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Green Gables

I Am 100% Clear. Severe Cystic Acne Cured With Spironolactone.

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Both men and women contain testosterone and estrogen (and progesterone, but let's simplify the idea here for a minute). The only thing that differs is the proportion.

Let's say for sake of argument the ideal male has 20 estrogen units and 60 testosterone units. If his testosterone level keeps spiking at 80 testosterone units, his androgen activity is going to be way off what is healthy and he may have acne because of it. You see what I'm saying here? Although males naturally have more testosterone, it is still possible for a male to have a hormonal imbalance that gives him more androgen activity than is healthy for a male.

In response to your "testosterone shots", in fact some women are given hormonal treatment with testosterone or progesterone to treat an "estrogen dominance" problem where there is too much estrogen in the body.

Spironolactone has been used clinically in males. Spiro was originally a very early form of blood pressure medication. It does not lower the blood pressure very much and has since been replaced by more effective blood pressure drugs. But it was definitely prescribed to males. Typically a male dose does not exceed 50mg. On the boards, most women on spiro are on doses of 100mg-200mg for acne, PCOS, or hirsutism. So to answer your question, a male would not see sex change characteristics because most males have massively more androgens than women already. A women with a testosterone spike that causes hirsutism (facial hair) typically will not see results until a dose of 200mg. A man would have to be on a dose closer to 300mg-500mg to decrease testosterone so much that his beard goes away tongue.png

Even without spiro, there are other anti-androgens with similar effects that are almost exclusively prescribed to males! A hormonal imbalance can cause severe problems with prostate health. Saw palmetto and stinging nettle are almost exclusively marketed for MALE prostate health.

Anyway, this is always the first thing that men seem concerned about, oh my gosh am I not going to be a man anymore?? smile.png The nice thing about spiro is that it "mutes" your androgen receptors, it does not get rid of them. Once you go off spiro your androgen levels return to what they were before. So if you try it and don't like it, all you have to do is stop taking it and no harm done.

I appreciate what you are saying but I'm just not sure....... I think it is unlikely a male would produce "too much" testosterone unless there is an under lying health issue because the body balances its own requirements (the hypothalamus / pituatary do this I believe? using hormones LH & FSH) by only stimulating the testicles to produce so much.

I would have thought that it is far more likely for a male to have either too much estrogen or not enough testosterone,especially if he is over weight.

As for prostate health I'm not sure that is right... I think there is an argument in the medical field over actual cause and effect....... It is well known that prostate cancer or BHP is made worse by androgens (DHT especially), but the information I have seen suggests that testosterone does not actually cause the issue in the first place.

As a male who has had some hormone problems I would be seriously reluctant to take any medication which can raise/lower or otherwise mess around with my hormone levels, even if it was being supervised by an endocrinologist, let alone a GP or dermatologist..

I mean testosterone is what makes a guy manly right? Anything that blocks/lowers/alters testosterone in the body is going to have some effect... I mean otherwise it wouldn't work on the acne in the first place.


Took Roaccutane for moderate but persistent adult back & body acne.

04/2013. Completed course after 32 weeks, cumulative dosage of approx 100mg per kg.

02/2014. Completed second lower dose course.

04/2014. Acne is already returning.....


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I mean testosterone is what makes a guy manly right? Anything that blocks/lowers/alters testosterone in the body is going to have some effect... I mean otherwise it wouldn't work on the acne in the first place.

It is very possible for a male to have excessive androgen activity. Bodies are imperfect. Why can my uncle eat a crap sugar-filled diet and be the picture of health, while his brother can't look at a donut without gaining weight? Different body chemistry. You may have been born with a defective pituitary or liver or simply live a lifestyle that your body cannot cope with.

Side effects of elevated testosterone levels in MEN:

  • Acne
  • Minor testicle shrinkage
  • Reduced fertility
  • Hair Loss
  • Enlarged prostate

None of those sound like good things to me. You want your hormones to be in balance and you certainly don't want to lower testosterone too much as a man, but you don't want to protect elevated testosterone at all costs. You're possibly lowering your sperm count, losing your hair, enlarging your prostate, and shrinking your testicles to protect that testosterone--is that very manly?

While your body can regulate your hormones, you are capable of living a lifestyle that elevates testosterone to a point that causes those side effects.

