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[padoodles]

I am a female in mid 30's. I did a strong course of accutane about 15 years ago and was very clear with normal skin for about 12 years following treatment. Over the past 3 years I very slowly started to produce more oil and now I've got more sebum production than I've ever remember having. My face is greasy all of the time and I now have very plentiful acne on my forehead and chin that is moderately severe. I have no acne on chest or back for now....

I've been on Yaz for nearly a year and over that time my acne has progressively gotten worse. From what I've been reading about spironolactone it might be a good next step. Will the spironolactone impact the efficacy of my birth control pills? I need them to work for contraceptive purposes. Also, should I try a different birth control pill that may work better to reduce my acne symptoms?

I really appreciate any feedback. My worsening acne is driving me more and more into social isolation and it is having negative consequences for my marriage and my family. It really hurts when even my young kids look at me with puzzled "yuck" all over their faces. :(

Also, no topicals thus far have helped (retin a, duac, bp, klaron) and even oral antibiotics (solodyn) haven't helped. I really believe this is a sebum problem and not an issue of exfoliation.

PLEASE HELP?? I'm going to my gyn tomorrow morning and would like to be prepared.

[zen.garden]

Hopefully this isn't too late!

Most people do take BCP in conjunction with spiro. In fact, my derm wasn't going to write it for me until she was sure I was on some form of birth control (Depo in my case). She said that the possible birth defects aren't nearly as serious as those experienced with Accutane, but that they are still serious enough to warrant reliable birth control.

Hope this helps!