I've been on Ortho Cyclen for around 5 years now (I'm 29). For the first 3 years or so, I took it in conjunction with spironolactone and was almost completely clear the entire time. Now I just use Ortho Cyclen and a topical benzoyl peroxide, and stay mostly clear.
Ortho Cyclen doesn't really keep me clear on its own, but it never worsened my skin or caused any health problems so far.
Well, there are several factors involved in acne formation: hyperkeratinization, sebum (over)production (which is stimulated primarily by androgens), presence/activity of P. acnes bacteria, and inflammation. Hyperkeratinization is abnormal shedding of skin cells within the follicles, which creates plugs... these "plugged follicles" are called microcomedones... if there is some drainage (of sebum and the other contents), it will become an open comedo, or blackhead. If there is no drainage, it will become a closed comedo, or whitehead, which can become an inflamed lesion, such as a pustule or cyst. So, microcomedones are the precursors to all acne lesions.
Current scientific research suggests that an inflammatory response, caused by our innate immune system (meaning this is a hereditary difference), interrupts the normal cycle of the sebaceous follicle, causing hyperkeratinization... and because of the other substances in the follicles (e.g. sebum and keratin), plugs form. Several factors have been implicated as triggers for this initial immune response, including various combinations of: androgens, certain hormone receptors, certain regulatory neuropeptides/ cytokines, deficiency in certain anti-oxidants, and certain environmental factors (specifically, stress response or topical stress, diets containing pro-inflammatory substances, and smoking).
A further immune response can result due to chemical changes which occur to the obstructed comedo as it progresses, which is where P. acnes can be involved. At this point, pustules or other inflamed lesions are formed.
So, why we get acne is pretty complicated, which is why there's no easy solution that works for everyone. Antibiotics are anti-inflammatory, which is why they're helpful for acne treatment in many cases.
Most people take spiro in conjunction with hormonal birth control.. yaz is a common choice because its progestin is chemically similar to spiro.
Spiro can take up to 10 months for full effects, but most people see effects in 3-4 months... if you're not getting clearer in the next three months, I'd consider talking your your doctor about other treatment options...
You might also consider doing a topical regimen along with your hormonal treatments... stubborn acne sometimes needs to be tackled from a few different angles... your gyno will be able to talk to you about it (and write prescriptions) if you're interested.
Yes, the gel should be better than the cream for oily skin. I suppose if you can't get the taz gel (because of insurance), you could check if retin-a micro (0.1%) is covered by your insurance... they are similar products.
Good luck, I hope your skin starts to clear up soon
What % are you using? I'd say give it a couple months or so, and if your skin isn't improving, talk to your derm about increasing the concentration... that seems to be the trick with retinoids for most people.
But in general, it does take 3-4 months for results... however, it seems like stubborn acne that doesn't clear up in a few months needs a higher concentration.
Are you using any other topicals?
Also, smart guy has a good taz log... I find reading successful logs to be encouraging
I agree that this post should be pinned, so that it's easier to find, since it's so awesome
The vast amount of info here is up-to-date with research... and I'm often browsing this post to further my understanding of the various supplements/ diet changes recommended to me by my doctor. This post definitely has good info for those of us with acne prone skin, but ultimately the info is relevant to general health as well. I think everyone trying to get clear will benefit from reading this post. (...though maybe they'll appreciate it more appropriately after researching acne formation, so that they also know the purpose/mechanisms of their various acne treatments.... and thus will further understand why the info here is valuable for any regimen...)
Well, drinking lots of water should generally help with the muscle cramps (it's a good idea to stay well hydrated while on yaz anyway).. it's not unusual for you to get muscle cramps while using yaz (or spironolactone... which is similar to the progestin in yaz). It will likely pass... but you should always call your doctor if you're worried.
It's also a good idea to go back to the doctor after the first month of using yaz, so that they can do some blood tests to check your potassium levels, etc...
You can use AHA's with retin-a so long as the combo isn't too drying for you. I use a glycolic wash and tretinoin (generic for retin-a) without any problems.
You should use the AHA in the morning and the retin-a at night.
It's a good idea to start off slowly with the retin-a... use it every three nights, and slowly work up to using it nightly over several weeks (and always take a break if you get redness or irritation). It's good that your skin is already used to the AHA.