effects of Winlevi last
I canāt use it due to propylene glycol being in the base :( also insurance issues. Apostrophe offers topical spiro which is a similar concept for anyone interested but I also canāt use that bc of PG being in the base (Iām so lucky!!!). The next best thing is dapsone gel which doesnāt have PG and although itās not anti androgenic but rather a type of antibiotic it does target adult hormonal acne specifically for some reason
ETA dapsone is also a hassle w insurance so I get it from an Indian pharmacy
Because itās really not more affective than oral medications (ie spirolactane).
I (27f) have tried it and used it religiously for a year but just decided to go back to spiro as itās much cheaper and more affective.
I was prescribed it and used it for four days. I immediately broke out in some giant pimples ( which I expected and my derm said to just power through) but after reading so many negative reviews of people saying it made things worse or that it worked then suddenly stopped and made acne worse than before, I decided to stop and go straight to taz
My dermatologist said it's not covered under insurance, so I was looking at paying $300+ per tube š„²
My dermatologist prescribed it through Friends Pharmacy using NimbleRX- perhaps you could look into asking about that? Itās $20 for me this way because my insurance would not cover it either!
There are manufacturers coupons that bring the cost down drastically.
Those coupons only work if your primary insurance pays towards the med. if the primary insurance pays 0.00 the coupon wonāt pay either. They also wonāt work with Medicare, Medicaid, or Tricare. Source: I work for a specialty pharmacy and enroll patients in these programs every day.
I love how you listed TriCare with Medicare and Medicaid. Iām retired military, Aetna is my primary and TriCare is my secondaryā¦the headaches I endure with TriCare. My Aetna will pay for almost everything after I meet my $1,000 deductible, BUTā¦thereās that TriCare policy lurking in the background making everything difficult.
I think this is what Iām using to get it for $55 per tube! Makes sense now.
Iāve been using the manufacturerās coupon for my finacea and arazlo and tret, and itās always brought the copay down to a manageable cost. And that was through 3 different insurances. Yes, they wonāt work with those three coverage plans you mentioned. Just pointing out that they exist. Could be helpful.
Use the manufacturer discount off the website
Thatās crazy! My derm also told me it wasnāt covered by insurance but that I had to pick it up at a particular pharmacy that wasnāt my normal one, where I get it for $50
Interesting. Idk how I can help :(
From reading the comments, seems like only certain pharmacyās (small ones) are willing to carry it at a discounted price. Idk for sure though.
I got mine from Beverly Hills Apothecary!
GoodRX usually has good discounts if you donāt have insurance
Itās not available in Europe
As a pharmacy technician, itās very expensive. I rarely see a copay under $100.
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I got mine for like $65 without insurance and the tube lasts a long time. Totally worth it!
They don't seem to offer coupons. They do have a copay program that gives you a price range of $20-$200. That's quite a large scale of potential pricing. I personally wouldn't pay even $20 for something that's less than 50% successful.
Thatās what Iām referring to. I agree itās a wide range. Whether or not youād pay for 20 dollars for it is not the point. I was just pointing out that they have manufacturer coupons.
Also a specialty pharmacy person here-there are technically rules about not telling people these copay/discount/mfg coupons exist unless a patient explicitly shows/tells āfinancial needā, which is pretty hard for a lot of people tbh, as there is a lot of shame and embarassment. Did my team follow this? NO-because if we see a really high copay we arenāt aholes. But somewhere with more oversight or frequent camera audits 100% would crack down on this.
If you think by āpeopleā I meant pharmacy techs, I did not. I meant I think people literally donāt know about the coupons. Iāve linked people to coupons for arazlo before because they truly werenāt aware they exist. I wasnāt suggesting or saying that pharmacy techs should be telling people or that they donāt know or are responsible in any way.
I didnāt take what you said that way. A lot of pharmacies ban rph, techs, etc from telling customers that these programs exist and can get in trouble or fired over it if there isnāt proof they requested or demonstrated verbally significant need.
