Just shy of the 2 month mark! I've had some ups and downs, but am still feeling confident this will be a good long-term solution. Taking 100mg/day of spiro and have tried to slowly taper off the doxycycline, which I've been taking 200mg/day of since August. I didn't think it was helping, but over the last 2 weeks every time I lower my doxy dose, I have a breakout! So maybe it was helping after all. I don't mind the daily spiro since I know that's okay for long-term use, but the antibiotics are really not my first choice since your body can build a tolerance and they're really not good for long periods of time. My derm recommened once I hit the 3 month mark with spiro, I can drop the doxy to 100mg/day for 2 months then stop altogether. So that's good there's an end in sight for the antibiotics. And I'm still feeling really happy I avoided accutane, even at the strong suggestion of my derm, since now I see how much my acne was related to my hormones and that I really can get it under control with spironolactone.
At my appt with my derm yesterday I asked her to use a cortisone shot for a breakout on my chin. There are 2 bumps that have all the makings of turning into swollen cysts, the kind that don't come to a head and just hang out on my face for 2 weeks. Since I haven't had any really large cysts in the last few weeks, and I'm trying hard to work on clearing my acne scars and hyper-pigmentation, I wanted to be proactive and try and get rid of these before they got any bigger. But she said she wouldn't inject them since there is too great of a risk of atrophy, which is when your skin sinks in and leaves a "hole" that can last for months, or even years. Sooo.... I guess that is a good thing? That they aren't that bad? I was a little disappointed since those shots are like little miracle workers that immediately make the bump go down, plus it's a $25 co-pay every time I go in, plus I have to take off work and travel to the office, so it's hard for me to get in there often. She said if they get bigger to just make an appt later in the week but I can't just keep trekking off to the dr. and leaving my job! Oh well. I guess I shouldn't complain since I've been relatively clear and these are certainly nothing like the kind I used to get. I think I just have such an emotional and knee-jerk reaction when I start seeing something forming. I immediately go into a kind of panic mode and worry that they are going to keep growing (which now I know makes it *even* worse since stress throws off your hormones and makes your body pump out even more acne-inducing stuff) so I try to keep calm. But it's hard when I feel like acne is controlling my life and my self-esteem and confidence basically goes down the drain when I see them appear. I feel ugly, I feel like a loser, I feel like no one will love me, etc. etc. of crazy reactions that I *know* aren't true but can't help from worrying about.
Last night I was thinking about all the times I either changed plans, or was in a bad mood, or stayed in, or avoided people including my boyfriend and friends, or snapped at my parents because of the stress I felt.... the list goes on. I know it sounds crazy but acne has controlled so much of my life for the last 10 years. It makes me feel sad and like I've missed out on feeling happiness and maintaining a carefree attitude. I see women around the city who are my age, late 20's or early 30's, who have perfectly clear skin and I seriously feel jealous. Jealous! Of complete strangers. I know it's not normal, but I can't help it. I think I might seek some professional help by setting up an appt with a therapist through a referral from my primary care physician. It's gotten really hard for me to relate to people and the only outlet I have right now for my stress is on this blog. Which helps! But I still feel like I have a lot of leftover anxiety, stress, and sadness from the experiences I've had. There were literally days last year when my face was so swollen that I would call out sick from work and mope around my apt all day by myself. I think that's borderline depressing. If not full-on depression. Granted, it goes in waves and is definitely better when my skin improves, there's a direct correlation. And everything else in my life is fine. I have a good job, friends, family, etc. so I know it could be way worse. But I can't stress enough how emotionally devastating it has been to look at my face in the mirror some days and just cry. Granted, it's way way way better since the spiro, thank goodness, and I don't think I'll ever go back to those terrible terrible days, but I do think I need to get a handle on how to deal with those leftover emotions. Some people say acne is a cosmetic condition, but I know for sure based on my experience that it can cause severe emotional pain. There were days I wanted to just curl up in my bed and sleep for days and days until the marks went away (which I obviously couldn't do, and didn't do) but still, those feelings are not healthy!! One big thing I've accepted in the past few months is that the more in control of my anxiety I am, the healthier I look. And since my anxiety is directly linked to what's going on with my face, I need to be confident that even if I have a breakout, or 4 or 5!, that it's not the end of the world and life goes on. Easier said than done, but I'm trying every day to work on my confidence and self-esteem. I start beating myself up that I'm inadequate, that my boyfriend will think I'm ugly, that he won't want to be with me, and loads of other craziness. When in reality, we've been dating for over 2 years and he's seen me without makeup at my worst. And has never said a bad or mean thing about it. He's also not super supportive, in that he doesn't understand how upset I can get when I get a huge cyst, but I think that's because he's never had anything like that and doesn't get why I think it's a big deal. I don't talk to anyone about it really, for that reason. I feel like no one understands how much it effects me. But that's just the thing...... it's my own fault for beating myself up about it! No one is making fun of me (or, at least, no one that I know of haha) and all the close people in my life love me unconditionally. I'm absolutely my harshest critic and feel this need to look perfect. I think a therapist could help me a lot. So that's my goal for 2013 --- to work on my self-esteem and improve my self-worth and stop beating myself up for not being perfect.
In terms of side effects of spiro, no more dizziness and only a slight increase in urination. Still need to drink extra water throughout the day. Other than the few spots on my chin here and there, no major crazy cysts and my forehead and cheeks are completely clear and look amazing. Chin is still on the mend, but my derm reminded me that 3 months is the ultimate mark for it to work so here's to hoping the next month is the best one yet! The tretinoin has been awesome in reducing my clogged pores and keeping my skin smooth, I've been using the 0.025% for over a year and love it. Lately I've been using it every other night, and just moisturizing on the "off" nights, which has really improved the tone and texture of my skin in the cold winter weather. I stopped using benzoyl peroxide and clindamycin (in the form of acanya or duac) altogether. My skin is MUCH less red. I noticed that without those topicals, my skin is actually in a better state. It's not flaking or scabbing or irritated, and that really those things were just making the cysts appear worse. Since not only were the cysts creating a bump on my face, the topical stuff was making the bump red and scabby. Without the redness, my skin can still look uneven since the cysts are deep within my skin, but at least the tone of my face is even (well, not perfectly even, but not red and inflamed and crazy looking!). I know those products can help certain kinds of acne, but for mine, I think it just made it worse. Mine are so deep within my skin that only cortisone injections or internal meds are going to make a big difference.