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Just Started Low Dose Of Spiro Yesterday...any Advice?


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#1 thedarlinglife

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Posted 18 August 2012 - 10:37 PM

Hey alllll,

I've had acne since I was about 13. I am about to turn 23 in a few weeks...So nearly ten years. I'm not really sure what my type is, but I know my skin is never clear. It is just always, always bad. I don't generally have cysts. Maybe once every 4 or 5 months. However, my acne is very widespread. I have it all over my entire face...literally no pore is exempt. It's also on my neck, chest, shoulders, back, arms and even occasionally on my stomach. I don't get a ton of whiteheads, it's just generally every pore is a flesh-colored bump. I have blackheads on my chin and nose. My pores just either look bumpy or gaping and huge.

I have always banked on it going away with age. Alas, it has not...so at the end of this past June I finally made a visit to see a derm. I was always convinced that a dermatologist could do nothing for me because I've always known that my acne was caused by something internal/hormonal. However, it's gotten to the point where I am so down because of it that I can't hardly maintain a social life anymore.

Anyway, she said everything I thought she would and immediately put me on Monodox (doxycycline) 100mg 2x per day. She also put me on Ziana gel and told me to come back in six weeks.

My skin calmed down for a few days, but after that nothing changed. In fact, the Ziana gel made my skin SO oily that I couldn't go an hour without using two of those oil absorbing sheets. I do have oily skin, but it was never that bad. So I went back after the six weeks and she said she noticed it looked a little better (it didn't.), but she told me to keep taking the Monodox for 4 more weeks and switched me to Tazorac (.05%). I asked her about BC, but she said she never really saw any success with it in any of her patients and wants me to go see a gyno instead. Sorry, I didn't know just because I have bad skin means I also need to have my lady parts violated by a stranger, UGH.

SOO, I knew about all of the antibiotics and acne B.S. so I really didn't want to be on them long especially since I wasn't seeing any difference. I called her up two days ago (2 weeks shy of my 4 week visit) and told her I wanted to be on Spiro. She was all hesitant and said she only does it for women who have excess body hair and stuff like that, but she said she would do it. She told me to stop the Monodox because it would be a bad drug reaction. She called the prescription into my pharmacy and when I picked it up, it was 25 mg ONCE a day. I was pretty disappointed about that, but I guess it's better than nothing.

I'm still going back in two weeks so I'm hoping there's a marked enough difference for her to want to continue with it and up the dosage. I've heard 50mg is minimum to see any change. I'm about 5'6" and 120 pounds so it's not like I'm some tiny little thing who can't handle it. She wants to do a blood test and all that when I see her in two weeks so maybe after she sees that my K levels are okay, she will increase the dose.

I am hoping that this is what clears me up! I don't care how long I have to be on it. I'd just die to be able to wear a tank top or not have to put so much makeup on all the time :( I've only taken it for two days, so no difference just yet, but no IB either. Hopefully won't happen since school is starting in a week.

Have any of you ladies with the same type of acne had success with Spiro? And at what dose?

Additionally, any success with it and Tazorac? My skin's been less oily, but it peeled pretty badly the first few days and still does somewhat. I guess that means it's working on something...


#2 Green Gables

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Posted 19 August 2012 - 02:15 PM

I doubt you will clear on 25 mg but you are supposed to start at that dose and work up to a larger dose anyway. I was on 50mg for a month and then my derm upped me to 100mg after my body got used to 50mg. 100mg cleared me but actually proved to be too high for my weight (125lbs). I am now maintaing clear skin on 50-75 mg a day.

If you do well on 25mg for a month, call up your derm and ask for a higher dose. She/he may just be trying to play it safe.

Remember with spiro you must have PATIENCE. It can take at least 6 months to see ANY difference in your skin. It is a LONG-TERM solution so you will not see short-term results like you will slathering benzoyl peroxide on your face. The spiro will slowly change your hormones. I did not see A SINGLE BIT OF CLEARER SKIN until month 4 on 100mg.

Edited by Green Gables, 19 August 2012 - 02:17 PM.


#3 thedarlinglife

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Posted 19 August 2012 - 05:53 PM

I didn't figure that I would totally clear up on 25mg. I would just like to see enough of a difference so that she sees it is worth keeping me on. She was hesitant to do it in the first place so I don't her to write it off if there isn't any improvement. When I asked her about the Spiro, she wanted to start me on Doryx. I firmly believe antibiotics aren't going to help me at all. I've heard they don't help with hormonal issues. I'll try to do whatever I can to stay on the Spiro for at least 4-6 months at a bit higher dose.

Thanks for sharing your story, I appreciate it! I've heard the Spiro is slow going, but I do feel like that means it is working at the target of the issue. I can be patient for a few months cause I've dealt for the last ten years pretty much.




