http://www.acne.org/messageboard/blog/6736-spironolactone-tretinoin/ Spironolactone + Tretinoin Syndication Fri, 22 Mar 2013 17:55:32 +0000 webmaster@acne.org (Forums) IP.Blog 60 http://www.acne.org/messageboard/blog/6736/entry-25808-im-clear-spiro-day-99-tretinoin-day-88/  
I was pre-diagnosed with PCOS when I was 17 and started taking Yaz birth control. I switched between Yaz and Nuvaring and didn't have too many problems. I always had acne, but it was never severe and quite manageable. 1.5 years ago I got an IUD. I love my IUD, but it is a low dose of hormones. My acne continuously got worse over the next year until I finally saw an endocrinologist. I had a full blood work test done and was formally diagnosed with PCOS. The majority of women with PCOS are overweight, but I am a normal weight, exercise regularly and eat well. My Dr. prescribed 100mg of spironolactone to help with the hormonal acne that is likely made worse by PCOS.
 
Nothing happened the first  month I took spironolactone. NOTHING. Even though my endocrinologist suggested that I wait to see a dermatologist, I went anyways. I wanted results! My dermatologist then prescribed 0.025% tretinoin gel and Aczone. The following 2 months were pretty hellish. My skin got worse. Much worse. I was always peeling and new breakouts were constantly popping up. I did a lot of damage to my skin and I regret it. I should have listened to my endocrinolist and waited for the spironolactone to have more of an effect before incorporating topical medication. 
 
During my second visit with my dermatologist I expressed how frustrated I was. It seemed like the tretinoing was making things worse, the Aczone wasn't helping at all. She gave me some new samples and told me I could start using Glytone on my face. (Glytone is a glycolic acid face wash). She also increased my dose of spironolactone 150mg. Seriously, 1 week later my chin just stopped breaking out. It was strange. And honestly, I still keep expecting breakouts to pop up, but it just hasn't happened. The acne on my cheeks continued to subside. For the last 3 days now, I have not had a single new cyst on my cheeks. I'm pretty sure this is it. The spironolactone is working and it feels so good!! 
 
So, this is what I would do if I could do it all over again. 
 
First three months AM routine: 
100mg of spironolactone
5000IU D3 supplement
Daily vitamin with Chromium, B vitamins, Vitamin A, Vitmain C, Vitamin E (Rainbow Light Women's 1)
Glytone or CeraVe cleanser
Aczone treatment
Neutrogena oil free moisturizer with SPF 15
 
First three months PM routine: 
50mg of spironolactone
Vitamin E supplement 
Fish Oil Supplement 
50 mg of spironolactone
Glytone or CeraVe cleanser
Aczone treatment
CeraVe moisturizer j
 
 
Now that I am no longer breaking out, I have adjusted my routine to include both:
- Argan Oil 
- Tretinoin Gel (Retin-A)
 
I wash my face, let it dry for 20 minutes, apply tretinoin, wait 1+ hours, rinse with water, apply 4 drops of argan oil. I would use argan oil, and any other oil, with serious caution. Some people seem to be able to use oils without any problems, but I often breakout just by looking at oil the wrong way.... I've tired a lot too. However, I really wanted to try argan oil because it is an anti-inflammatory, contains vitamin e, helps with hyper-pigmentation, and is really great for dry skin. So, I am giving it a chance. I use Acure Organics and I bought it from Whole Foods for about ~$17. I expect it to last awhile. However, at the first sight of a breakout, the oil will be the first to go from my routine. Same with the tretinoin. Since my skin is no longer breaking out, I feel like I can focus a bit on the hyper-pigmentation that is quite obvious in my photos and both of these should help quite a bit.  
 
Anyways, I am so happy. My skin looks better every day. I just want everyone to know the importance of patience and to stay diligent. Also, stay happy. I hit quite a few lows during this process and was way too hard on myself. We are not always in control and just have to do what we can.
 
Here is to good health and good skin!!! 
 
