11 replies to this topic

[Green Gables]

I'm at my wit's end with acne, so I'm finally keeping a log to track my progress (or lack of it). Like most of you, I've run through the gamut. I've tried everything, and no one can fault me for not sticking with regimens to the letter. But nothing has really worked. I stopped being a teenager a long time ago but I never "grew out of it." If I'm not seeing progress by this fall, then I'm doing the one thing I haven't done: Accutane.

I have moderate to severe cystic acne combined with big pustules. They form a sort of U shape from my lower cheeks to my chin. The area around my chin and jawline is definitely the worst. Lots of blackheads in this same area and on my nose. Very little on my outer cheeks or forehead.

This log is mostly for the regimen I started on February 15 (2 months ago from this posting).

100mg spiro (generic)
Nightly application of Retin A Micro 0.04 (brand-name)
Nightly session of LightWave CS

I've been doing this for 2 months, although the spiro started at 50mg, so I've only been on 100mg of spiro for 1 month. Before spiro and retin-a, for the last 8 months, I've been using the Lightwave CS blue/red light. It does make a small difference. Pustules that are closer to the skin resolve faster. But it doesn't touch the cysts, and it's not killing bumps fast or well enough to make my skin clear.

Right now I feel like I've had the worst inflamed acne of my life. By the third week my face became Pus Hell. The one positive is that some of the cysts that have reocurred in the same spot, never coming to a head, for YEARS, have actually come to the surface and popped. Some pustules that I thought had disappeared months or years ago have also come back up in the exact same spot. I've got a cluster of 5 on one cheek, and a sea of diagonal lines of pustules and cysts across my chin and jaw.

I have never found, through the many cleansing regimens I've tried, that how I clean my face makes a serious dent in my acne. I do notice that washing gently once a day seems to be the best. More than that and my face overproduces oil, less than that (I did try the don't wash your face trend a few years ago) and things start embedding themselves into my pores. Right now I am cleansing once a day with CeraVe and a clean washcloth. If my face is getting flaky, I moisturize with CeraVe face moisturizer. I wear sunscreen daily. I've been makeup-free for about 5 years. I gave up trying to cover it up since it's still so obvious no matter what I do.

I'm also maintaning a few health practices I started in order to eliminate acne, which none of them did, but they improved my mood and energy a little.

-Pearls Probiotic
-Zinc supplement
-Vitamin D, 5000 IU
-MSM supplement, 1000mg
-Very little dairy in my diet

I should note on the dairy, that I went off dairy completely 3 years ago and stuck with it for 3 years. I was very strict about not even eating a little dairy and checking for hidden sources of dairy in processed foods. For the first few months I thought it was the miracle cure. My inflammation went down a ton—not completely clear, but it was the best improvement I'd seen in ages. After about 4 months, though, my acne came back with a vengeance even though my lifestyle hadn't changed. I'm still staying mostly dairy-free because I feel better and lost some weight, but since it didn't cure my acne, I don't freak when there's dairy in Olive Garden's alfredo sauce.

I haven't felt a lot of side effects from the spiro. The first few weeks I was going to the bathroom a lot and was a bit insomniatic. That stopped, though, and even when my derm increased my dosage, I didn't notice those effects coming back.

So, right now I hate my face, but I'm trying to focus on the fact that a few persistent cysts are gone, even though with all the new acne, the overall level of acne on my face has not really gone down.

Feel free to comment, ask questions, give advice...I'm just hoping this works.

Edited by Green Gables, 19 July 2012 - 12:18 PM.

[KateLibby]

Ask your derm about adding birth control pills to help. I did a ton of research online when my daughter was having bad acne. I read many things that say adding birth control pills with spiro gives you more clearing. But it has to be one with low androgen activity like ortho tri cyclen or Yasmin. You can do a google search for best birth control pills for acne. I read a lot about spiro. I saw where many people said it took 6 months for them to start clearing but after that 6 months they really cleared. Some people said they had to go up to 125 -150 mg to see a difference. So hang in there.

I took my daughter to a derm and asked about spiro but he wouldn't give it to her because she was only 16. She took ortho tri cyclen birth control pills and that cleared her. He also told her to wash with cera ve, pan Oxyl 4%, and gave her a prescription for clindamycin lotion.. This combination has helped so much. The clindamycin is an antibiotic. We could tell a difference after 3 days with it.

Anyway good luck.

[Green Gables]

Thanks for the encouragement, Kate. I would love to try birth control to get rid of this acne, but it's only something I would try if spiro and Accutane don't work. Due to family medical history I am at a higher risk for blood clots so my doctor won't put me on Yaz. As for Ortho...there are a bunch of ladies in my family who were or are on Ortho Tri Cyclen and every single one gained a ton of weight on it. I am a dancer and significant weight gain would be very problematic for me.

I am really glad it worked for your daughter and will definitely consider it if this regimen fails me.

Edited by Green Gables, 26 April 2012 - 03:06 PM.

[Green Gables]

Week 10:

Is my acne getting better? It's so hard to tell. When I look at my face in the mirror it looks worse than it's ever been. The acne's "nature" has changed some though. I got a big zit on my forehead. I never get zits on my forehead. Some of my chin cysts have been replaced by multiple pussy nodules in a chain.