Things that boost testosterone:

• Sexual arousal and sex, especially with semen retention (citation: http://www.ncbi.nlm....1?dopt=Abstract)

• Exercise, particularly muscle building

• Research suggests that when total fat, saturated fat and monounsaturated fat intakes increase, so does testosterone.

• Alcohol (depending on the amount and type consumed, sometimes it lowers testosterone see http://alcoholism.ab...lacer030117.htm)

• Zinc, reservatrol, vitamin D, L-carnitine (http://www.livestron...sterone-levels/)

• Dairy and sugar (http://www.huffingto...a_b_822163.html)

• Consuming proteins and carbs after exercise has been shown to increase the amount of testosterone

• Broccoli, cauliflower and cabbage yields compounds called indoles that help lower certain estrogens, which in turn can help reduce estrogen’s inhibitory effects on testosterone production

• A higher ratio of carbs-to-protein – somewhere around 2:1 – results in higher testosterone levels

• Low fiber diets

• Eggs: Testosterone is synthesized from cholesterol, and as such, food containing cholesterol is a good source of building blocks for testosterone. Eggs are a source of pure, unadulterated cholesterol

• Garlic (http://www.ncbi.nlm....0?dopt=Abstract)

• Certain amino acids, such as D-Aspartate

So while you could plausibly alter your lifestyle to eliminate anything that is spiking your testosterone levels. Or you could try an anti-androgen and see if it clears your acne without making you into a girl wink.png If I were a guy I would definitely try it before ruling it out, especially since anti-androgens have been safely used in males for decades.


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GreenGables

 


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I mean testosterone is what makes a guy manly right? Anything that blocks/lowers/alters testosterone in the body is going to have some effect... I mean otherwise it wouldn't work on the acne in the first place.

It is very possible for a male to have excessive androgen activity. Bodies are imperfect. Why can my uncle eat a crap sugar-filled diet and be the picture of health, while his brother can't look at a donut without gaining weight? Different body chemistry. You may have been born with a defective pituitary or liver or simply live a lifestyle that your body cannot cope with.

Side effects of elevated testosterone levels in MEN:

  • Acne
  • Minor testicle shrinkage
  • Reduced fertility
  • Hair Loss
  • Enlarged prostate

None of those sound like good things to me. You want your hormones to be in balance and you certainly don't want to lower testosterone too much as a man, but you don't want to protect elevated testosterone at all costs. You're possibly lowering your sperm count, losing your hair, enlarging your prostate, and shrinking your testicles to protect that testosterone--is that very manly?

While your body can regulate your hormones, you are capable of living a lifestyle that elevates testosterone to a point that causes those side effects.

Things that boost testosterone:

• Sexual arousal and sex, especially with semen retention (citation: http://www.ncbi.nlm....1?dopt=Abstract)

• Exercise, particularly muscle building

• Research suggests that when total fat, saturated fat and monounsaturated fat intakes increase, so does testosterone.

• Alcohol (depending on the amount and type consumed, sometimes it lowers testosterone see http://alcoholism.ab...lacer030117.htm)

• Zinc, reservatrol, vitamin D, L-carnitine (http://www.livestron...sterone-levels/)

• Dairy and sugar (http://www.huffingto...a_b_822163.html)

• Consuming proteins and carbs after exercise has been shown to increase the amount of testosterone

• Broccoli, cauliflower and cabbage yields compounds called indoles that help lower certain estrogens, which in turn can help reduce estrogen’s inhibitory effects on testosterone production

• A higher ratio of carbs-to-protein – somewhere around 2:1 – results in higher testosterone levels

• Low fiber diets

• Eggs: Testosterone is synthesized from cholesterol, and as such, food containing cholesterol is a good source of building blocks for testosterone. Eggs are a source of pure, unadulterated cholesterol

• Garlic (http://www.ncbi.nlm....0?dopt=Abstract)

• Certain amino acids, such as D-Aspartate

So while you could plausibly alter your lifestyle to eliminate anything that is spiking your testosterone levels. Or you could try an anti-androgen and see if it clears your acne without making you into a girl wink.png If I were a guy I would definitely try it before ruling it out, especially since anti-androgens have been safely used in males for decades.

I tried the saw palmetto, and the next day my throat was sore and i had a minor headcold =( there has to be something else out there! im desperate!

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I tried the saw palmetto, and the next day my throat was sore and i had a minor headcold =( there has to be something else out there! im desperate!