Cheers, 
 
xx Shawna ]]> Mon, 11 Mar 2013 15:41:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25808-im-clear-spiro-day-99-tretinoin-day-88/ http://www.acne.org/messageboard/blog/6736/entry-25657-spiro-day-80-tretinoin-day-69/  
xx 
Shawna 
 
 ]]> Tue, 19 Feb 2013 20:22:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25657-spiro-day-80-tretinoin-day-69/ http://www.acne.org/messageboard/blog/6736/entry-25575-spiro-day-66-tretinoin-day-57/  
Chemical burn aside... my skin is looking pretty good. It seemed like as soon as I upped my dose of Spironolactone to 150mg all the breakouts I was getting on and under my chin have subsided. Its quite beautiful. My cheeks still look like a crime scene, but I see quite a bit of improvement on the right side. I'm not entirely sure if the improvements under my chin can be chalked up to the increase dosage because I am a little past the 2 month mark. I think I should start seeing significant improvement in the cysts from now on. 
 
I just don't know what to do now! I'm sort of a little skittish about the tretinoin and my skin's sensitivity. I think I'll start using it everyday but only leave it on for an hour, then rinse and apply lotion. I'll see how this goes for a week or so. I have an appointment with my derm again in about 2 1/2 weeks, so I'll bring it up with her.
 
xx
Shawna ]]> Thu, 07 Feb 2013 19:05:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25575-spiro-day-66-tretinoin-day-57/ http://www.acne.org/messageboard/blog/6736/entry-25489-spiro-day-56-tretinoin-day-47/  
I told my doctor that the Aczone wasn't doing anything for my skin so she gave me some samples of Epiduo (Aldapene + BP). Its okay but it would be really expensive for me to switch. I love my $5 Tretinoin! I also told her that I've been using glycolic acid + salicylic acid face wash in the morning instead of the CeraVe because it seemed like all of the peeling form the retin-A was clogging up my pores. She said it was totally fine as long as my skin wasn't getting too irritated.
 
Does anyone else have issues with figuring out how to moisturize at night? What I've started doing is washing my face as early in the evening as I can, wait about 30 minutes, apply the gel, and then right before bed I rinse it off and apply the CeraVe moisturizer. If the gel and the moisturizer mix it gets really weird and sticky almost like glue. So I've finally realized that I either have to apply the moisturizer first or rinse after the medication has been on for awhile and then put on the moisturizer. Its so confusing and takes a long time. I'm not really sure what to do. If I don't bother moisturizing, my skin will be too flakey the next day.
 
I want to recommend that everyone look into taking Fish Oil or Cod Liver Oil to supplement Omega-3s. It wont likely clear the skin but I notice a significant reduction in inflammation whenever I take them regularly. I've also been taking a Hair+Skin+Nails daily vitamin but I'm going to replace it soon with a Woman's daily vitamin. For a few years now I have been taking various supplements to help my skin (Zinc, vitamin E, vitamin A, Saw Palmetto, Magnesium, Chromium, B Complex...) but few have given me any significant results. I started the Hair+Skin+Nails supplements because they offered a good amount vitamin D but I've read a lot lately that biotin in excess of 1000mg can cause breakouts. Most who take Biotin and see signifiant results take about 5000mg but I don't really want to risk taking any more then 100% d.v. I finally found a multi-vitamin that has respectable amount of the all the supplementation that I want and it only requires taking 1 pill per day. WINNER!!! This is the one:
http://www.amazon.com/gp/product/B0009KNLV6/ref=oh_details_o00_s00_i00 
 
Updated Routine:
 
Morning:
Neutrogena Stress Control Face Wash (glycolic + salicylic acid) OR Glytone
CeraVe moisturizer
Skin79 BB cream and/or Physicians Formula Correcting Powder
50mg Spironolactone
Hair + Skin + Nails Vitamin
 
Evening: 
CeraVe Foaming Face Wash
Tretinoin 0.025%
CeraVe moisturizer 
100mg Spironolactone
Fish Oil Supplements (Omega-3's)]]> Mon, 28 Jan 2013 18:45:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25489-spiro-day-56-tretinoin-day-47/ http://www.acne.org/messageboard/blog/6736/entry-25342-spiro-day-38-tretinoin-day-29/
I've been continuing to alternate the BP and Tretinoin in the evenings and it has been working out very well. All of the inflammation is down. Its so nice to not worry about new cysts and whiteheads popping up and waking up every morning feeling around for new ones to prepare myself for looking into the mirror. It can be so dramatic and such a pain to cover up. I'd take a face of hyper-pigmentation over a handful of cysts any day... Anyway, this treatment is great. In another week or so I'll try going 2:1 on the Tretinoin to BP until I can phase out the BP completely.

