If you don't read any further in my review, please know this: IT GETS A LOT WORSE before it GETS MUCH BETTER. HANG IN THERE.

I'm posting this in hopes this helps someone. First, some history: I've struggled with moderate acne from my teenage to adult years. In my early and mid 30s, my acne has turned into painful cysts that predominantly cover my cheeks, jawline and neck. I also have breakouts on my shoulders, back and chest, though they aren't anything like my face. The areas I break out in would lead me to believe it's hormonal. Since I've also had hair loss and have had cysts on my ovaries, there was a thought it was PCOS, but dozens of blood tests and expensive doctor visits later, that was ruled out.

I spend COUNTLESS, and I mean COUNTLESS hours researching about acne. It's ruined my self-esteem and confidence, I never feel attractive, and I even have trouble looking at people sometimes. My skin is PAINFUL due to the deep cysts and inflammation. So much so, some days I just wanted to cut my skin off. It's been hard not to pick, but of course even if I don't, my skin is left with red marks that are just has hard to cover up as the inflamed bumps.

I've tried EVERYTHING over the years. You name it, I've tried it, and that includes Acutane (but I wouldn't stay on it due to concerns over liver damage). The only thing I haven't tried that I heard could work is Spirnolactane. I was actually prescribed it but decided not to take it, again, over concerns about what it would due to my health. I don't even know how many dermatologist, primary care and OB/GYN appts I've had to discuss the matter. One derm went so far as to tell me, "If you still have acne at this age, you'll always have acne." In other words, I'm hopeless. I hated that guy. That was told to me when I was around 22 and I've never forgotten it 13 years later.

Recently, I moved to a new town and got a facial. The woman that was treating me suggested Differin Gel. She mentioned she'd seen some success with it and that it was a fairly new OTC product. I figured, what in the heck do I have to lose. Desperate, I ordered it from Amazon.

And after using it for the first time, I BROKE OUT EVERYWHERE, particularly my forehead. It was AWFUL. My only patch of clear skin was now what seemed to be infinite whiteheads. Every pore was a whitehead. It was awwwwwful!!! I immediately quit the product, and was so angry that another thing failed me. It took WEEKS for the whitehead breakout to clear up.

While I waited, I kept researching it. I don't know why. And I read how people talked about it "purging" the skin so people get a bad initial breakout. Ok. Well, I don't know if it was out of frustration or a little nagging gut feeling, I decided to try it again.

AND MY SKIN GOT SO RED AND DRY AND BURNED SO BADLY. I mean, excruciatingly painful. And it turns out that's just because I was coating on a thick layer of it all over my skin. How embarrassing showing up for work and my whole face is just red and massive FLAKES.

But after all that flaking and peeling, and using non-stop aloe on it (also borrowed my husband's thick Aveeno Eczema lotion... it seems to really work!), I had.... clear skin. I can't believe I'm typing this. It's been weeks, and my skin has cleared up 98% (I did have a couple neck and jawling cysts this period cycle, though - but they're not as hidden under the surface as they used to be). My skin doesn't get nearly as oily (overcompensating for the dryness of Differin) or as flaky (because I'm using a little bit for the whole face with a little more added onto my problem areas). It seems to have finally balanced out.

I really just can't believe it, and I am so unbelievably happy and feeling so much more confident than I have in a long time. I truly hope this helps someone. Shoot me a question on here if you have one and I'll be happy to answer.

For the record, after a ton of my own research, I believe I have a sensitivity to DHT. My blood test DHT levels are normal, but as I understand it, sensitivity to DHT cannot be measured, and I believe that may explain my female hair loss and cystic acne. I recently purchased Saw Palmetto Extract to see if that can help -- though it made me feel very faint so I stopped after a third day.

I started using this about a month ago and it works great! I noticed a difference within a week. I use it at night and a collagen moisturizer in the morning. My skin has not looked this good in a very long time!

