Oh...I have gone to dermatologists and I've used tretinoin for over a year now (2x a week, I only use it on my lower face) and my acne is worse than ever. Also, ignore what it looks like; I constantly wear hats/sunglasses outside and 20% zinc oxide sunscreen. I avoid sun damage at all costs!
I at the moment have been using Cetaphil gentle cleanser, and Cerave PM lotion with a layer of vaseline at night.

Also, yeah, I know I'm very old. The problem is, my skin has *always* had this texture and look to it, even in my youth. I had massive dry patches and flakes, even before I started using tretinoin as well.

And yeah this is my skinniest. I grew up pretty fat, and I can't really imagine being more slender than I am now. Feedback welcome, though. I do lift weights and do have muscle under the blubber.