I just moved this weekend, so now I'm all comfortable in a new apartment and focus on my skincare a lot more. I recently bought some hair-skin-nails vitamins. My nails have been very brittle all of my life, so I'm looking forward to seeing how these work. If they can help my skin too, then great! I've also started exercising again and focusing on my diet. I mostly just try and keep my sugar intake low. I've never noticed a significant correlation between exercising/diet and acne, but I believe both can help.

So, all things are going well again and it feels good.

I purchased my first B.B. cream a few days ago and it is supposed to arrive tomorrow. I don't normally use liquid makeup. I've been using Physicians Formula redness correcting powder for as long as I can remember with the Dusty Rose blush. I have been seeing B.B. creams popping up all over the place in blogs and never considered them an option to me until I finally read about Skin79's pink B.B. cream. So I bought it. I haven't even read up on the ingredients because I'm so hopeful that it will work well and not break me out that I don't want to become biased by discovering that it contains something bad. I've done a lot of reading (nomoredirtylooks.com) about make-up and acne causing/irritating/toxic chemicals that are often used in formulas so I usually have a difficult time finding new products that fit my requirements. I'll give it a go this weekend and post some pictures.

xx Shawna]]> Thu, 10 Jan 2013 17:35:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25342-spiro-day-38-tretinoin-day-29/ http://www.acne.org/messageboard/blog/6736/entry-25327-spiro-day-35-tretinoin-day-26/
I was about to give up on the Tretinoin, but I think the minor BP usage with help me get through this initial breakout until I can phase it out.

I must mention that the breakouts are healing FAST. I had an area on my cheek with three big breakouts that all merged into one about a week ago and it has already healed nicely with just a small amount of hyperpigmentation. Simply, AMAZING. The Tretinoin is great for that. If only I could just stop breaking out in the first place...

I feel so guilty that I couldn't keep up the routine that my Dr. prescribed. I have an appointment in a few weeks, so hopefully we can work through this. Until then, its CeraVe, BP & Tretinoin.

I can't say much about the spironolactone. My breakouts have still been on my chin and cheeks. I even started getting cysts under my chin, near my neck, which has never happened before. Its virgin skin So sad. The spiro may be doing its job just fine, but in combination with the initial breakout from Tretinoin, there is no way to tell.]]> Mon, 07 Jan 2013 18:08:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25327-spiro-day-35-tretinoin-day-26/ http://www.acne.org/messageboard/blog/6736/entry-25306-spiro-day-32-tretinoin-day-23/
My skin has been horrible. HORRIBLE. I am pretty sure that it is from the Tretinoin (retina-A). I thinkI started too early. I should have waited for the Spiro to take more of an effect so that my initial breakout wouldn't be so bad. I think the problem is that there is so much dead/pealing skin that the pores get too clogged. The only benefit is that they heal more quickly then usual. At first, because I wanted to the initial breakout to get over quickly I was using the gel every night despite how more peeling/redness I had. Now, I am going to use it only every 2 or 3 nights until my skin adjusts a bit more. I seriously think the Aczone has no benefit at all but I guess it isn't very fair to say so since I'm using it with so many other products. Anyways, I'm going to take it a little easier for the next month or so while I try and get over this initial phase. UGHHHH. It is so frustrating. Other then the craziness with tretinoin, I was pretty good about my routine while I was on vacation. Occasionally I went to bed really late and/or woke up late so I wasn't very good about keeping up my routine on regular intervals... I also wasn't drinking enough water... I'm sure this didn't help my skin any.

Small success: I hit 1 month on Spiro!!! 2 more to go and I should be seeing some real benefits (fingers crossed). My happy trail (which isn't too bad to begin with), seems to be growing back very slowly. I plucked it once and its only sparely growing back.

I'll post some better photos in a few days.

Happy New Year!!

xx
Shawna]]> Fri, 04 Jan 2013 00:01:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25306-spiro-day-32-tretinoin-day-23/ http://www.acne.org/messageboard/blog/6736/entry-25222-spiro-day-21-tretinoin-day-7/ Days on Spironolactone: 21
Days on Tretinoin: 7

3 weeks on Spiro and 1 week on Tretinoin! I wish I fast forward time and already be at the magical 3 month mark that so many people talk about. Oh well.