This is a great product! But there is a side effect you should make sure you're ready for.
I'm almost 26yrs old & I've been struggling with acne since I was a teen. I had been using Aveeno Clear Complection face wash for years & it usually kept it under control. The past few months my skin just kept getting worse & worse (no change to my diet, skin products, etc.) & no idea what caused my skin to have such horrible breakouts. I decided to look into Proactiv to help. I know a few people who have been on it & half loved it & half hated it. But all of them hated the price & how difficult it was to unsubscribe. That made me not want to get Proactiv. I did more research & found this product, Differin. It has the exact same amount of Adapalene Gel .1% as the ProactivMD Acne Treatment gel. It's basically the same product, they just charge you 2x or 3x the cost for it, depending on the size you order.
With that in mind, I order the Differin gel & Differin Gentle Cleanser. Now I did read the reviews on the Differin gel. I knew it would cause dry skin. But I didn't worry about it because I knew I had a pretty good moisturizer (Bio Oil is not meant to be used as a moisturizer but I accidently discovered it makes an awesome one) that I've been using for at least a year.
However, when I started using the Differin products, my beloved moisturizer did Not stand a chance. I switched to an Aveeno face moisturizer & Nope, that didn't work either. My skin felt Raw. It was so dry, it started to peel which then made my skin feel raw, itchy & so red. I started shopping around buying different face moisturizers & every one I used made my skin feel like it was set on fire. It burned. I guess because it was raw, I'm not sure. I didn't want to stop using the Differin product because I had read in other reviews that the dryness & peeling was normal & a good sign that the product is working (hard to believe, I know), all I had to do was use a good moisturizer.
So I did some more research for what I could use for very dry & itchy skin. A few websites suggested a number of things that I already wasted money on except petroleum jelly (aka Vaseline). I know... Vaseline? On my face? It's really thick, won't it clog my pores? I had given just about everything else a try & my skin was screaming for relief. A website said the thickness of it helps prevent waterloss in the skin. So I decided to give it a try.
Oh my goodness.... It worked!! After a couple of days the dryness, peeling, & itchiness was almost completely gone. After a little over a week, no more redness, no more rawness & no more anything. Well I still had acne, lol. The greasy texture takes some getting use to. I apply small dabs & rub it in, leaving a thin layer to soak in.
Okay, I found an excellent moisturizer to combat the drying side effect of the Differin products. Since I've been using all three; Differin gel, Differin Gentle Cleanser, & Vaseline. My skin is looking Amazing.
I started using the gel daily but it was/is too much for my skin. So instead I use it every other day but I use the cleanser & moisturize daily & nightly. You will go through a "purge" phase. This is normal for most acne products, even Proactiv. So don't be scared away when this happens. Think of it like it's digging out all of the built up junk that's been lying under your skin, waiting to pop up at the most inconvenient time like a date or job interview.
For me, it's been about a month. I battled the dry skin side effect & patiently waited out the purge phase & now my skin is truly looking amazing & so much better. I still have acne but only about 50% of what I had when I started. Your skin might take longer or less time to purge before clearing up. Just be consistent. Be patient. Don't chicken out. And be realistic, this is not a one week or one month cure. It'll take time & you'll have to continue using it even when you're acne is gone. Or else it'll come back. So you might as well buy the 2 large bottles. I've already order again & plan on using these products long term.
My advice.... Buy this product!! You won't regret it. Just make sure you have a really good moisturizer.
I would add a photo of my skin now but it wouldn't mean much because there's no before photo so you would have no idea of how bad my acne was when I started. Just know, I'm very impressed after one month.

This product has been very effective to maintain clear skin. It is lightweight and easy to apply. It is a small tube and this is good for travel. I do not find it drying. I do think there are stronger products out there; I use this for maintenance with a moisturizer overtop every night and for several months my skin has remained consistent.

how i use differin
i use only at night time
-do your normal skin care routine
- after moisturizing, apply a small pea sized amount to your acne area and spread over whole face
- AVOID eyelids, under eye, lips, neck, as those are the most sensitive and thin areas of skin
- start off skipping 2 days between application, then skipping 1 day, and working up to applying every night
- wear sunscreen during day
- expect skin sensitivity, stinging, dryness, little bits of flaky skin
- DO NOT mix with benzoyl peroxide, salicylic acids, aha bha, etc, check if any of your face products cannot be used with differin
- takes 4-6 weeks to see visible results
- use consistently

so ive been diving in and trial and error-ing many acne treatments products
this has been the only thing that has been visibly helping with my cystic and hormonal acne in 2 weeks, tho i ran into problems:

my birth control causes me painful cystic acne and for the first time in my life i started to get cluster acne on my sunburns and cheeks, which also left dark spots after that would not go away
i tried the ordinary salicylic acid, and cerave benzoperoxide face wash, but my acne would not budge. my acne was being so stubborn
every morning i would wake up with a new red painful bump despite me doing my face routine consistently.

i was scared to try adapaline bc of how harsh i've heard it can be, as well as the purge period.
i want to say my skin is not sensitive
i can pound the ordinary BHA & AHA like it's nothing, and put 30 vol bleach on my eyebrows

so i started it, pea sized amount at night on top of moisturizer, and it felt fine at first, then days after i felt a slight sting that would get worse. then the adapaline made my neck sting rly bad and it turned into a scary red stingy itchy rash.
i realized that its bc there was still product on my hand when i went to moisturize my skin, and i had to wash my hands before touching my neck to not cross contaminate.

soon after i noticed my skin became dry flaky and sensitive to even my regular skin care routine (niacinimide and hyaluronic acid) and even stung with my moisturizer.

but i kept at it for 2 weeks and sure enough
my cystic acne has gone down
and it is lighting my dark spots
however my skin is now sensitive and flaky which is to be expected

i will keep using it to see if it keeps helping
also full disclosure i went rly intense in and forgot you need to take breaks but i accidentally put it on every night since night 1, instead of skipping nights and working up to every night, which probably caused the dryness and sensitivity