Um, it could have been a coincidence that you had a cold developing when you took the saw palmetto. There are other options:

Stinging nettle

Pygeum

Pumpkin seed oil


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GreenGables

 


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Spiro has been a godsend for me, too. I started on 50 mg last December (I think...?), just as you did, then upped it to 100 mg myself. When I told my derm, he felt it was fine to officially prescribe the 100 mg, and I've been on it ever since. I still have the occasional break out when I'm highly stressed or it's around the time of my cycle, but it's nothing like it was. I had moderately severe cystic acne, but haven't had one of those doozies since being on spiro. *Knock on wood*

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Thanks for sharing your story Green.

After 3 trials of Accutane, and developing Interstitial Cystitis from it, I'm trying Spiro for the first time.

I'm taking 50mg of Spiro once a day. I really would like to up it to 100mg (50mg twice a day). No clearing yet, it's been exactly 30 days. Fingers crossed that it works, I'm always paranoid that I'm going to be the one person it doesn't work on.

Did you use any topicals while waiting for your skin to clear? I got prescribed Tazorac/Aczone at the same time as Spiro and it's KILLING my skin. I'm thinking about switching to BP once a day.

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do you believe the main reason you didnt get deep scars is because of using retinoids... or is it because you POPPED the pimples?

I think popped is too strong a word. Popped implies that something broke. Once a zit has reached a whitehead it has already broken through the upper layer of the skin. I just squeezed it out so it wasn't stretching the skin further.

I think I have fewer scars than some is because of retinoids and because I moisturized regularly. But I don't think it's a good idea to let pus sit in your skin for extended periods of time. If it's popped already, get that crap out.

Tazorac is very strong. The strongest I've been on is Retin A Micro 0.04%, and my skin could only handle it about once every 3-4 days.


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GreenGables

 


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what type of moisturizer did you use?

what do you consider to be extended period of time?

were you always on retnoids when you had acne?

how exactly do you squeeze the zit? thanks

I feel that for me its all hit or miss. Sometimes if i leave the zit it heals flawlessly, other times not so much.

I have only popped 2 pimples, both scarred.

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what type of moisturizer did you use?

what do you consider to be extended period of time?

were you always on retnoids when you had acne?

how exactly do you squeeze the zit? thanks

I feel that for me its all hit or miss. Sometimes if i leave the zit it heals flawlessly, other times not so much.

I have only popped 2 pimples, both scarred.

I have pretty much always used CeraVe moisturizer. I have tried others on and off, but ended up throwing them out because they either irritated my skin or had pore clogging ingredients. I went on a natural kick for a bit and tried Burt's Bees moisturizers. Great, rich and creamy stuff, but they're all based on coconut oil, which is highly comedogenic.

Look dude, as far as the zit thing, I don't have some proof for you that squeezing a whitehead is always better or worse than not squeezing it. But either way, having a cyst on your skin is stretching it. You don't want to make matters worse, but that cyst is already doing damage to your skin just by being there. If you can gently remove the infection with very light pressure, I'm just guessing it's better for your skin than the pus sitting inside your skin for weeks. So my rule of thumb is, if it comes to a head on its own, I squeeze it out.

I have been on retinoids off and on. Mostly Differin, some Retin A Micro. I have changed insurances and dermatologists multiple times in the last thirteen years. I have not been on retinoids the whole time. Sorry, I can't tell you exactly how long and how many times, I've had acne for too long to even remember that.

I squeeze it the way my derm told me to, quote "if you must squeeze a whitehead, do it this way." You disinfect your hands with hydrogen peroxide and gently apply light pressure with both fingers, no fingernails, about an eight of an inch away from the very outside of the edge of the pimple. One derm also said it sometimes helps to take a big chunk of skin outside the zit, like you're trying to pinch your cheek, and just squeeze a little that way. People tend to squeeze too close to the zit, so they push stuff back into the skin.


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GreenGables

 


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I'm a guy and im taking Spiro, my sisters hooking me up, and the results are AMAZING! within two weeks all the redness has gone no new pimples/cysts have come up and no side effects yet.

I know you're not suppose to take it as a male, but im at the point in my life where ive taken/tried everything and nothing has worked, so i really dont care anymore.

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I'm a guy and im taking Spiro, my sisters hooking me up, and the results are AMAZING! within two weeks all the redness has gone no new pimples/cysts have come up and no side effects yet.