No serious changes today. I had one cyst developing on my chin yesterday but the swelling went down very quickly. I think this might be from the Aczone? I'm not sure.

I also applied the Tretinoin again last night. I'm glad I took a night off. There wasn't any burning and my skin wasn't peeling nearly as much as before this morning. Most of my peeling is occurring where I've had recent breakouts. I feel like its helping the scabs heal a lot quicker.

I'm leaving for California tomorrow morning. Hopefully I can keep up my routine!!

xx Shawna]]> Tue, 18 Dec 2012 17:58:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25222-spiro-day-21-tretinoin-day-7/ http://www.acne.org/messageboard/blog/6736/entry-25215-spiro-day-20-tretinoin-day-6/ Days on Spironolactone: 20
Days on Tretinoin:6

I'm not going to keep the quantitative track anymore. I figure that my summaries and pictures will be good enough.

My skin felt a lot more irritated last night so I went ahead and skipped a night of the Tretinoin. I also picked a bit and I regretted it right away because it just added more redness to my already irritated face. One of the things that I like about the Tretinoin is that it helps suppress my urges to pick. I learned my lesson.

My skin is pretty flakey today and I think I'm experiencing the beginnings of a breakout. The right side of my chin has a few new spots, but the rest of my face is still the same. I was feeling really good about my skin yesterday, today, not so much. I still have plenty of faith in this routine though.


xx Shawna]]> Mon, 17 Dec 2012 17:08:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25215-spiro-day-20-tretinoin-day-6/ http://www.acne.org/messageboard/blog/6736/entry-25212-spiro-day19-tretinoin-day-5/ Days On Spironolactone:19
Days On Tretinoin: 5
Days without Picking: 6
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 1 active
Right Side of Chin: 1 active
Left Side of Chin: 0 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

My skin is a bit more pink today and peeling is continuing. I'm realizing now that I should probably back off a little bit on the trying to get the skin to peel more (i.e. using scrubs) because my skin is starting to feel a bit more dry and irritated. I think the spiro + aczone are helping keep my skin from experiencing an initial breakout from the tretinoin because I haven't had very many new spots and my skin is continuing to heel. It still looks bad, but my hopes are still high.

I'm leaving for holiday vacation on Wednesday. I am nervous that I wont be able to stay diligent about my routine, but I'm going to try really hard. I might cut back to tretinoin every other day while I'm gone to give my skin a break and to make things a little simpler while I'm gone.

I started using the Aczone a little differently. My Dr. said to use it once in the morning but she said that I could use it twice a day if needed. I started mixing it into my moisturizer twice a day. I think I will do this for awhile to help prevent an initial breakout. When my skin stops peeling and the redness goes down I'll switch back to morning use and use it more like a spot treatment. I think it is helping.

Looking forward to continued success!

xx Shawna]]> Sun, 16 Dec 2012 16:52:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25212-spiro-day19-tretinoin-day-5/ http://www.acne.org/messageboard/blog/6736/entry-25207-spiro-day-18-tretinoin-day-4/ Days On Spironolactone:18
Days On Tretinoin: 4
Days without Picking: 4
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 0 active
Right Side of Chin: 3 actives
Left Side of Chin: 0 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

This morning I have quite a lot of peeling. My skin feels okay though. It doesn't feel dry or anything, which is not what I expected. It sort of feels good to have the skin peeling, because I feel like all of the bacteria/dead skin that is trapped in my skin is coming out. Its probably just psychological, but its a nice feeling. I ended up using the tretinoin last night, but I only targeted my worst problem areas (sides of chin & scarred areas of my cheeks). My eyes are not any worse then they were yesterday and the dark circles have faded quite a bit.

