i was thinking it was skin barrier issue because the products he uses are causing irritation and breaking out is also a causation of a bad barrier
Nah he says anything he eats breaks him out horribly, he just needs to take isotretinoin and the other stuff i proposed, but let me expand on that.
Isotretioin: dosed ED at 10-20mg (systemically stop oil production, improved cell turnover, reduces inflammation etc)
Tretinoin/Tazarotene: Only introduced if tolerated.
Topical E3: Used EOD or ED, works by binding to the ER and activating TGF beta signaling (Signals fibroblasts to increase synthesis of elastin and collagen type 1 and 3, and will deposit more hyaluronic acid and better absorption and will thicken the dermis)...