From the picture that you've shared, it looks to me that your skin is dehydrated, so we need to fix that so that it is less prone to inflammation and the spots & wounds heal faster.
I wanted to start with good news though: you are using a strong concentration of tretinoin already, and it is one of the most powerful acne treatments. I think you need to stick with it, and you'll see results (while removing irritation & dehydration).
Here are the changes to your routine that I recommend:
- Cleansing: change the cleanser for something even more gentle (I'd also try avoiding coconut derived surfactants and see if it could help - sometimes it does). Skip the morning cleanse all together, just splash your face with cool/tepid water. It will help restore your skin barrier faster (leading to more hydration, faster healing & less inflammation). Cleanser product options: https://whatsinmyjar.com/product/cerave-hydrating-facial-cleanser-for-normal-to-dry-skin; https://whatsinmyjar.com/product/neutrogena-hydro-boost-gentle-cleansing-lotion; https://whatsinmyjar.com/product/avene-tolerance-extreme-cleansing-lotion; https://whatsinmyjar.com/product/wunder2-wundercleanse).
- Niacinamide: Skip the ordinary niacinamide serum - 10% might be too high for skin dealing with tretinoin already, you are getting niacinamide from your moisturizer any way
- Versed serum: it's a good product overall, but I think it makes sense to exclude all potential irritation triggers for your skin and focus on actives only. I'd suggest that you get a salicylic acid product like this: https://whatsinmyjar.com/product/paulas-choice-skin-perfecting-bha-liquid-exfoliant-full-size. Use it 1-2 times per week (no need for more with tretinoin) + as a spot treatment 1-2 times per day directly on the inflamed spots).
- Instead of the niacinamide serum, I'd recommend you to start using azelaic acid, once per day, I think AM would work better with the tretinoin at night. Product options: https://whatsinmyjar.com/product/the-ordinary-azelaic-acid-suspension-10; https://whatsinmyjar.com/product/inkey-list-azelaic-acid-serum; https://whatsinmyjar.com/product/naturium-azelaic-acid-emulsion-10; https://whatsinmyjar.com/product/garden-of-wisdom-azelaic-acid-10-serum;
- Keep using your moisturizer (you can skip it in the morning if sunscreen feels hydrating enough).
- Use a sunscreen daily: you need it to prevent pigmentation after the spots are healed and to speed us the healing. Go for a mineral-based sunscreen, many good options here: https://whatsinmyjar.com/search/sunscreens/mineral-sunscreens?light_texture=true&category_texture=Lotion&sortBy=Irritancy&sortBy=Promises%20fulfilled.
In the evening, wash your face with a cleanser, apply tretinoin and moisturizer.
Please stick with this simplified routine for at least 4 weeks (but of course, stop the new products if you notice a reaction). Please let us know here how it is going for you, I'd love if we could support you along the way.