7 replies to this topic

[justsomeone212]

PICTURES:

Hey everyone! So I've struggled with acne since highschool (I'm 21 years old now), but my breakouts were always manageable. This past summer, during the month of August, I went through an extremely stressful period which lasted virtually all month. I think it is for this reason that I experienced a huge (what I think is hormal) breakout. Prior to this breakout, my skin was always clear unti the week before my period, which has always led me to suspect hormones were the culprit.

I started Spironolactone exactly two months ago with 75mgs. My very mild back acne cleared up within a few weeks, and about a month in, I thought I was seeing some improvements. Then, I got way too excited about these improvements, and upped my dosage to 125mgs thinking I could speed up the process. Exactly two weeks after this increase (and mind you for the first few days on 125 mgs my skin seemed to be improving), I broke out like crazy up my cheeks in cysts.

I have two concerns. I've always heard hormonal acne is located on the chin/jawline, while mine is primarily located up the sides of my cheeks (and is cystic), although I do get the occasional pimple along my jawline. Before my August freak out episode, I would break out on my cheeks the week before my period. I had blood tests done in September which showed elevated DHEA levels. Knowing that, and looking at my acne, can anyone who might be more informed than me tell me if my acne appears hormonal/did anyone who had success with Spironolactone break out in the same places as me? (see attached pictures)

My second concern is this: I'm almost certain that my most recent break out was brought on by the increase in mgs which I'm assuming happened too abruptlyand my body couldn't deal. Do you think I should go back down to my 75 mg dosage? Or should I try to remain on this 125mg dosage that I've been on for two weeks.

Also- how would you rank the severity of my acne?

Thank you all so much in advance! Today's been an awful day and any advice/comments would be SO appreciated!

[talenaabrams]

Your acne looks almost identical to what mine looked like before Spiro. I take 75mg spiro, and you look like you are smaller than me (I'm 5'2" 125 lbs), so I'm concerned that 125mg is way too much for you. I had TERRIBLE side effects on 100mg, and I feel like 75mg, while it works for me, is higher than I need it. I had major hair loss and emotional side effects as well as weight gain/bloating on 100mg. Please consider lowering your dosage! It took me 5 months to get clear on 75mg, so be patient!

[justsomeone212]

Thanks so much for your reply! I think you're right- I'm going to stick to the 75 mg dosage and wait it out. Was your acne as severe as mine? How long did it take for you to start noticing improvements? My acne seems to go away, and come back in waves. If you could give me any more details It would really help, especially since you said your acne was almost identical to mine!

[LolaSophia]

Hi!

So this is exactly what I'm experiencing right now. I'm having breakouts on my cheeks exactly where you are.

I recently upped the dosage to 100mg and am very concerned about what's going on. I've read a lot of reviews that said spiro didn't start working for them until they stared taking at least 100mg. I've been on it for about 4 months and my skin is way worse than before I started the treatment.

I'm also concerned on how dependent our bodies become on this stuff. If you don't take it at the same time every day, you're likely to break out. I've been researching a lot of natural remedies (healthy diet, exercise, tea tree oil) instead of all these extra things.

[bizz]

I had the same side effects (or lack of side effects) as you. Prior to spiro I was on Accutane for about 3 years. I purged zits when I started Accutane (at 14) but that lasted less than two months.

When I started Spiro in 2009, I had newly greasy hair, some thinning, and hyperkalemia starting six months to one year after starting on 50-100 mg. My skin only slightly improved from what you show in your pictures. Then the benefits tapered off, even though I'm careful what I put on my face, wash off make-up, clean make-up brushes, etc. I now have skin like yours after three years on 50 mg.(That isn't to say your acne is horrible; I know this isn't any more in your control than in mine. This is my point--it wasn't just the initial purge that gave me trouble. The drug has done more harm than good.)

Even when the drug finally started "working", it was underwhelming, and I still had the mottled appearance your skin does now, just less active zits (until my period hit. Then it was hell),

All that said, I have other issues going on that exacerbate the side effects/bruising/acne marks (anemia and bad circulation I manage okay, but still feel) and cystic acne from both parents. The derm that prescribed Accutane used to comment on how stubborn my acne was. I'm not surprised spiro couldn't do what Accutane did for my skin.