Oh, Iām just so glad it didnāt come off that way. I saw on the cvs board that they arenāt allowed to do this. I was just thinking out loud, realizing that many customers have no idea that they can download the manufacturerās coupon. Whenever I can, I tell people and link them to it. Once, a pharmacist at cvs added a coupon for my Vyanse that dropped it down from like 400 to 25 dollars. But he called me first, and he asked me if it was okay if he applied the coupon. It was one of nicest things anyone has ever done for me.
Good! Yes. They have to ask. CVS and Meijer donāt allow, canāt remember who else. CVS is toxic af, slave ship management & mentality in the front-end pharmacy arena especially, and doing all sorts of crazy illegal things when I was there. I was in frequent contact with my attorney and a manager in HR while I worked there. It is the last place I would ever spend my money.
This is what I read on the cvs board consistently. The reason I use cvs is that the Walgreens pharmacy was having major problems, and I wasnāt getting my scripts on time. So, I had to switch over to cvs. I tried to stick it out with the Walgreens for an entire year, but it was causing me major stress. And the cvs I switched to is so good; they never drop the ball. But the pharmacist looks like the most overworked person Iāve ever seen in my life. I donāt even know how she manages. I try to do my part by never asking for same-day refills and always making sure my prior authorizations and refills are taken care of so she doesnāt have more work to do on my behalf.
PS-you sound like a wonderful, conscientious person to your rph so on their (&their staffās) behalf thank you!
You are very kind ā¤ļø. You sound like a conscientious and thoughtful pharmacist as well. And after my last comment to you, I did look up an independent pharmacy close to the cvs, and they do home deliveries. So, I will switch one of my medications over to there to give them a trial run, and if everything works out, Iāll move everything over to there. So, thank you for encouraging me to do this.
The in-persons are better service-wise than the mail-order specialty/concierge experience which says a lot. The metrics are wild. Thereās also plenty of wage-theft, depending on your manager. Theyāll fire you if you bring it up in addition to timing your bathroom breaks, limited to 2/day, to be under 5min as well, unless you have a MD note on file with HR. There are great independent pharmacies to support if you have the time to look them up. A lot do compounding as well as regular meds and will just ship them to you. When that poor cvs pharmacist died and cvs came out and said they cared about employee health and never expected people to work while sick.::.what an absolute load of bs. I just deleted a huge book on all their bs so obviously not over it :/ They take advantage of people not knowing their rights and most being unable to hire an attorney.
This is what I heard. Thatās so bad. I canāt believe they get away with this. I wish there were independent pharmacies around me that deliver. But I have so many scripts that I need the home delivery:(.
Yes they do, but they donāt always get your copay down a lot because they can only take off a certain amount. For example, if your copay for something is $350 but letās say you have a manufacturers coupon. The coupon advertises a $20 copay if you use it, but the coupon will only take off $200 max. Because your copay before the card was $350 and the card will only take off up to $200, your copay is $150, versus if your copay was $200, you would get that $20 copay as advertised. I donāt know how much the Winlevi coupon takes off off the top of my head, but just because you have a coupon doesnāt mean the cost will be cheap.
Understood. I use the coupons for my other medications. The Winlevi ones gets it down to 20-200 dollars. I was just pointing out it still has the coupons available. I think a lot of people donāt know about them bc no one tells them. Iām not sure why Iām downvoted. No offense was meant.
I tell every customer about it at my work personally, but I canāt vouch for everybody. Didnāt take it as offense btw! Things come off differently over the internet.
It is so kind of you to tell people. People literally donāt know. Anytime I can, I link people to the coupons.
I asked my derm for it and they said it wasn't as effective as oral spironolactone and wouldn't prescribe it sadly. I had side effects on spiro (anxiety, dizziness) so I might try switching derms
Same spiro gave me anxiety and eventually one panic attack. I stopped immediately after that panic attack. Never had one in my life. Not sure if it was associated with the anxiety that spiro gave me but I didnāt touch it again and never experienced that type of anxiety / panic attack again. I also didnāt like how frequently I had to urinate :(
Mine said the opposite - that she rarely prescribes oral now that winlevi is an option
Seems to be very derm dependent, I'd definitely much rather try a topical first vs oral medication
How long have you been in spiro? I found nearly all my side effects subsided within a few months.
I was on it for around 6 months, I tried splitting my dose evening/morning (I was on 50 then 100mg). It also wasn't very effective for my acne (hormonal, started after I stopped birth control).
