110 replies to this topic

[m1m1m]

So happy to see your results have been positive!
I am considering spiro for my severe acne, ive been struggling FOREVER I'm to scared of 'tane and birth control makes me crazy.
spiro sounds like a godsend, I'm just weary of the potassium levels, and I read it can affect your eyes (glaucoma?)
Any advice on how to quell the fears? Did you have an IB? your skin looks soooo good

[Green Gables]

So happy to see your results have been positive!
I am considering spiro for my severe acne, ive been struggling FOREVER I'm to scared of 'tane and birth control makes me crazy.
spiro sounds like a godsend, I'm just weary of the potassium levels, and I read it can affect your eyes (glaucoma?)
Any advice on how to quell the fears? Did you have an IB? your skin looks soooo good

If you look at the studies, spiro is about the safest man-made acne medication you can be on. It has less serious side effects than Accutane, birth control, and systemic antibiotics. The nice thing about spiro is that if you are going to have side effects you will notice them and can lower your dose without long-term damage. Unlike Accutane, spironolactone does NOT make permanent changes to your body. It "mutes" your androgen receptors. Once you stop taking it, your androgen activity will return to what it was before. There are plenty of posts on here that anecdotally show women who went off spiro and went back to their pre-spiro state. That is great for someone like me who is not comfortable with all the possible permanent side effects of Accutane.

Spiro is also older than Accutane and many forms of birth control, and has been studied to be safe for long-term use.

CONCLUSIONS:
After 200 person-years of exposure to spironolactone and 506 person-years of followup over 8 years, no serious illnesses thought to be attributed to spironolactone were reported. The long-term use of spironolactone in the treatment of acne in women appears to be safe. Side effects, however, are common, although not usually a cause for stopping the drug.

Frankly, I have no idea why this drug isn't prescribed more. My bet is that since most women eventually end up on a hormonal birth control, they want to clear their acne and prevent pregnancy all in one go.

The one big thing that spiro can cause is hyperkalemia. This is very rare. Spiro is a potassium-sparing diuretic so you retain more potassium in your body. You just need to be careful of consuming lots of potassium. One person on this board was a gardener and consumed several pounds of raw vegetables while on spiro and temporarily passed out. But like I said...for any normal person it's pretty hard to consume that much potassium...

A caring derm will get your potassium levels checked every 3 months for the first year on spiro to ensure that you're doing okay. If they don't force you to do it, you can still request the test on your own, it's a cheap test ($15-$20).

I would recommend starting on a low dose (25mg) and just see how you react for a month. Some people have even cleared on 25mg! When I was on 25mg my body didn't even seem to notice. On 50mg now I do have to pee more often, but that's normal for spiro, and drinking a lot of water and peeing a lot are worth clear skin.

I did not have an IB. My skin was very bad to start with, but I didn't notice a sudden burst of acne coming to the surface like I did with retinoids. I was actually very discouraged the first 3 months of spiro because my skin was EXACTLY the same. But at month 3 I noticed some small clear patches of skin...and slowly over the next few months I noticed I wasn't getting any new acne.

Long story short, it's a very non-scary medication, and I HIGHLY recommend it for hormonal acne. It's so weirdly refreshing to look at myself in the mirror and not see acne. That hasn't happened since elementary school!!!

Edited by Green Gables, 10 August 2012 - 09:12 PM.

[jaydeec]

Awesome your skin looks nice. I'm on 50 mg's it's been almost 3 weeks. I stopped taking it for a week due to stomach issues because of it. But it cleared me up within a month (at least I think it was the Spiro) so after a week and a half almost 2 of not taking it i got back on it . I'm waiting patiently for my face to clear, I'm still very oily though. I'm thinking I may need to increase.

[lionfish]

congrats on clear skin! i wish guys could take this stuff =(

I got really excited reading about this especially because you've had such amazing results, but then I saw only girls can take it. Damn...back to the drawing board lol.

It's not officially recommended for males, but some have used it. Reviews are mixed. It is an "off-label" acne medication, its original use was a diuretic. It has been prescribed to males. You just need a very low dose, which may or may not help your acne.

See:
http://www.acne.org/...actone-for-men/
http://www.acne.org/...-works-for-men/
http://www.acne.org/...spironolactone/
http://www.acne.org/...spironolactone/

I would highly recommend trying a natural anti-androgen route though. If women can get such great results from hormonal treatment I think men can too, just need a different ratio of hormones. E.g. Saw Palmetto is natural anti-androgen used by a lot of males for various reasons. I did try saw palmetto without results...but I think that's because a) saw palmetto's effects really work better with men and b) my dosage was probably way too low.

The results are clearly fantastic and for a female the side effects sound a lot more reasonable than accutane....

BUT... why would a man want to take something which is going to suppress natural androgens (i.e. DHT, testosterone or whatever)? Surely the side effects would be massive... loss of beard/hair growth/sexual problems... and so on... in fact pretty much all hypogonadism symptoms would be likely I would have thought.

If you reversed the sexes this would be like giving a woman a testosterone injection or something... going completely against what is natural imo.

[Green Gables]

The results are clearly fantastic and for a female the side effects sound a lot more reasonable than accutane....

BUT... why would a man want to take something which is going to suppress natural androgens (i.e. DHT, testosterone or whatever)? Surely the side effects would be massive... loss of beard/hair growth/sexual problems... and so on... in fact pretty much all hypogonadism symptoms would be likely I would have thought.

If you reversed the sexes this would be like giving a woman a testosterone injection or something... going completely against what is natural imo.

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

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?? 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.

Edited by Green Gables, 12 August 2012 - 11:09 AM.

[lionfish]

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

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?? 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.

[Green Gables]

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 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.

Edited by Green Gables, 12 August 2012 - 05:00 PM.

[ohmygod]

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 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!

Edited by ohmygod, 12 August 2012 - 05:24 PM.

[Green Gables]

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

[Jabberwocky80]

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*

[RightMeow]

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.

[whoartthou1]

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

[Green Gables]

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.

[whoartthou1]

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.

[Green Gables]

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.

Edited by Green Gables, 24 August 2012 - 04:29 PM.

[whoartthou1]

thanks. Maybe i am just stressed and frustrated. sorry

[Green Gables]

thanks. Maybe i am just stressed and frustrated. sorry

No problem, good luck on your search.

[ohmygod]

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.

[Green Gables]

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.

Edited by Green Gables, 30 August 2012 - 09:12 PM.

[Brarei200]

How did you not scar???