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I Think I Figured Out Why Spiro Makes Some People Break Out

spiro spironolactone androgen antagonist hormonal cyproterone acetate steroid

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#1 michi31

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Posted 29 October 2012 - 08:01 AM

While spiro is primarily and in most instances an androgen receptor antagonist, it can also act as an agonist (enhancing androgen receptors) in the absense of sufficiently high testosterone:

"It should be noted though that spironolactone, similarly to other steroidal antiandrogens such as cyproterone acetate, is not a pure, or silent, antagonist of the androgen receptor, but is actually a weak partial agonist with the capacity for both agonist and antagonist effects.[31][32][33] However, in the presence of significant levels of high-efficacy full agonists like testosterone and DHT,[33] which is usually the case, even in regards to the relatively low female ranges for androgens, it behaves, for all intents and purposes, purely as an antagonist, at least under normal circumstances and at typically-used doses. Nonetheless, there may still be a potential for spironolactone to produce androgenic effects in the body at sufficiently high doses and/or in those with low enough endogenous androgen concentrations."

I have been on spiro for a week and have all the signs of increased testosterone, including a deep cyst on the left side of my chin. I rarely, if ever, have gotten a cyst like this. My testosterone measures on the low side of normal, and now I'm thinking this explains why spiro is not working for me. I do have facial hair issues - so I figured my androgen sensitivity was high and sprio would be perfect. I know people say it takes months to work, but I cannot risk the additional scarring especially given this new information.

Now why some people have an IB and get over it and have clear skin I have no idea.

Thoughts?

#2 Know Hope

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Posted 31 October 2012 - 01:32 PM

Very interesting! I am considering spiro but am afraid of the dreaded IB.

Are you going to continue with the spiro?

I was on saw palmetto and saw an immediate decrease in oil and reduction in acne in the lower jaw and chin. But, it appears to have screwed up my estrogen/progesterone balance because I started feeling very emotional leading up to my period and got a huge flare up after my period started.

It's unknown whether saw palmetto reduces or increases estrogen, but whatever it did to my body, it caused a different type of break out that I don't normally get either. I feel it helped and hurt at the same time.

I'm researching how these drugs and herbal supplements interact with our hormones, and it's all so unpredictable.

I think it's possible the spiro will eventually adjust once you find that magic dosage suited for your body. But how frustrating to have to go through all of that!

I was planning on being on antibiotics if/when I start spiro - any chance you can do that too?

#3 michi31

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Posted 31 October 2012 - 02:54 PM

Hey there! I quit taking the Spiro - it is not worth it to me to find out whether it works if I'm going to be getting huge cystic pimples. I truly feel it was making me more androgenic, not less. I think taking antibiotics with it is a good idea - I had been considering that too. Keflex worked great for me when I was pregnant and was the only thing I could take. If S.P. worked for you, then maybe Spiro will too. It's weird because my derm and the nurse said that this is uncommon, and no one has complained of an I.B. Yet it seems to be the norm on this board. Very strange.

#4 Know Hope

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Posted 31 October 2012 - 05:25 PM

When I was first learning about spiro, I saw this gallery: http://www.acne.org/...actone-journey/

It scared the crap out of me and I don't know that I could do what this girl did, even though her end results are amazing. So maybe it has an androgenic effect for awhile as you go through a few menstrual cycles? No clue. And I'm not surprised most derms don't know about the IB - mine didn't, swore all of his patients are thrilled with spiro.

I'm still figuring out what to do, but I think I'm going to keep experimenting with SP (the devil I know) and get a hormone test to figure out what it's doing to my estrogen. Good luck to you!

#5 michi31

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Posted 02 November 2012 - 07:09 AM

That is frightening. It's unacceptable to me to go through that to get clear skin because I will inevitably be left with more scars. I went back to the derm yesterday and showed him my cyst, and he thinks I would have gotten it anyway and that the Spiro didn't cause it. He said he has written over 1,000 scripts and no one has had their acne get worse. I am so conflicted. How is that possible unless people on this board are all mistaken about what spiro did to them initially. I really don't know what to do. To top it off, I FORGOT to ask him for Keflex, so I called the office back to see if I can get a script and no one has called me back (sigh). If I could get the antibiotic then I'd be willing to try again..

Good idea to get a hormone test - I think I'm going to do the same.

#6 michi31

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Posted 02 November 2012 - 08:52 AM

I just found an old post by a member who did get hormone testing before and during Spiro. Her testosterone actually went up! So she switched to Flutamide (which is a pure antagonist) and was instantly clear. Wow, that's just what I suspected would happen to some people. I just made an appointment with my regular doctor to get testing done. I need to get to the bottom of this before diving in too fast and making things worse if Spiro is NOT for me!

Edited by michi31, 02 November 2012 - 08:53 AM.


#7 sarbear2822

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Posted 02 November 2012 - 03:38 PM