I know you're not suppose to take it as a male, but im at the point in my life where ive taken/tried everything and nothing has worked, so i really dont care anymore.

That's great. If you read my previous posts, low doses of spironolactone have been used in males in various clinical studies with great success. As far as I can tell, males mostly need to worry about doses 100mg or higher.

If you do happen to get a cyst, keep up with it. I didn't see real consistent results until month 4. Hormonal changes can take a while to cement into your skin. But if you're seeing results so soon, kudos to you.


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GreenGables

 


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How did you not scar???

I do have some shallow indented scars on my chin and icepick scars on my cheeks.

I'm guessing the reason I did not scar too bad is

1) Did not use BP long-term (BP causes free radical damage, slows healing, and can increase scarring). Most of my indented scars are from the time when I was using BP a lot.

2) Tried to keep my face moisturized. Dehydrated skin can't heal. I don't wash my face more than once a day, sometimes less.

3) On-and-off use of retinoids may have helped some.

4) Avoided sugar and refined carbs like the plague. Sugar reduces collagen.

At blame is a natural process that's known as glycation, in which the sugar in your bloodstream attaches to proteins to form harmful new molecules called advanced glycation end products (or, appropriately, AGEs for short). The more sugar you eat1.gif, the more AGEs you develop. "As AGEs accumulate, they damage adjacent proteins in a domino-like fashion," explains Fredric Brandt, MD, a dermatologist in private practice in Miami and New York City and author of "10 Minutes 10 Years." Most vulnerable to damage: collagen and elastin, the protein fibers that keep skin firm and elastic. In fact, collagen is the most prevalent protein in the body. Once damaged, springy and resilient collagen and elastin become dry and brittle, leading to wrinkles and sagging. These aging effects start at about age 35 and increase rapidly after that, according to a study published in the British Journal of Dermatology.

Besides damaging collagen, a high-sugar diet also affects what type of collagen you have — another factor in how resistant skin is to wrinkling, says Brandt. The most abundant collagens in the skin are types I, II, and III, with type III being the most stable and longest lasting. Glycation transforms type III collagen into type I, which is more fragile. "When that happens, the skin looks and feels less supple," says Brandt. The final blow: AGEs deactivate your body's natural antioxidant enzymes, leaving you more vulnerable to sun damage — still the main cause of skin aging.

and of course

5) Luck.

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GreenGables

 


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Luck, I'd say. Mine didn't look that bad but I have so much more scarring than you... guess it was the BP sad.png

While I don't think BP is the worst thing in the world, I really don't think it was ever intended to be used every day. I think it can be more damaging than people realize especially when your skin is trying to heal from tons of acne.

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GreenGables

 


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Can spiro be used on all acne. I ask because i am questioning whether my acne is 'hormonal' or not. It's always there. The worsening doesn't happen in a pattern (my cycle). I have it mostly on chin, sides of mouth, some jaw and lip -inflamed clusters that start as undergrounders and get sore.

Should i ask for a hormone test?


It's a rocky road but like everything else in life, there is always a beginning and an end. Here's to finding my end.

God is good to me..........more than I deserve.

James 1:2-4

Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance. And let endurance have its perfect result, that you may be perfect and complete, lacking in nothing.


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Can spiro be used on all acne. I ask because i am questioning whether my acne is 'hormonal' or not. It's always there. The worsening doesn't happen in a pattern (my cycle). I have it mostly on chin, sides of mouth, some jaw and lip -inflamed clusters that start as undergrounders and get sore.

Should i ask for a hormone test?

I didn't get a hormone test. Hormone tests can be helpful or they can be completely inconclusive. It was also going to be super expensive with my insurance, so I opted to just try spiro, which costs me about $10 a month.

Spiro mutes your androgen activity. It does not change anything permanently about your androgens. Think of it like this. If it is outside raining, spiro is an umbrella. It protects you from the rain but it doesn't reduce the number of raindrops. As soon as you close the umbrella, you get wet.

So if you're worried about spiro changing something permanently about your body, it won't. You can dance in your acne rain as much as you want just by closing the spiro umbrella. I would JUST TRY IT because it's so dang cheap and mild as far as drugs go.

If excess androgen activity is your problem, then in 4-6 months you should see a dramatic clearing of the skin. If it's not the problem, then you won't see any changes. If you stop taking the spiro, the umbrella is closed, and everything is back the way it was.