#4 jaydeec

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Posted 20 August 2012 - 01:31 AM

I started on 50 mg a day almost 2 months ago. I was also applying Epiduo at night. i found that my face cleared up after a month, well almost a month. I wasn't really expecting it to. I was looking in the mirror one day and saw no active acne, I was like ''wow, I'm actually completely clear''. I stopped taking it for a couple of weeks because i was having stomach issues with it, really bad bloating that made it uncomfortable to walk or do anything really. At the second week I started breaking out again, it was a bad breakout, not severe but bad. So i decided to go back on it regardless of my stomach issues. My derm told me to take it at night, that way I would sleep thru the cramping. I have been doing that and don't really have any side effects anymore. I have oily skin and I thought I would see a decrease in my oil, but I haven't . It's been almost a month since i went back on it and am still breaking out, I upped my dose to 75mg about 2 days ago. So far I've noticed a reduction in oil, which i'm happy about Posted Image I'm REALLy hoping that from now on I'll start seeing things clear up. one thing to remember is that Spiro is not a drug that will get rid of the androgen causing the oiliness and breakouts, it will only ''mute it'' so chances are you will continue breaking out when you stop taking it. But from what I've read if you have hormonal acne , it can be a god send Posted Image. FYI: there have been some women who have cleared with 25mg..at such a low dose. It may not happen often but it does. My derm was telling me she had a patient who cleared on 25mg's quite nicely. She suggested I go down to 25 mg's since i was having gastro-intestinal issues BUT I knew that would not work for me because I am not a tiny girl, I'm 5'9 and 200 pounds, so yeah..no!! Lol.

I too was prescribed an antibiotic by another derm ( before I switched) and wasted my money because i never wound up taking it. Antibiotics destroy the good bacteria in your stomach which in turn further aggravates your body and may also be the cause of acne (leaky gut, etc) I was told by my Endocrinologist I should see a difference with a month of taking Spiro...yeah right. I was told about 2 maybe 3 months by my current derm. Who knows, patience is key i suppose. Good luck , keep us updated on your progress..fingers crossed Posted Image

Edited by jaydeec, 20 August 2012 - 01:33 AM.


#5 cinnamon_stix

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Posted 20 August 2012 - 08:54 AM

Please be patient. Greengables is spot on with her post. I started spiro drastically on 100 mg and didnt realize what i was doing. I had horrible side effects and guess what? Even starting out on the full dose, it STILL took 7 months for my acne to go away completely. If you are impatient, then this is not the medicine for you. You have to start out at 25 mg. You have to allow your body time to adjust. I just restarted spiro at 25 and after a month i plan on cutting another 25 mg pill in half and upping to 37.5 mg before i even consider jumping to 50 because the medicine is so hard on my body. Best of luck to you and keep us all posted!

Also, i just wanted to throw it out there that spironolactone does infact only mute androgens. Spiro does not lower the testosterone in your body. It simply blocks androgen receptors. So if you stop taking it, receptors will be free to bind again and acne will return. I plan on staying on this med for life, along with some topicals.

#6 Iris9

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Posted 20 August 2012 - 03:33 PM

I agree with everything that's already been said.

You might see results from only 25 mg. I lowered my dosage from 50mg to 25mg based on side effects (hair shedding) and my cystic acne has not returned on 25mg.

About Tazorac: I hope you love it! It's by far the best topical for me. I've tried them all. Tazorac is another med with which you have to be really patient. Tazorac doesn't seem to help with my cystic acne (the spiro does) but Tazorac helps with everything else. Start with a tiny TINY amount. In the winter, I can only tolerate using it every other night, although I'm on a higher dosage than you (.1%). Get a good lotion and apply it before Tazorac if you want to lessen the strength of the Taz. Lotion will also help you spread around a small amount of Taz more easily.

Good luck!

#7 thedarlinglife

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Posted 21 August 2012 - 12:06 PM

From everything I've been hearing, it seems as though people tend to have more success when starting out at 25mg..even if they need more eventually. I'm okay with it, I'm just impatient :) haha. I'm also okay with taking it for long term. It's not fun, but if I can get some self esteem back out of it, it's totally worth it.

Cinnamon_stix, did you eventually get clear? Are you still?

I'm on day 5 of it and I haven't seen or felt any side effects so far. I've been making sure to stay hydrated and crossing my fingers that there is no IB. Good to know that if it causes cramping I should take it at night! Thanks

I use a pea sized drop of the Taz at night only. I've heard you have to wait 30 minutes after washing your face in order for it to be effective.

#8 cinnamon_stix

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Posted 21 August 2012 - 08:26 PM

after 7 months of spironolactone (100 mg) i was clear as a doll. no pores, no oil, not a single zit. not even on my period. women at makeup counters refused to cover my skin with foundation when i went to buy some because they claimed my skin was too beautiful to cover up. unfortunately, after stopping the medication due to heavy side effects, the acne returned. its not as bad as before, but it still came back. i stopped the medication for about 3 months and the acne started creeping back. i just now restarted on 25 mg and dont ever plan on jumping to 100 ever again. i suffered panic attacks, and was taken to the hospital multiple times because i felt like i was loosing my mind. not just that. constant emotional swings. bladder infections and yeast infections. i almost didnt want to restart but i dont have any other options. you need to be drinking alot of water so you dont getr sick. make it a priority. you wont start to feel side effects untill your about 3 months into treatment (if you do experience any side effects). some people dont feel any side effects untill months later, so just be careful.

#9 thedarlinglife

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Posted 23 August 2012 - 12:37 PM

Ayyy...I'm sorry to hear you had so many negative side effects. I've been trying to drink tons of water every day even though I don't feel thirsty or that I have to go to the bathroom any more than I usually do. Hopefully the low dose does well for you and gets you cleared up again. Let me know how everything is going.