I'm in love the with the CeraVe products. I didn't think I would like the foaming wash, but it isn't drying at all and my skin feels really nice when I am done. The lotion soaks in really well and makes my skin feel really soft. I regret not using these products earlier!

xx Shawna]]> Sat, 15 Dec 2012 16:33:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25207-spiro-day-18-tretinoin-day-4/ http://www.acne.org/messageboard/blog/6736/entry-25201-spiro-day-17-tretinoin-day-3/ Days On Spironolactone:17
Days On Tretinoin: 3
Days without Picking: 4
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 0 active
Right Side of Chin: 4 actives
Left Side of Chin: 0 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

Major improvement today. Still, a lot of scabbing (healing takes time!) and hyperpigmentatiion, but by all accounts, things are looking good. I had quite a bit of peeling this morning when I woke up. Some of it comes off in big chunks, like one entire side of my nose... which is somehow refreshing. I used a mild scrub this morning to help get rid of some of the flaking. I forgot to apply the Aczone

I feel like this routine is really helping me not pick because I want the Tretinoin to do its job. I can tell a lot of deep clogged pores are sort of coming to the surface and becoming more visible so I'm hoping that I'll have the patience to just let them clean themselves out [fingers crossed].

I want to mention that my eyes have been puffy in the morning. Abnormally puffy. I read on the dug info for Tretinoin that you should notify your Dr. if you have eyelid swelling and I'm having a difficult time determining if this is a problem. I'm not applying the medication remotely near my eyes and I wash my hand when I'm finished to make sure I doesn't accidentally get in my eyes later. I really really really hope I'm not allergic. I'm allergic to so many antibiotics, it would be quite a disappointment to add another prescription to the list. My mom is also allergic to a long list of medications... I'm going to stick with it for a few more nights and see how things go because it seems to be helping my skin. I was talking to a friend about it and she couldn't even tell they were "puffy". I just know, because I know what they should look like.

xx Shawna ]]> Fri, 14 Dec 2012 13:15:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25201-spiro-day-17-tretinoin-day-3/ http://www.acne.org/messageboard/blog/6736/entry-25195-spiro-day-16-tretinoin-day-2/ Days On Spironolactone:16
Days On Tretinoin: 2
Days without Picking: 3
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 2 active
Right Side of Chin: 5 actives
Left Side of Chin: 3 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

I started the Tretinoin last night and it was a little different then I expected. I have the gel and it is some sort of alcohol base, which I don't like. Isn't alcohol really drying? I know they have other formulas, but I'll stick with this until I see my dermatologist again in January. I didn't apply any lotion last night and I think that was a bad idea. Tonight I will cleanse -> moisturize -> wait an hour -> apply Tretinoin.

So today my skin is looking a little pink but less flakey then it did yesterday and some of my minor actives have become more inflamed. I have one deep cyst on the right side of my chin and it hurts.

I'm still feeling very optimistic though and I am prepared for things to get worse before they get better.

xx Shawna]]> Thu, 13 Dec 2012 17:12:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25195-spiro-day-16-tretinoin-day-2/ http://www.acne.org/messageboard/blog/6736/entry-25189-spiro-day-15-tretinoin-day-1/ Days On Spironolactone:15
Days without Picking: 2
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 2 active
Right Side of Chin: 3 actives
Left Side of Chin: 3 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

My skin is looking really nice today! Obviously there are still some scabs, scarring and hyperpigmentation, but I don't have very many actives. The actives that I do have are small and are not too inflamed. Since my skin is looking better I have almost no urge to pick! Its great.

I'm pretty happy and it makes me nervous about starting tretinoin tonight because there are so many stories about it making things worse in the beginning. At least I have a bit of the Spiro in my system, so hopefully that will prevent things from getting too bad. I know a lot of people take an antibiotic with it to help combat the IB, but since I'm allergic to so many of them when ingested my Dr. decided it was probably not worth the risk. So, I'll be using Aczone instead. Does anyone have experience with Aczone?

I tried out the CeraVe foaming wash and moisturizer samples that my Dr. gave me and I really like them.

And finally, I posted some pictures of my skin throughout the year including some from last night. I'll try and post new ones every few weeks with the same lighting and camera.


xx Shawna]]> Wed, 12 Dec 2012 19:21:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25189-spiro-day-15-tretinoin-day-1/ http://www.acne.org/messageboard/blog/6736/entry-25188-spiro-day-14/ Days On Spironolactone:14
Days without Picking: 1
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 0 active
Right Side of Chin: 4 actives
Left Side of Chin: 4 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:

I'm seeing a lot of improvement today! My cheeks are very clear and my chin is healing and a little less inflamed. I've actually noticed that since I have started spironolactone, I have not had a single new cyst on my cheeks. I guess I just had to wait for the ones I had to heal.

