10 replies to this topic

[thedarlinglife]

So I've been on Spiro for 7 and a half weeks now. I started at 25 mg for the first near three weeks and then was at 50 mg the remainder. I saw my derm after the 2-3 weeks of being on 25mg and she was ecstatic. She said everything was already looking so much better and she seemed very genuinely happy for me. The oil production on my face slowed down SO dramatically. So at that time, she upped my dose to 50 mg. Meanwhile, I went to an internist and got prescribed Ortho Lo. I really wanted to be on the bcp simply because I am using Taz and Spiro, both of which are awful to be on if you ever get pregnant. I don't want to take the risk, plus, word is that it helps in conjunction with the spiro...like an added bonus.

So I started Ortho Lo. After 4 weeks of 50 mg spiro, she wanted to see me again. This was just this past Thursday, about day 4 of my bcp. She seemed disappointed. She said that I was still inflamed and wanted to put me on another oral antibiotic and I couldn't believe it! She also wanted to switch my topicals. I couldn't believe how impatient she was. I know I had just recently gotten a breakout but it was because I had just had my period and you know how that goes..

I told her I really wanted to stay on the Spiro because I know ALL of you ladies have said it takes patience. She reluctantly agreed to keep me on 50mg for another 6 weeks. She also gave me samples for a topical antibiotic. She mentioned getting blood work done too. I am literally experiencing no symptoms whatsoever from the spiro other than a little thirst here and there. When I was at the internist several weeks ago, I had blood work done and everything was fine. I plan on faxing the results to the derm. But anywayy.

I am super nervous and disappointed and anxious and all that. I feel like I am in a rush to get clear so she keeps me on the spiro. I haven't been on it nearly long enough and she just didn't want to increase the dose. She acted like 50mg was the absolute max and that we had hit a wall. From what I understand, some women are taking 200mg per day!

I am noticing in the last few days that my skin is pretty yucky. A little bit of the oil is coming back and I'm getting some whiteheads. My chest is also breaking out in little bumps whereas before the bcp it was getting smoother and even. I am not sure if it is from the first 9 days of the bcp or if my body is getting used to the low dose of spiro. Anybody have experience with this/could guess what it might be?

I feel like I may have to double check my blood work to make sure the K levels are good and then high tail it to another derm. She is a nice lady, but TOO IMPATIENT and I really want to increase the Spiro.

My arms have completely cleared up since being on it and the oil decrease alone has been amazing. My chest also calmed down a lot and my back was improving too. I feel like I had some hope and then it was just ripped away.

:/ any advice/comments?

Thank youUUUuuuU!

[hearts]

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Edited by hearts, 08 December 2012 - 12:24 AM.

[Green Gables]

I really would not recommend OTC or OTC Lo. They really don't help acne. At best their form of progestin is "acne-netural" meaning it won't help but it won't harm either, however, some women have also found that it increases acne.

It seems like things were going great with spiro and then you made a very silly decision to add a whole package of hormones with OTC Lo. Not trying to be harsh, but I know personally and from research that Spiro by itself works for many many people. If you start combining it with a birth control it's a completely different ballgame.

If you must be on a birth control and don't want to use condoms or whatever, then at least pick a better birth control for acne.

All birth controls contain a type of synthetic progestin. You will find that most mini-pills or "Lo" birth controls have a type of progestin that increases acne.

Progestins that minimize acne are:

Drospirenone (Yaz, BeYaz, Safyral)
Desogestrel (Orthocept, Mircette, Apri-28)
Ethynodiol diacetate (Demulen, Zovia)
Cyproteone acetate (Dianette, Diane-35)

Progestins that are acne neutral (supposedly, they actually still have some androgenic activity, but not a ton):

Norgestimate (Ortho Tri Cyclen, Ortho Tri Cyclen Lo)

Progestins that create acne:

Norgestrel (Ovral)
Norethindron (Necon, Errin, Ortho-Novum)
Levonorgestre (Alesse, Plan B, Mirena, Triquilar)

Edited by Green Gables, 10 October 2012 - 12:16 PM.

[thedarlinglife]

I really would not recommend OTC or OTC Lo. They really don't help acne. At best their form of progestin is "acne-netural" meaning it won't help but it won't harm either, however, some women have also found that it increases acne.

It seems like things were going great with spiro and then you made a very silly decision to add a whole package of hormones with OTC Lo. Not trying to be harsh, but I know personally and from research that Spiro by itself works for many many people. If you start combining it with a birth control it's a completely different ballgame.

If you must be on a birth control and don't want to use condoms or whatever, then at least pick a better birth control for acne.

All birth controls contain a type of synthetic progestin. You will find that most mini-pills or "Lo" birth controls have a type of progestin that increases acne.

Progestins that minimize acne are:

Drospirenone (Yaz, BeYaz, Safyral)
Desogestrel (Orthocept, Mircette, Apri-28)
Ethynodiol diacetate (Demulen, Zovia)
Cyproteone acetate (Dianette, Diane-35)

Progestins that are acne neutral (supposedly, they actually still have some androgenic activity, but not a ton):

Norgestimate (Ortho Tri Cyclen, Ortho Tri Cyclen Lo)

Progestins that create acne:

Norgestrel (Ovral)
Norethindron (Necon, Errin, Ortho-Novum)
Levonorgestre (Alesse, Plan B, Mirena, Triquilar)

I need to be on BC because I have been pretty unreliable with condoms and whatnot. Thanks for the info on OTCLo. It's okay if it's just a "neutral" though. If i find that it is causing too many problems, I'll switch it, but hopefully this is just a little bit of an initial breakout because I had a really bad one with Spiro.

