Acne is caused by a sensitivity to the effects of androgens -male hormones found in male and female bodies. Androgens stimulate the sebacous (oil) glands in the skin. Bacteria on the skin feeds off this excess oil, blocking the pores and resulting in spots. Factors such as sleep and diet are unlikely to affect this process.
Stick with the Retin-a, it often takes about 8 weeks to work. Your doctor could also prescribe oral antibiotics (such as Oxytetracycline 250mg twice daily or Lymecycline 408mg once daily). These can be taken in addition to using the Retin-a.
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