So here is my obligatory sad backstory:
I am 23 years old. I started getting acne when I was around 13 years old. Mostly big, painful, inflamed pimples on my forehead and chin, and horrible cysts on my back. I tried Retin-A, tetracycline, then minocycline, none of which had any effect on my skin. Finally, in 10th grade, I went on a round of Accutane. My skin cleared up brilliantly, but then the acne returned within a few months. So I went on a second round of Accutane. Then, like clockwork, in about three months the acne returned (though it wasn't as severe as it had been previously). Instead of trying a third round of accutane, my doctor started me on Bactrim and Spiro, as well as topical Benzaclyn and Differin gel. This little cocktail worked like a miracle- my skin was crystal clear. Not even a clogged pore. I remained on this combination til probably my sophomore year of college. (Quite a long time to be on Bactrim. I thought nothing of it then, but now, being a nurse, I know that extensive use of antibiotics is bad, bad, bad.) Anyway, in my sophomore year of college, my skin was absolutely perfect, so my derm slowly weaned my off the Spiro and Bactrim. My skin was fine for a while, but then, of course, the acne returned. This time, I was started back on just Spiro and my topicals. Perfect skin for a couple more years. Then, my senior year of college (last year), I weaned off the spiro again.
I graduated college last May and had a really difficult time finding a job. I think the stress of being done with college, having to start my life as a "grown up", and having such difficulty finding a job brought on a lot of stress that eventually triggered the return of my acne. By October 2011, I had huge, inflamed pimples on my cheeks, my chin, and along my cheekbones during my period. Everything would get worse around the time of my period. I finally found a job, though, so I thought that maybe having some stress lifted off my shoulders would allow my acne to calm down. I tried a lot of over the counter treatments- Olay's acne system, some Clinique products, face masks, etc, but with little success. My skin has this cyclic behavior where it gets really terrible the week before my period, then starts to clear up after my period. Every time my skin would start to get better, I would think that maybe my acne was finally going away, but then the cycle would continue.
Finally, in January I found a derm (I had moved to a new city for my job, so I couldn't go back to my usual dermatologist). It was a derm office in the city- very busy, and the dermatologist seemed like he had little time for me. I explained to him that my acne was mostly hormonally influenced, and what had worked for me in the past. Without really listening to me, he placed me on doxycycline and retin-a cream and told me to come back in three months. Two months later, my skin was horribly irritated from the retin-a, and I had developed a ton of little bumps all over my forehead and cheeks. I had never experienced this before- they weren't really pimples, just tiny little bumps filled with a hard, waxy substance. Weird. So I went back to the derm. He simply told me to come back in a few months because the doxy and retin-a hadn't taken effect yet. Annoying. I knew that my acne was mostly hormonal, and I had heard that birth control could help clear acne, so I made an appointment with an OB-Gyn and started BC- Lo Loestrin Fe.
In April, I made an appointment with an Accutane specialist who I heard was really, really good. I explained my entire history to her, and she actually LISTENED and understood how stressed out and frustrated I was. She told me to immediately stop taking the doxy. She felt that since I had been on so many antibiotics in the past, the usual amount of bacteria in my body had been suppressed and I was actually possibly developing a fungal infection (the tiny little bumps on my face). She explained that she could put me on Accutane again and it would certainly clear my face, but the acne would eventually return. Instead, she explained, we would need to address the actual cause of my acne- hormones. She told me to continue with my BC (Lo Loestrin Fe), and start and Spiro (25mg daily). I also started using Ketoconazole cream (for the little fungal bumps on my face), a sulfur shampoo (like a dandruff shampoo- she explained that if there was any dandruff that I couldn't see on my scalp, it could actually get on my face and shoulders and clog up my pores), a sodium sulfur face wash (supposed to help with the bigger pimples), and another topical gel containing treitoin and clindamycin, I think. She told me to come back in two months.
After two months of using this system, I've noticed very little improvement in my skin. My skin still gets terrible the week before my period, then starts to clear up a little, and then gets bad again. My bigger pimples seem to heal up a little faster, though, and I have noticed a decrease in the acne on my back and chest. It's still incredibly disappointing because in the past, spiro has worked WONDERS for me, and relatively quickly. We're talking clear skin in like two weeks. So I made my two month follow-up appt with my derm on Monday. At this point, I was breaking out BADLY and she seemed genuinely upset that my skin hadn't cleared. She explained that with birth control, your hormones don't really start to regulate until after your third period. I had just finished my third pack, so I'm hoping maybe in the next couple of weeks my hormones straighten their shit out and I start to see improvement. She also increased my Spiro dose from 25 to 100 mg/daily. I also explained to her that the ketoconazole cream had done nothing for the tiny little bumps on my forehead and cheeks. She explained that if they were fungal, the Keto cream would have certainly cleared them up, so they might just be little plugged up pores/whiteheads. She told me to start using a Neutrogea salicylic acid face wash instead of my gentle cleanser, and that might help. She also DC'd my treitonin/clinda topical gel and started me in Differin and made an appointment for me to come back again in 8 weeks. She seems hopeful that my inflamed, hormonal acne will be pretty clear by then, and if I still have the tiny little plugged pores at that point, I can do a couple chemical peels with her.
So I am on day 73 of Spiro (but only day 2 of being on 100 mgs). I currently have three HUGE, red, inflamed pimples on my forehead that are starting to heal, three big (healing) ones on my right jawline, and one under the skin type right smack dab on the middle of my nose. I am NOT touching that one, and praying that it doesn't become red and inflamed. Another problem that I have is picking. I will sit in front of the mirror for an hour, examining every single pore on my face. It's pathetic how consumed my mind has become with my skin. I hate that I've become this way. It's seriously like a psychological disorder how obsessive i am. UGH.
Anyway, I am going on vacation with my boyfriend to visit his family in LA next Friday, for two weeks. There will certainly be beaches and pools and bathing suits involved, and I am so nervous about being seen without makeup/having body acne. I am really, REALLY hoping that my skin starts to clear up by then. At least the stuff on my back. Ugh. But I am super hopeful with my increased dose of Spiro. I'm just wondering why, this time around, it's not working as quickly as it has in the past? Is it possible for my body to develop a resistance to spiro?
Ahh sorry this has been so long.
Here is my current routine if anyone is interested:
Shower- wash face with Neutrogena oil-free salicylic acid wash. Wash shoulders/chest/back with Neutrogena body clear acne scrub.
-Clinique oily skin toner
-Olay combination skin UV lotion
-Makeup- clinique foundation and Maybelline concealer. I HATE wearing so much makeup, and I know that it's clogging my pores, but if I go without makeup I look awful. Any suggestions on foundation/concealer?
-50 mg Spiro
-Wash face with neutrogena oil-free salicylic acid wash
-Clinique oily skin toner
-Differin gel to face, chest, back
-50 mg Spiro
ALSO! I have a bunch of hyperpigmentation marks from old acne on my cheeks. This never happened when I was a teenager. I'm Italian and have dark olive skin, so these marks are pretty dark. Not pitted scars or anything, just reddish marks that don't go away. Does anyone know of any products that can help fade these?
Feel free to post your own Spiro experiences in here! I will try to keep updating.
Edited by Ekr150, 17 June 2012 - 03:01 PM.