scars heal tho, specially in conjuction with retin a which i feel everyone should be on if they can after you get in to it a few months it polishes your skin and fades scras and freckles and reverses and helps stop wrinkle formation. i have hardle any acne now. i am using spiro, retin a 1% at night wash my face in the morning and sometimes at night with neo-cutis glycolic acid cleanser which is a dream and polishes all dead skin away and hydrates your skin so you dont become oily. in the middle of the day if i work out or evening on my drive home from work i use simple cleansing face whipe which is super mild and delicate on skin and leaves face refresh and free from oil as well. during the day i use acanya (BP) for spot treatment and moisturize with ulta acne sport spf 55 sun screen. this combo is a dream. i was hormone tested and fine and even have hair issues. i highly reccomend all these products not only do they clear skin but also have anti aging properties. THE REASON YOU BREAK OUT WHICH MOST PEOPLE DO, IS BECASUE ITS AN INTENSE PURGING PROCESS OF GETTING THE BAD OUT. ALOT OF THE BAD LIES UNDER YOUR SKIN AND COMES THROUGH IN CYCLES. THATS WHY THE IB CAN HAPPEN. THIS IS HOW IT ALSO PREVENTS MORE BREAKOUTS BECASUE IT HAS DONE ITS JOB AND HAS REVERSED THE PROBLEM AND IS IN YOUR SYSTEM NOW AND HORMONES HAVE BEEN SITUATED. THIS IS HOW MY DERM EXPLAINED IT. BUT ONCE YOU MAKE IT THROUGH THE 6 MONTH MILE STONE YOU REALLY SEE A DIFFERENCE WITH EACH PRODUCT AND ALL TOGETHER AS A ROUTINE. I HAD OILY ACNE SKIN FOR YEARSSS AND I TOOK CHARGE AND STUCK IT OUT. like i said all scarring can heal and fade beautiful. and and a trick of the waiting period is to try not and count done on how many days its been. just takle your medicince deal with life and keep moving and have mark a date reminder in your phone for each week and new month and youll be suprised at how quickly time flies and your phone calander will pop up and say 2 months on spiro and routine and you'll be like heck ya! you get closer to your goal every day but you have to be good to your skin and stick it out. this is the first time i stuck through anything making me pel at first (retin a) or medicine with an ib and my acne kept comming bak. im glad i finally stuck it out or else ur face will never really get better on its own if it hasnt all this time. (right before the prescribed me spiro i was on droxly antibiotics mixed with routine and when the two refills enede is when my dr. had told me id start spiro into my routine and droxly wud be done.

p.s. i have only been on routine for 3 1/2 months and my face is 90% better already.

i also had hormone testing done and was normal although i swore it couldnt be becasue my cycle was out of wack and had hair issues too. good luck though with your testing. but remember all things with acne you have to jump into medicine wise somehwat bnecuase its trial and erro and process of elimination to find the perfect product or products for you. hormone testing is the first stop then as soon as you get results take them to derm and talk with them. ask about the products i mentioned they are great.

#8 Know Hope

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Posted 04 November 2012 - 05:19 PM

I just found an old post by a member who did get hormone testing before and during Spiro. Her testosterone actually went up! So she switched to Flutamide (which is a pure antagonist) and was instantly clear. Wow, that's just what I suspected would happen to some people. I just made an appointment with my regular doctor to get testing done. I need to get to the bottom of this before diving in too fast and making things worse if Spiro is NOT for me!


That's crazy! But I think you are on to something. I hate that the hormonal treatments are so unpredictable. Yet, I know the answer to my problem lies in there.

#9 michi31

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Posted 09 November 2012 - 10:29 AM

Hi Sarbear - Good to know you have normal hormones too and Spiro worked for you. I had another blood test today to check for free testosterone, as it was the one thing that wasn't checked last time (just total testosterone, DHEA and SBGH, as well as thyroid and other things). If free is normal too then I think it might be an estrogen/progesterone imbalance...so strainge - I also have had hair issues ever since puberty but the acne didn't start until I was 19. I'm on keflex now and don't have any active acne (knock on wood) except for the cyst that I got after five days on Spiro (praying it doesn't scar). My doctor did agree that Spiro is a partial androgen which could have been part of the problem. We'll have to see what the hormone test reveals and go from there...

#10 LoveGreenSmoothies

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Posted 09 November 2012 - 02:23 PM

I just found an old post by a member who did get hormone testing before and during Spiro. Her testosterone actually went up! So she switched to Flutamide (which is a pure antagonist) and was instantly clear. Wow, that's just what I suspected would happen to some people. I just made an appointment with my regular doctor to get testing done. I need to get to the bottom of this before diving in too fast and making things worse if Spiro is NOT for me!


Was that person me? If so, I don't think I said my test went up in my labs. I know I read that some on flutamide had test increase in labs. I was still clear, but towards the end I was seeing some acne, so I was wondering if it was stopping working.

My labs before and during flutamide stayed within range.

My guess on why sme ppls goes up is that they're not aromatizing estrogen so more test goes unopposed leading to an increase in lab values of test.

But flutamide gave me some major side effects so I stopped.

Have you tried Bp or some other topical for your acne? That's what I've been doing.

Edited by LoveGreenSmoothies, 09 November 2012 - 02:24 PM.


#11 michi31

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Posted 09 November 2012 - 04:18 PM

Hey there. No it wasnt you...cant remember the member's name now. I was actually wondering after I wrote that whether her increase in T could have been attributed to something else. It's unclear from what I've read whether Spiro actually affects your T level, I've read it might and I've read it doesn't. The only clear thing is that it blocks the androgen receptor. I asked my doctor about flutamide and she hasn't ever prescribed it and wouldn't. I was on duac and differin for awhile. I suspect overuse messed up my skin more - I stay away from BP now because it causes free radical damage and my skin can't take it anymore. I was probably 90% clear while I was on it though. I really want to get to the root cause.

#12 LoveGreenSmoothies

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Posted 09 November 2012 - 06:53 PM

Ok. I' wasnt sure if I had written aout the studies I read saying that. I also knew someone on another board whose went up on fluatamide.

A lot of ppls test goes down on spiro. You'd think it'd be the reverse...fluta should block it and make it go down.

You're seriously better off without the flutamide.

I use the Bp and did my entire life until I was 30 and I'm told I look 10 yrs. younger than my age, so it hasn't aged me. It's also anti inflammatory so maybe it's a wash? Either way, I don't want new scaring ( I have enough) so I don't mind using it.

Have you tried smoothies? they seem to help my skin for some reason. Maybe the phytoestrogens. Never expected better skin from a smoothie!