Also, can I note that I did not eat sweets or dairy yesterday! Woohoo.

I went to the dermatologist and it was a bit confusing, to be honest. I got 2 prescriptions and I bought a glycolic acid cleanser from the office for my back. My prescriptions are for Aczone (5% dapsone) and tretinoin 0.025%. I'm supposed to use Aczone in the morning and the tretinoin at night. I also got samples for CeraVe. I already use the cream cleanser but they suggest that I switch to the foaming cleanser. I think that I will alternate the foaming and cream cleanser since in the morning all I really need to do is remove the previous night's medication. The foaming cleanser should be better at removing makeup and dirt. When I run out of cream cleanser, I'll consider using the foaming all of the time. I am worried it might be more drying.

The Aczone is expensive!!! I got 3 samples and 3 coupons. For now I will only be paying $25 per tube. I probably one be buying after that though. Anyone have experience with it??

So, starting tomorrow, my regimen is this:

AM
50mg Spironolactone
Cleanser: CeraVe Cream Cleanser
Toner: Proactiv Revitalizing Toner
Treatment: Aczone
Moisturizer: CeraVe Moisturizer


PM
50mg Spironolactone
Cleanser: CeraVe Foaming Cleanser
Toner: Proactiv Revitalizing Toner
(wait 30+ minutes)
Treatment: Tretinoin
Moisturizer: Cerave Moisturizer if needed

xx Shawna]]> Wed, 12 Dec 2012 19:19:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25188-spiro-day-14/ http://www.acne.org/messageboard/blog/6736/entry-25187-spiro-day-13/ Days On Spironolactone:13
Days without Picking: 0
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 4 actives
Left Side of Chin: 4 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:
I have a lot of scabs, so I'm really struggling with the picking. Yesterday I went crazy and spent quite awhile in front of the mirror. It could be worse... but its not good. I'm seeing a dermatologist tomorrow and I am hoping to get a retinoid. I might not be able to start until January though. It might also be good to give my skin a little bit more time with Sprironolactone before I try and incorporate more topical treatments anyways... My total count of actives has gone down, but there are countless scabs right now and because I picked so many blackheads I am sure that in a few days I will have more cysts developing.

I've been using proactiv a bit. I've always sort of ignored the toner but I just realized today that the toner has glycolic acid as its main ingredient. Glycolic acid is supposed to be great for fading scars and unclogging pores. Since my face has been peeling a lot and is very scabbed, I wonder if using the toner more will help. I feel stupid for never really thinking about it before...

My side effects with spironolactone have been mild. Sometimes I feel a little light headed, but I can't tell if it is just all in my head. I haven't really noticed any of the diuretic effects that many other people have, which is good, I suppose. I definitely need to drink more water.

I have also decided to give up milk and sugar. Well, I will give sugar up for the a week or so because I'm going home for Christmas and there is no way I can not have sugar then. Giving up dairy seemed to help my skin in the past, but I later decided it was a placebo effect. Now I figure that it can't hurt. Not eating dairy and sugar also helps me naturally lose weight, so it has an added bonus.

Sorry for the rambling!

xx Shawna]]> Wed, 12 Dec 2012 19:18:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25187-spiro-day-13/ http://www.acne.org/messageboard/blog/6736/entry-25186-spiro-day-11/ Days on Spironolactone: 11
Days without Picking: 1
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 6 actives
Left Side of Chin: 4 actives
Lower Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:
Ok, so I'm counting yesterday's whitehead removals as picking because I think I went a little overboard. I have 2 new scabs that shouldn't be there. Discouraging... but the rest of my skin seems ok with minor improvements.

I'm changing the format of my log to "actives" so that its easier to keep track of improvements.



xx Shawna]]> Wed, 12 Dec 2012 19:17:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25186-spiro-day-11/ http://www.acne.org/messageboard/blog/6736/entry-25185-spiro-day-10/ Days on Spironolactone: 10
Days without Picking: 1
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 5 actives
Left Side of Chin: 5 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Update:
My skin is slightly worse today. A lot of stuff came up on the right side of my chin. I don't think its really "new" it just came up to the surface. I got rid of 2 white heads in that area. One is now flat, so I know it was ready to go, but the other is a little swollen. I have a cyst on the left cheek that is bigger today and it hurts...

