Pocketderm Review: Dermatology by Mail

I thought that by the time I turned 30 I would not be dealing with acne or break-outs. I thought it was a phase we all passed through and magically vanished as we aged leaving us only to worry about aging and wrinkles. This is not the case at all. A lot of people (including myself) suffer from problematic skin well into adulthood. It's frustrating and embarrassing.
 
Early in 2013 I was incredibly fed up with the condition of my skin and scheduled an appointment at a dermatologist in Allentown. This was no easy task as this particular dermatologist's clinic was booked out for several months. When the appointment finally rolled around (spring), I wasn't sure what to expect. I was hoping for well, something.

Here's a summary of my dermatologist experiences from early 2013 into 2014

Initial consult: You have a lot of pustules and weirdness on your skin. Take doxycycline (oral antibiotic), use clindamycin gel, and use a higher-concentration retional every other day. Cost of scrips $63, Cost of co-pay $35

Follow-up 1: antibiotics blow and I'm not taking anymore (hello abdominal issues!), the retinol was too strong, 10% BP made my skin scaly. $45 for a lower-dose prescription retinol. $35 for co-pay

Follow-up 2: scratch all of the above, here's some %0.1 adapalene gel ($31), $35 for co-pay.

At this point (early 2014), I had spent $245 in visits and who knows how much time driving and waiting around at the doc's and really wasn't any better off than when I'd started. Crap.

I floundered around a lot in 2014 and had some really nasty breakouts that were not getting better. In came the help of Reddit's /r/skincareaddiction in late 2014. I found a lot of great ideas for a new routine based on my (actual) skin type.

SkincareAddiction also led me to PocketDerm. Everyone on the subreddit was raving about this service. I had no idea what it was all about. It's an online dermatology service that does not require insurance or office visits. It costs $19.95 per month and includes consults with a certified dermatologist. On average, most users consult with the derm each 30-90 days. From what I can see, shipment frequency may vary from user to user. There is no limit to the amount of medication you can request, but typical frequency is every 30-90 days. My shipments are on a 90 day schedule, though I may have to request a new one at 45 days. The ONLY downside to PocketDerm is that it's not available in all US states yet. They're working on that, though.

The initial process involves creating an account with PocketDerm. You're asked to upload a series of photos of your face (side, front, side, neck) and any other problem areas. For me - shoulders and back. Your photos need to have proper lighting and clarity for best results. This is probably the one time when it's acceptable to take some bathroom mirror selfies and put them to actual good use. You also progress through a number of questions and provide some skincare background. I gave some details on my previous disappointment with dermatology. You provide payment information, submit, and wait. Not long after, I received a confirmation email and a "what to expect" email. PocketDerm also sent another email with tips and preparation for my skin treatment.

Less than a week after submitting my info online, I received a package in the mail! Ooh! Included in the package was my personalized treatment, instructions, and a couple samples. Bonus! In case you're wondering what the point of the fancy container is containing your treatment - here's the simple version: the formula you receive is a compound acne treatment. This treatment is light and air sensitive. The container is designed to block out light and not allow contamination. You may have to press the pump a few times to obtain product, but rest assured that the medication inside will stay fresh before use.

My own personal formula contains
– 0.018% tretinoin (unclogs pores and improves skin texture)
– 1% clindamycin (antibacterial and anti-inflammatory)
– 8% azelaic acid (antibacterial that also fights redness and hyperpigmentation)

I've been using the formula for about three months now. In the first week of use I noticed my skin improving. The 2nd through 4th weeks brought some patches of break-outs, which can be described as "purging" - AKA your skin purging gunk from your pores. Into weeks 5-8, there was less purging. In the last few weeks I've noticed my skin is smooth with visibly reduced pores and very few breakouts. The breakouts that I do get (now) seem to be related to not using enough moisturizer.

My routine from December to early March has been as follows:

Face/Neck
Morning - Wash with gentle Cerave cleanser in the shower, apply Cerave cream (the stuff in the tub) after shower, wait 2-4 minutes, apply EltaMD SPF 46 lotion (crucial to use because the Pocketderm treatment contains retinol - tretinoin - which can make skin sensitive to light and prone to irritation).
Evening - Wash with foaming Cerave cleanser, pH 5.5 (no washcloths!), pat dry, apply Pocketderm treatment, wash hands, apply Cerave cream, wait 2-4 minutes, apply a thin layer of Aquaphor healing ointment.

Shoulders/Back
Morning - Wash with zinc oxide (2%) soap in the shower (using a gentle wash cloth or a Salux cloth a few times weekly for extra exfoliation), dry, apply Cerave cream. I then use regular Cerave lotion on the rest of my body.
Evening - Refresh shoulders / back with a Simple cleansing wipe or damp washcloth. Dry. Apply Pocketderm treatment to tops of shoulders and top of back. Apply Cerave cream. Wait 2-4 minutes. Apply a thin layer of Aquaphor healing ointment to shoulders and arms.

Here is a before and after shot of just over 5 weeks of use. Notice the reduction in red spots and improvement of skin texture. What's even further amazing is that the "after" photo is a pretty candid shot of me sitting at my desk late afternoon and the "before" photo was a photo of me with a freshly cleansed face at home.

Here is a shot at 10-12 weeks of use (I am wearing BB cream in this photo):

My end goal is to use the product for as long as it takes to see a real improvement in my skin quality and then consider switching to their anti-aging line.

As for the routine above, I have begun to transition to a Japanese/Korean skincare routine with a few more steps. The Cerave routine has been good for a start, but I'm finding it's not fully addressing moisture and redness. I would also like to start a routine of AHA/BHA to better smooth out my skin.

I highly recommend the PocketDerm subscription. I will spend less in a year of use (with actual results!) than in my previous history with a dermatologist. If anyone is interested in trying it out, you can click here for an invite code.

Keep in mind that PocketDerm is paying me zip to do this. This review is all my own opinion, photos are my own. I want to get the word out about this great service. Hopefully it expands to more states!