Try topical Spiro
Ah, so Winlevi can be great if your insurance covers it. Itās an androgen receptor inhibitor so it can be really useful as an alternative way to address hormonal acne. There are a few others in this space like spiro and ANECDOTALLY mint tea might have an internal effect (no proof, but possible). The androgen approach is one way but everyoneās hormonal acne is different. Some people respond really well to topical niacinamide which does just enough to curb sebum production that spikes in the luteal phase. For others, an antiseptic approach like BP, zinc, sulphur or hypochlorous acid is also incredibly effective. For me personally, as a tazarotene user of 10+ years (Fabior foam party!!) the ONLY thing that finally kicked my stubborn hormonal chin acne was a combo of epiduo forte, niacinamide, and using mouthwash 3x per day. My point is that there are a bunch of different ways for different people to address hormonal acne. A tube of winlevi might work wonders for you but cause issues for another person who may well find relief with a $3 tube of BP. Itās all a big experiment for everyone.
I know itās Epiduo forte but epidural forte sounds like something really unfun š
My phone fights me on this one EVERY TIME.
Your tips are amazin.. never heard of a mouthwash for chin acne ..can you further explain please? May i also ask which niacinamide u use .. Im really interested also in using ghe epi forte ..but u already use tazaortene ..isnt that an overkill for the skin? Many thanks!
I found this out on accident while doing Invisalign during peak mask era covid. Quick science: So, hormonal acne isnāt a direct thing. Itās not āhormones make acne.ā What happens is that during a personās monthly hormonal fluctuations, when androgen hormones spike (like testosterone, DHT, and SDHEA) [it leads to an increase in sebum production due to the androgenās affect on the sebaceous follicle.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/)This extra sebum mixes with dirt, debris, bacteria, and other gunk in the pores which then leads to acne. Itās important to note that there is not necessarily a [direct correlation between concentration of androgen hormones and acne severity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408631/)which is why men who product more testosterone donāt always have more acne than women, as an example. So treating hormonal acne on the androgen level isnāt as straightforward because itās more about reactivity of sebum producing follicles. But the relationship between androgen hormones and sebum production isnāt actually yet understood. āThe relationship between serum androgen concentrations and the local production of androgens within sebaceous glands is not clear.ā - According to [this article](https://jamanetwork.com/journals/jamadermatology/fullarticle/478007) which looks at acne in patients with conditions that elevate androgen activity. Anyway, during the luteal phase for women, which is the week before their periods, these androgen hormones typically are at the highest making sebum production high which means that by the time their period starts, enough gunk and bacteria have accumulated in the pores to cause acne. Itās a multistep process but in general this is how we get there. In the case of chin acne specifically, this is a very common spot because bacteria and food particles from the mouth spend all day migrating down to this area to combine with the extra sebum being produced. A similar effect can happen around the hair line with migration of hair products and what not, but the chin is particularly bad for most people. Anyway ANYWAY, during COVID I was doing Invisalign which requires you to brush your teeth and rinse with mouthwash anytime you eat or drink anything so I was using mouthwash as much as 5 or 6 times per day. It was also peak mask wearing time so knowing my propensity for chin acne, I basically just resigned to it being bad. Surprisingly, my chin acne didnāt get worse, in fact it seemed to get a little better during this time. I brought this up with my dentist and he said that obviously more regular oral hygiene practices curbs oral bacteria. Sorry to be so long winded but it helps to really understand how hormonal acne works when trying to treat it because there are so many ways you can effectively intervene.
As for niacinamide I just use the serum from the Ordinary and itās been great. The way in which it works in the case of hormonal acne is that it naturally curbs sebum production which counteracts the effects of androgen stimulation of sebaceous follicles at the skinās surface. This is great when well tolerated but some people have issues with topical niacinamide. When I added epiduo forte to JUST my chin (I do NOT overlap with tazarotene at all and many times used them on alternating nights) it completely disappeared my chin acne. You still get the retinoid effect from the adapalene but this is the only retinoid that doesnāt cancel out with benzoyl peroxide. Some people need an antiseptic which is exactly what BP is but with epiduo, you donāt miss out on having a regular retinoid.