I don't really count getting rid of the whiteheads as picking... but I probably should leave them alone.... I think I can go the rest of the day without picking, so hopefully I wont have to update this later.

Blood work Results:
I got the rest of my blood work results back. Everything was normal except for my testosterone levels. They are at 71. Technically, 0-90 is considered normal, but above 70 is elevated. My concern is that if all of my androgen levels are "normal", will spironolactone help?

xx Shawna]]> Wed, 12 Dec 2012 19:16:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25185-spiro-day-10/ http://www.acne.org/messageboard/blog/6736/entry-25184-spiro-day-9/ Days on Spironolactone: 9
Days without Picking: 0
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 3 actives
Left Side of Chin: 6 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.

Background:
I had acne on my forehead as an early teen. When I was 17-18 my acne transitioned to my cheeks and chin and my forehead completely cleared. At this point, my forehead never breaks out but I do have enlarged pores due to scarring. When I was 17 I went on Yaz and I believe this helped regulate my skin a lot. I still had breakouts pretty consistently but they only consisted of 1 or 2 cysts that were very manageable. Finally, last year, I got an IUD (Mirena) and my skin has been horrible since. To be fair, I also moved across the county and have undergone a lot of stress in that time period, so I think my increase in acne could be related to that as well.

I always have had irregular periods when I am not on birth control. Since my skin has been getting progressively worse, I decided to get my hormones tested. I am still waiting to get some of the results back, but I have been prematurely diagnosed with PCOS. My Lutenizing Hormone (LH) and Follicle Stimulating Hormone (FSH) ratio was 4:1 and it should be 1:1. Since I am not overweight (I've lost 30 or so pounds in the last few years), my doctor said it is no surprise that my androgen levels are normal. Androgens are what often cause acne and extra hair growth. Anyways, I'll update more on my blood work when I get the rest of the results back. I am still trying to interpret them. Since my androgen levels are normal, I'm also curious if Spironolactone will help since it works as an androgen blocker?

In the meantime, my Dr. (an endocrinologist) has decided to put me on 100mg of spironolactone. I take 50mg in the morning and evening.

Preliminary Results:
It has been 9 days so far and I feel like there is no visible improvement in my skin, but I feel like the inflammation under the skin has decreased.... if that makes sense. These results could be meaningless, since spiro is not supposed to take much of an effect until after a few weeks/months of use.

My major problem is picking. In fact, I just had a 10-15 minute picking session in the mirror about an hour ago. It makes me feel horrible and I know that I am not doing any favors for my skin. I wasn't always that bad, but the last year or so has put me to the test. My picking is the main reason why I have decided to post a log here. I know that documenting my results with spironolactone will help others, but posting here might also help me be more accountable when I'm in front of the mirror.

I'd like to somehow replace the habit with something that is good for my skin, but I am not sure what. Ideas? I'm also thinking about controlling how much time I spend in front of the mirror, since I know that it is a really big trigger for me.

The Rest of My Routine
I have gone on and off Proactiv for about 7 years. I am not the biggest fan, but I find that when I use it after discontinued use I get good results for a short time. Maybe 1-2 weeks. Then my skin declines and gets overly dry and new breakouts start. I know that i can use it safely for one week, so I will go ahead and do that now to try and clear up my skin a bit more. Then, I'll use a gentle cleanser (CeraVe) and moisturizer for the remainder of the spiro trial period.

In April I will see my endocrinologist again. I might request a larger dose of Spiro then if I do not see a lot of improvement. I'm also planning on seeing a dermatologist at some point. I would like to get Retin-A micro. In fact, I'm dying to get my hands on some. I feel like it is a great alternative treatment to benzoyl peroxide because it is known to actually improve the quality of the skin, whereas BP just dries it out.

My plan is to update ~daily to help control my picking, and maybe ~weekly to talk about the spironolactone results.

Thanks for reading!

xx Shawna]]> Wed, 12 Dec 2012 19:14:00 +0000 http://www.acne.org/messageboard/blog/6736/entry-25184-spiro-day-9/