I would recommend you consider keeping a log on your computer or something so you can actually examine whether you want to stick with this. Note that you started purging at "x" months in, how long ago you menstruated, etc. Another thing--has your skincare routine changed recently? Did your derm prescribe anything topical like Retin-A or Renova, which helps others (not me) with zits and those post-acne spots? (The other thing I tried recently was Aczone. Not impressed--made me purge so I went back to benzoyl peroxide.) Did s/he talk to you about antibiotics or other means of treating hormonal acne?

Other people here couple spiro with birth control--I'm either going to quit spiro or take it with bp, but I am sick of this drug.

Know that you're not the only one that's dealt with acne like that in the images shown while taking spiro. I would google "spiro purging" as well.

Don't give up yet--just keep records so you can track your progress and really think about whether you want to stay with this.

Good luck!

[justsomeone212]

Hi!

So this is exactly what I'm experiencing right now. I'm having breakouts on my cheeks exactly where you are.

I recently upped the dosage to 100mg and am very concerned about what's going on. I've read a lot of reviews that said spiro didn't start working for them until they stared taking at least 100mg. I've been on it for about 4 months and my skin is way worse than before I started the treatment.

I'm also concerned on how dependent our bodies become on this stuff. If you don't take it at the same time every day, you're likely to break out. I've been researching a lot of natural remedies (healthy diet, exercise, tea tree oil) instead of all these extra things.

Hi! I read that a lot of as well (that the medication can only truly work once you've started taking 100mg or more). But, my feeling is that it is absolutely possibly to take doses that are too high in proportion to your own hormonal imbalances, which will then serve to only further the imbalance. I think that's what may have happened to me when I tried to up my dosage by 50mg (from 75 to 125) overnight. Not only do I think the dosage was too high for me (I only weigh about 95 pounds), I think my upping the dosage so suddenly caused my system to flip out.

I'm currently healing from the breakout shown in these pictures, and my skin is looking the best it has in the past two months. Thing is, I'm unsure if this is due to the Spironolactone, or just due to time passing. I had never experienced a breakout as bad as the one I experienced in August, so I can't say whether the breakout would've continued/gotten worse if I hadn't started Spironolactone.

I'm also currently taking 200mg of Doxy (have been for about 5 or 6 days now I believe) and haven't experienced any side effects so that's good!

Do you think you're maybe taking a dosage that is too high for you? I remember having read somewhere that Spiro can act as an androgen agonist (as opposed to antagonist) if your hormonal levels are not suited to the dosage. Have you noticed any kind of signs of increased androgen like extra hair growth or skin oiliness?

I had the same side effects (or lack of side effects) as you. Prior to spiro I was on Accutane for about 3 years. I purged zits when I started Accutane (at 14) but that lasted less than two months.

When I started Spiro in 2009, I had newly greasy hair, some thinning, and hyperkalemia starting six months to one year after starting on 50-100 mg. My skin only slightly improved from what you show in your pictures. Then the benefits tapered off, even though I'm careful what I put on my face, wash off make-up, clean make-up brushes, etc.  I now have skin like yours after three years on 50 mg.(That isn't to say your acne is horrible; I know this isn't any more in your control than in mine. This is my point--it wasn't just the initial purge that gave me trouble. The drug has done more harm than good.)

Even when the drug finally started "working", it was underwhelming, and I still had the mottled appearance your skin does now, just less active zits (until my period hit. Then it was hell),

All that said, I have other issues going on that exacerbate the side effects/bruising/acne marks (anemia and bad circulation I manage okay, but still feel) and cystic acne from both parents. The derm that prescribed Accutane used to comment on how stubborn my acne was. I'm not surprised spiro couldn't do what Accutane did for my skin.