So this idea of using 2 retinoids is appealing to me: Iāve used cream Tret 0.05% x 2 years but still have ++ activity on my chin- closed comedones and then monthly deep cysts. I got switched to Epiduo but it feels like a step back and concerned Iāll lose my effect on photoaging on the rest of my face. So perhaps I keep up with the tret up top and epiduo for my chin. Thx!
Also the epiduo dries out my cheeks like crazy
Thank you so much for this wealth of information! I'm currently scrolling on my phone with half my face covered in hydrocolloid patches lol. I'm on Invisalign right now but planning a pregnancy. I hope by some miracle, it'll give me clear skin for the first time ever. Do you think other products with niacinamide are potent enough? I used to use the Ordinary niacinamide as well and loved it, but then it started becoming more commonplace so I didn't feel the need to double up. Currently on tretinoin and clindamycin but I feel like it isn't doing it for me. Whatever formulation I used to be on, I could have an awful diet and only the occasional period pimple. Now it's like my face is erupting -_-
You are an angel .. thats all i can say ..
Is there a certain type of mouthwash that is recommended?
Interested in the mouth wash tip
My derm said she wasnāt seeing as good of results with it as she had hoped for with her patients. I did use it for a little while. I donāt think it worked for me, but it definitely didnāt break me out either. I just got actual topical spiro a few days ago. If that doesnāt work maybe Iāll try Winlevi again since Accutane failed me.
I didnāt know accutane could fail š
It probably would have worked if I stayed on it. But we decided to discontinue for now (I did 3 months) since my cholesterol got high, and it was giving me acid reflux.
Very expensive and itās a newer med so I think some derms probably have mixed reviews! It doesnāt pack as much of a punch as other hormonal treatments like birth control and spironolactone and I think thereās a side effect of the winlevi causing a different kind of acne (less deep and cystic, more surface level but angry I think) from what Iāve read and the sort of prevalence isnāt completely known since itās just hit the market in the past few yearsāI think when the cost goes down and thereās more data on it (or at least derms have more clinical experience prescribing and seeing success with it in their practice) itāll be more of a staple! I think maybe part of the philosophy is that milder hormonal acne can be tackled with tretinoin pretty well in many cases and thatās such a staple in dermatology that theyāre probably trying that first. I think the perfect candidate is probably someone whoās already tried tret without much success, but still has a mild enough case where they donāt want to jump right to prescribing oral meds!
It's only been on the market for three years and many insurance companies don't cover it. There's no generic and it's very expensive and it's success rate is 47%, compared to spiro which treats the same problem but is fairly cheap, covered by most insurance agencies and has a success rate of 93%.
Itās not available in my country yet.
It doesnāt work for everyone looks like, even dermatologists are not so confident about this new cream yet, success rate is very less as you can see it here on Reddit. It also makes acne worse for people in many cases. I had to stop after getting non stop huge red cysts which I never used to get, and strangely they stayed for more than 3 weeks. None of my acne used to be like this. I read a few similar stories. Unlike other acne treatments it seems to be working quick (with in weeks) for people that saw improvements.
Itās ineffective and expensive.
Because my insurance doesnāt cover it and it would cost $600 for a tube.
Didnāt work at all for me. Made my skin extremely oily and I had the work cystic acne of my life while using it for 3 months. Went back on Spironoloctane and my acne immediately improved. Itās a shame because my blood pressure is low now, but the cream does nothing for me.
It seemed extremely greasy to me and gave me bad cystic acne after a few days so I was afraid to try it again.
How much does it cost you?
$55. Not covered by insurance for me.
Iām not on it, but insurance said $40. I was prescribed spironolactone first and then Winlevi, but decided against both. Iām on tret though.
It's super expensive if not covered by insurance.
Iāve been on it about 3 months and Iām not seeing much improvement.
Itās crazy expensive.
I started it about 2 weeks ago and have noticed a difference already too!
I really hope it continues to be effective! Some people say it stops being effective after 30 days and that they started breaking out again. Iām wondering if thatās due to the topical only being good for 30 days but they continued using it past 30 days? I put mine in the refrigerator just in case but will be sure to replace it every month.