I am 125lbs and cleared on 100mg. If you weigh significantly less, dose at 50-75. If you weight significantly more, dose at 150-200.

Please just try it already smile.png I only say this because I never dreamed that I could solve my acne problems by taking a pill twice a day. I don't have to worry about BP bleaching my sheets, or getting sunburned from acids, or looking red and irritated from retinoids, or going through some complicated face washing regimen, or taking 200 supplements a day, or eating some crazy raw diet for fear of triggering another breakout. My skin is now "normal." I can touch it, not wash it, sleep on a dirty pillowcase, eat a dessert, or whatever, and it is completely fine!!!


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GreenGables

 


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Thanks for the quick response. I guess i am afraid of making it worse - which i have by trying all these natural products so.......Will talk to my derm about ti Friday, thanks!


It's a rocky road but like everything else in life, there is always a beginning and an end. Here's to finding my end.

God is good to me..........more than I deserve.

James 1:2-4

Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance. And let endurance have its perfect result, that you may be perfect and complete, lacking in nothing.


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Thanks for the quick response. I guess i am afraid of making it worse - which i have by trying all these natural products so.......Will talk to my derm about ti Friday, thanks!

You may want to print this out and bring it to your visit: http://acne.about.co...ronolactone.htm

In explains in clear language, but also with medical citations, why spironolactone is a good choice for acne. Note that right underneath the title it says "About.com Health's Disease and Condition content is reviewed by the Medical Review Board". So another plus.

I only suggest this because, from my experience, spironolactone is not on the top of most derms list for acne. I went into a derm that I knew prescribed spiro. All of my previous derms had pushed me on more antibiotics, birth control, or Accutane. So it would be helpful to just have that list printed out if they try to brush you off.


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GreenGables

 


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spiro did nothing for me. I am perimenopausal and therefore have not much estrogen left. my testosterone was low also. I really thought this would be the answer to my comedogenic acne but after a year it was still plugging up.

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Hi Green Gables.....so i went to my derm today and she said no to Spiro - especially because i did not want to take birth control. She also said she suspected i had rosacea and prescribed a cream that just my luck has pore clogging ingredients in it - not gonna use it. Not sure what to do noweusa_wall.gif


It's a rocky road but like everything else in life, there is always a beginning and an end. Here's to finding my end.

God is good to me..........more than I deserve.

James 1:2-4

Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance. And let endurance have its perfect result, that you may be perfect and complete, lacking in nothing.


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Hi Green Gables.....so i went to my derm today and she said no to Spiro - especially because i did not want to take birth control. She also said she suspected i had rosacea and prescribed a cream that just my luck has pore clogging ingredients in it - not gonna use it. Not sure what to do noweusa_wall.gif

What the hell? I have rosacea and acne and spiro obviously was a miracle drug. I'm not on BC.

There are even studies about it and rosacea:

Spironolactone at 50 mg/day was orally administered for four weeks to 13 male patients with rosacea in order to observe its clinical effectiveness. Serum estradiol (E2), 17OH-progesterone (17OH-P4), testosterone (T), androstenedione (delta 4 A), dihydrotestosterone (DHT), dehydro-epiandrosterone sulfate (DHEA-S) were measured prior to and after treatment. Although there were no significant changes in T, delta 4A, DHT, or DHEA-S, the serum levels of 17OH-P4 increased significantly. E2 tended to increase, although the change was not significant. Two of the 13 patients discontinued spironolactone treatment because of general malaise, but seven of the remaining eleven patients exhibited an improvement in their rosacea. These findings demonstrate that a low dose of spironolactone is effective in the treatment of rosacea in some male patients and suggest that it is possible that changes in the metabolism of sex steroid hormones such as cytochrome p-450 isozymes have some bearing on the etiology of rosacea.

Can you switch derms? There is no reason that you can't go on spiro unless it's been proven that you have some potassium retention problem, which is like 0% of the population. What reason did she give? She just sounds like she's a bit of a control freak and can't stand to actually have a specific medication requested...she wants it to be her idea.

You can go the natural route with saw palmetto + stinging nettle anti-androgens, but you're playing more roulette with that route because you have to find a good brand that has great standardized extract, and play with the dosages since there's not really a defined dosage range...

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GreenGables

 


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