I would recommend you consider keeping a log on your computer or something so you can actually examine whether you want to stick with this. Note that you started purging at "x" months in, how long ago you menstruated, etc. Another thing--has your skincare routine changed recently? Did your derm prescribe anything topical like Retin-A or Renova, which helps others (not me) with zits and those post-acne spots? (The other thing I tried recently was Aczone. Not impressed--made me purge so I went back to benzoyl peroxide.) Did s/he talk to you about antibiotics or other means of treating hormonal acne?

Other people here couple spiro with birth control--I'm either going to quit spiro or take it with bp, but I am sick of this drug.

Know that you're not the only one that's dealt with acne like that in the images shown while taking spiro. I would google "spiro purging" as well.

Don't give up yet--just keep records so you can track your progress and really think about whether you want to stay with this.

Good luck!

Hey! You're right, I'm not going to give up just yet, but it is definitely a good idea to track my progress. I read over the Spironolactone reviews posted on this website quite often (as a source of motivation), and am a little confused about one thing: when people say 'it took me 3 months to see results' do they mean it took them 3 months to be clear, or 3 months to even begin seeing a lessening of breakouts?

I think that overall, I'm seeing a gradual lessening of breakouts. It seems that each time I break out it's a little bit less severe than the last, although it is still happening. Is it the case that people (who are eventually cleared by Spiro) completely cease to break out as soon as they take the drug?

I was prescribed Retin-A at one point last month, used it for about 3 days but found it made me more oily and as someone with extremely sensitive skin I was basically terrified of using it! I decided to take the 'gentle' route with my topical treatments. I wash twice a day with Cetaphil and spot treat with Benzyl Peroxide.

I was prescribed Doxy by my derm after I explained to her that I'd read about people taking Doxy+spiro, then weaning off the Doxy in hopes that the Spiro will have kicked in by that point. She was surprised that I was taking Spiro because I have not been diagnosed with PCOs. While I have not been diagnosed, tests showed I had slightly elevated DHEA levels, my breakouts (prior to the massive one I experienced in August- before all of this medication stuff began) only ever happened before my period- my skin would go from producing no oil, no being very oily before/during my period, and I do have some excess hair growth. So it does seem to me that my acne is hormonal. However, I've investigated other possibilities such as food intolerance brought out by periods of prolonged stress (which I went through in August).

Were your hormone levels ever tested? Is it possible your acne isn't hormonal? One source of acne I've been looking into is leaky gut syndrome, maybe google that to see if you're experiencing anything that could maybe be attributed to that.

[Battle with acne]

I think your acne is hormonal. I got the same acne, same place, and the same reason : stress stress stress caused acne.

 

I m on spiro too.. but my dermatologist said spiro is for body acne..( back and chest). For my face, I use aczone and ziana.. nothing is improved yet.. But can't stop hoping hoping...

 

Good luck...

[michi31]

I believe your acne is in the typically hormonal area of the face. But more importantly you have had your hormones tested and you have elevated DHEA.  Here is what I found on DHEA:

 

Although it predominantly functions as an endogenous precursor to more potent androgens such as testosterone and DHT, DHEA has been found to possess some degree of androgenic activity in its own right, acting as a low affinity (K_i = 1 μM), weak partial agonist of the androgen receptor. However, its intrinsic activity at the receptor is almost completely negligible, and on account of that, due to competition for binding with full agonists like testosterone, it actually behaves much more like an antagonist there, and hence, like an antiandrogen. However, its affinity for the receptor is very low, and for that reason, is unlikely to be of any significance under normal circumstances.^[29][30]

 

^{I think that's interesting in that it won't simulate your androgen receptor, but it could lead to more testosterone and DHT. What was your testosterone level? Spiro works by competing with testosterone for the androgen receptor (the same way they describe DHEA competing above). So if there is no testosterone, or not enough, it will stimulate the receptor instead. I have also read that Spiro has 1/20th the binding capabilities of testosterone to the androgen receptor, so higher doses are often needed. Therefore, I feel that increasing the dose would only cause a negative impact if it was acting as an agonist. That being said, it could just be hormonal craziness because lots of people seem to have these huge breakouts from Spiro and then clear up and  I have no explanation for that.}

Edited by michi31, 23 January 2013 - 10:32 AM.