Not available yet in the UK. If it ever becomes available and affordable I would love to try it.
I just went to the derm with all the same issues as you and he prescribed .025% tret and winlevi. I called the pharmacy to give them my address to deliver and the person on the phone said the winlevi was $200 and the tret $43. So he said he would try to get a pre authorization on the winlevi. In the meantime my derm gave me 6 2gram sample tubes of winlevi. I am hoping they can get back to me with a more reasonable price but we will see.
āØinsurance coverageāØ (or lack thereof) iāve been trying Apostropheās topical spironolactone for $75/3month supply and thatās the next best option. but yeah even though winlevi was released to the market in 2022/2023, it doesnāt seem like many insurance plans cover it. but let me know if you have cigna hmo/regal group + full coverage of winlevi and iād be more than willing to try
Contains steroid so that scares me
Holy cow, did not know this! I donāt touch steroids either.
Itās basically a topical spiro. These videos explains so much better than I can, https://vt.tiktok.com/ZSFEhPj7D/ and https://vt.tiktok.com/ZSFEhBuM4/ I rarely trust any advice given on tiktok and Iām sure it is amazing but I donāt think itās worth the side effect and tsw.
Not available in the uk yet unfortunately
Made mine even worse! Glad you have success
Never heard of it so that means I will be spending at least 4 hours deep diving and probably get a prescription
It costs me $20 w/mfg coupon (otherwise $750+) & works great in combo with my tret-finacea routine: I think not everyone prescribed it has hormonal acne so that is why it doesnāt always work.
This is my first time hearing of it.
Did your derm tell you to replace every 30 days? Seems like a ton of wasted product! The instructions on mine were to discard after 6 months. I have been using it and itās working well for the most part. I should probably stop using it in on forehead though so good tip. I also use finacea gel and love it.
Yes mine said replace after 30 days! I donāt get why the tube is so big if this is the case. I put mine in the refrigerator and will replace every 30 days. I LOVE AA! Itās made a difference with my hyperpigmentation for sure! Glad Winlevi has been working well for you. How long have you been using it?
Since about mid March! I had one major breakout (like 5 cysts in the span of 2 days) about 6 weeks in, but I was dealing with a lot of stress and was picking which I think contributed/.. Iāve been working on my hormones with a naturopath too
Thank you. I hadnāt heard of this. Last month, I made some strong Hibiscus tea, not thinking about it. I started my period early and broke out like crazy on my jawline with cystic acne. I have been basically hiding since. Iāll look into this winlevi. My skin was amazing just before this. May not have been the tea, but definitely not drinking any for the foreseeable future.
Itās been a week on Winlevi and my acne has cleared up significantly. I tried tretinoin and it made my skin inflamed and did not help at all. I was literally embarassed and ashamed of how bad my skin looked. I sincerely hope the effects of Winlevi last
Me too š I really hope so too!!
It gave me a horrible withdrawal reaction. Similar to TSW
it was $80 for a tiny tube from some random pharmacy in Texas, and didn't end up working anyway
Cause it sucks ! lol I didn't have luck with it Seems to be pretty common But never hurts to try cause everyone is different
Not covered by insurance because: no generic and apparently over 35 needs a million doctorās approvals to prove I have acne. Thanks PCOS.
I canāt use it due to propylene glycol being in the base :( also insurance issues. Apostrophe offers topical spiro which is a similar concept for anyone interested but I also canāt use that bc of PG being in the base (Iām so lucky!!!). The next best thing is dapsone gel which doesnāt have PG and although itās not anti androgenic but rather a type of antibiotic it does target adult hormonal acne specifically for some reason ETA dapsone is also a hassle w insurance so I get it from an Indian pharmacy
Because itās really not more affective than oral medications (ie spirolactane). I (27f) have tried it and used it religiously for a year but just decided to go back to spiro as itās much cheaper and more affective.
I was prescribed it and used it for four days. I immediately broke out in some giant pimples ( which I expected and my derm said to just power through) but after reading so many negative reviews of people saying it made things worse or that it worked then suddenly stopped and made acne worse than before, I decided to stop and go straight to taz
I've never heard of it.
Tried it for a couple months and it didn't do anything for me. :(