Zits will pop at random times of the day, and I'll put my finger up to my chin and feel pus and blood coming out. It's really doing a number on my work/school/social life. During my work presentation, one of my zits really obviously popped and blood came trailed down my chin right in the middle of my presentation. This better be a sign that things are getting better. This is awful.

A few days ago I applied some 2% benzoyl peroxide to my face. It calmed things down a little bit, but I know it's only a quick fix. I have tried long-term benzoyl peroxide regimens and never had significant success with them. It will work for the first little while, but then I feel like my skin goes "static." Something about the benzoyl will keep zits from growing and spreading, but it also seems to keep my skin from healing. Some of my longest-running zits stem from my 3 year stint with Proactive.

My derm didn't want me to use antibiotics because she wanted to see if the spiro and retin-a is actually working for me--without the temporary clearance from benzoyl or an antibioitic pill. But I am really tempted to ask for a new antibiotic. If this regimen is working for the long-term, can't antibiotics at least help the short-term? Can my skin even heal from all the purging without something killing the existing bacteria? I regularly use probiotics but they don't help my face

I really wish I could be sure that this is helping and not hurting my skin. I had a crop of blackheads on my chin this morning that I removed with my extractor. I'm not sure if they were new, or if the retin-a has finally thinned my skin to the point that oooold blackheads are getting pushed out.

Edited by Green Gables, 26 April 2012 - 03:31 PM.

[Green Gables]

I'm upping my Vitamin D to 10,000 IU at my doctor's recommendation. He ran a test and my Vit D levels came back low.

Edited by Green Gables, 03 May 2012 - 09:47 AM.

[Green Gables]

Guys, I'm getting pretty excited, because my skin is getting clearer. Last time I was this clear was when I was on really heavy antibiotics.

I cut down my regimen. It was just too much all at once. Right now I am:

100 mg spiro daily (50 mg morning, 50 mg night)
400 IU Vitamin E
10,000 IU Vitamin D-3
Retin A Micro 0.04% nightly
Alternating wash routine: OCM with Jojoba/Castor oil one day, CeraVe cleanser & Clarisonic brush the next. That's at night. I only splash my face with water in the morning.

The one down side is I think the spiro is making it harder to maintain muscle mass. I am a dancer and dance teacher, and am constantly exercising. Because spiro decreases the effects of androgens, it might also affect my muscles. But if I have to work a little harder on staying strong...well being clear is worth it.

Edited by Green Gables, 14 May 2012 - 12:10 PM.

[Green Gables]

I haven't had a cyst in a few weeks. I did get a few nodules that came to a head. but it's a big improvement. I still have some persistent under the skin bits that seem to be coming up s-l-o-w-l-y by degrees. Also some blackheads that I have to manually squeeze out or they get infected. I might ask my derm to bump up the strength on the Retin A. I haven't experienced much peeling from it, so maybe my skin can handle a bit more.

This is the best treatment that I have tried so far. I still am concerned though because spiro seems to be changing my body composition. I've gained 5lbs, and it's not water weight and I don't think it's muscle because my pants feel tighter. I've gone up half a cup size and my thighs/butt are bigger...I didn't really need any more fat in that latter area...

[Green Gables]

I tried going down to 75/mg for a week and a half because of the weight gain. That was a mistake...I have new breakouts today. I'm going back up to 100/mg. If I gain much more weight than this, not sure what I'm gonna do, though. I'm a dancer and 10lbs extra is killer in this profession.

[Green Gables]

Day 128 on spiro. Still clearing for the better. Some bumps but they're not true cysts, they're inflammations around embedded seeds the Retin A Micro keeps unearthing.

[Green Gables]

I've started cutting my pills in half so each dose is 25mg and I just take it more often. My body seems to absorb it better that way. I've also lowered to 75mg a day again. Maybe I'm crazy..but the FAT gain just doesn't seem to stop on 100mg. I'll stick with the lower dose a little longer than a week and see if it keeps my cysts at bay. Sometimes it's hard to tell what breakouts are from a lower spiro dose, and what are just from Retin-A Micro doing its things.

Fingers crossed for 75mg!

Edited by Green Gables, 27 June 2012 - 12:40 PM.

[Green Gables]

No nodules or cysts except one barely visible under the skin bump that's been there for...5 months. Will post pictures soon.

Gained a couple more pounds on 75mg since last month. Starting to think this dosage is really too high for me and is letting estrogen take over my body. I might have cleared on my original dosage of 50mg, but I didn't give it enough time--my dose was upped after only one month. I'm going completely off spiro for a week or two to see if I can kick my metabolism back into gear, then I'm going to start up 50mg again.

I've also stumbled across a thread on another board that discussed cycling Spironolactone and only taking it on days 4 to 22 of your menstrual cycle (when most likely to develop acne). Sounds interesting.

Edited by Green Gables, 19 July 2012 - 12:11 PM.

[Green Gables]

Lost a few pounds this last week on no spironolactone. Got a tiny whitehead. Starting back up at 25mg a day and seeing how clear I stay on that dose.