I am more concerned about my derm trying to completely take me off of the Spiro after 13ish weeks on 50 mg. Any suggestions about that? Or how to find someone who is willing to up the dose without wasting time and money going in and paying a copay and all of that?

[KateLibby]

Get off the ortho lo and go to ortho tri cyclen regular. My daughter broke out like crazy on ortho lo. Her acne got worse and worse for five months. It made her acne go from mild to awful. It doesn't have enough estrogen in it. She went on the regular ortho tri cyclen which has 35 mg and started clearing immediately. Ortho tri cyclen reg cleared my acne at the age of 25 also and that is all I used. No topicals, no spiro. Nothing else. It also cleared a good friend of my daughters. Her derm did want to put her on Yasmin though. I was afraid for her to take it because of all that you hear about it so we went with ortho reg. She does still get a few sits here and there but nothing like she used to have. No more big knots. What she gets now goes away fast. with that being said the Yasmin might have been better. I really want to ad spiro to her birth control but her derm wint give it to her because she is 16. By seriously get off of the ortho lo. It simply does not have enough estrogen to combat the little bit of a androgen activity that it's progestrin has in in it. Take it from me I have seen it do some serious damage. It made my daughters face horrible.

[KateLibby]

Also if you are not afraid to go on yaz or yasmin they would probably be a better choice in birth control for acne. But I have seen the ortho regular work too. But get off the lo for sure.

[Green Gables]

You could show your current derm studies about spiro...but in my experience if a derm is set against a treatment, you just gotta switch derms.

But yeah, I would get off the OTC Lo. Obviously no one can force you to do anything, but the tiniest amount of hormones in a birth control pill can make your skin freak out. People can get remarkably stubborn about changing their birth control...but the evidence says that OTC Lo is probably not helping you.

Edited by Green Gables, 11 October 2012 - 01:25 PM.

[KateLibby]

My daughters derm said he prescribes spiro all the time he just won't give it to an adolescent. We are going back in December so I am going to ask him why. But her skin still looks 100 times better. We can live with 2 or 3 small bumps, just not the huge widespread ones she used to get. It was the kind that leaves scars. Luckily she didnt scar because she only had bad acme for about 6 months. Sometimes I think we should have changed to the Yasmin when we decided to ditch the ortho lo because it was making her face so bad, but I was just afraid with all the commercials about lawsuits about blood clots. But she is happy with how her skin looks so I guess that is fine. All long is she is not worried and asking to change again I guess we are good. So she is pleased with the ortho regular. Having 2 or 3 bumps sometimes is still better than what she had. Ortho lo was the worst thing we ever did .

[thedarlinglife]

Yeah, I am going to finish this pack and see where things go. I've actually been okay the last few days. It seems like I had an IB and then it's just been clearing up, not getting worse or anything. I don't have any inflammation or whiteheads, just an overall little bumps texture. But keeping that in mind, I will still definitely watch for any changes. I am kind of freaked out by Yaz too, but there are other options. My doctor just gave me OTC Lo because she said it is FDA approved for treating acne. But as we all know, you can't always go by those standards...

If things with my skin continue to improve, I am going to ask her to increase the Spiro to at least 75 mg. I will print out a study for her to read or something along those lines and if she doesn't want to, I guess I will switch to another one. Thanks for the advice both of you!

[KateLibby]

Yeah, I am going to finish this pack and see where things go. I've actually been okay the last few days. It seems like I had an IB and then it's just been clearing up, not getting worse or anything. I don't have any inflammation or whiteheads, just an overall little bumps texture. But keeping that in mind, I will still definitely watch for any changes. I am kind of freaked out by Yaz too, but there are other options. My doctor just gave me OTC Lo because she said it is FDA approved for treating acne. But as we all know, you can't always go by those standards...

If things with my skin continue to improve, I am going to ask her to increase the Spiro to at least 75 mg. I will print out a study for her to read or something along those lines and if she doesn't want to, I guess I will switch to another one. Thanks for the advice both of you!

Ortho tri cyclen regular is FDA approved for acne. The lo is not. Trust me we went through all of this. Google it and you can find all kinds of info about it. The studies were done on ortho tri cyclen regulat not lo.

My daughters started out as little bumps, almost like an acne rash on ortho lo. And it got worse every month. Did you tell your derm about starting the ortho lo?

[LoveGreenSmoothies]

You should switch bcp until you find one that works for you. If it were me, and I knew I needed/ wanted to be on the pill, I'd try that w/o spiro first, because many times that's all you need.

You don't need yaz or Yasmin either. The older pills can be great for acne and don't have as many risks as yaz/yasmine.


I haven't heard great things about Lo. Regular OTC wouldve been better for your skin.


If I were younger I'd seriously just go on the pill, but I'm too old for it.

Edited by LoveGreenSmoothies, 13 October 2012 - 03:50 PM.