As far as diet is concerned, low carb and low calorie are good, but you also need to make sure that you are getting the the vitamins and minerals that you need- do you track micro nutrients at all? Do you take a multi-vitamin? You may check those areas. Was the tretinoin given to you for acne? Have you called the doctor to let them know you are seeing these areas after using the cream? I would also give your doctor a call and let them know what you are seeing.