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Spironolactone (Aldactone)

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Yeah I'm definitely going too. I'm just still kind of upset she didn't the last visit I had because she said the aczone would help although I told her I was still breaking out. With the breakouts I'm having now it feels like its completely ruining my skin. :(. The last thing I wanted was to worry about my skin while stArting school so antibiotics I think are going to be my only hope.

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Bay breeze: ugh I'm so sorry. I know, it's so frustrating. I'm still really wondering why spironolactone would case an initial breakout! I can't seem to get a real answer!

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Sumisee that's great they're starting to dry up and it's going better your second round. I've been on 100 mg for a month now and I feel like its still just been getting worse day by day. I see a new one pop up everyday. I just don't know if this is normal, I thought it may not clear up what I had but would start preventing new ones. It's really making me depressed from how much worse its gotten sad.png

Let's just assume for a minute that your acne is caused by androgenic activity and you don't have some crazy weird issue thrown in the mix, meaning that we're assuming that lowering androgenic activity will eventually clear your skin.

Now let's look at what spironolactone actually does. It is an antagonist (think "anti") of the androgen receptor. This means it competes with agonists (think "pro") of the androgen receptor. Basically less androgenic activity occurs because the spironolactone gets to the androgen receptor and binds to it first.

This is all great and puts you on the path to clear skin. But it takes a freakishly long time to actually show up in your skin. It's kind of like exercise. You don't go from flab to toned and buff after a few workouts. It takes time for your body to respond to exercise, build muscle, heal from that process, build more muscle, etc. until you finally get your six pack. It takes time for spiro binding to your androgen receptors to have a systemic effect on the hormones in your body, and then even more time for your skin to adjust.

Okay, you say, so I won't clear overnight. But why am I creating new acne when theoretically my androgenic activity should be gradually lowering?

The main reason is that hormones are just part of the chain of inflammation that creates acne. They are a HUGE part, don't get me wrong, but not the only part. Even if you work on the hormone part of the chain, other parts of the chain can actually continue for quite a long time by themselves. Maybe it helps to think of hormones like food. Androgenic activity feeds acne, but your body has ways of storing and using that food for extended periods of time. Even if you cut off new food, they've still got a lot in storage, and maybe they'll even go on a little binge eating fest when you disrupt their supply with spironolactone. Any time you change your hormone cycle, even if it's a good change in the long run, your body can react "defensively" with things such as an initial breakout. The processes in your body like the status quo and will fight to the death to stay the way they are.

Meanwhile, while you're waiting for spiro to do its magic, other parts of the inflammation chain are at work. The natural bacteria in your skin happily feeds on your sebum, and create excess amounts of lipase, which creates more free fatty acids, which irritates your skin and contributes to cysts. (This is why some people find antibiotics helpful for controlling initial breakouts, but the pros and cons of antibiotics are a topic for another day.) The irritation triggers white blood cells to produce pus, which blocks even more pores. An acne breeding cycle starts which can continue on its own for a while, even if you're starving it of androgens.

If it helps, my skin looked the same from about month 1 to month 4. That means I was getting new pimples, I was getting them in different places, we're talking zero improvement here. Sometimes I felt like it was worse, too, though that's hard to judge because I didn't take pictures or count zits because it depressed me too much! By about month 4, I was finally seeing a slow decrease in the number of pimples on my face, but I didn't look clear at all, not by a long shot. Getting to zero-zit land took another 4 months.

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GreenGables

 


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Green Gables is absolutely right! Please be patient because it takes time for your body to adjust. she had severe cystic acne and only after 8 months did she see dramatic improvement. On September 20, it will make my 6 month mark (w/ only 1 week off completely) on spiro and I only saw improvement in month 5. This drug is crazy slowwwww. Please give it at least 6 months before u give up and believe that its not helping, if anything making things worse. Im very sorry ur experiencing an intial breakout cus sme ppl didn't. but I did so I know how u feel girls! Hang in there sweeties!!!!!

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JennaBean, what were your testosterone levels? are you saying you want to go to the derm to lower ur dose or increase it? 50 mg is a perfect dose but u never know if 25 mg might help. that low dose seems to help me because I dnt struggle with PCOS or high DHEA, Testosterone, estrogen levels etc. that's why I think I was losing crazy amounts of hair on the 100 mg and other girls didn't because they may have higher hormone levels. Im still unsure why that hair shedding occurred.

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Sumisee: my testosterone is mildly high. It's 55. Normal range for my age bracket is 2-45. So yes, it is considered high. I do not have severe acne by any means. I DO gets cysts though. Thats all I have ever gotten since I entered my 20's. I do get small breakouts from products or what not. But majority is cysts! This whole journey started because in one week I had 3 cysts on my chin. Usually it would just be one big one at a time. I had a feeling it had something to do with my hormones.

So I just got back from the derm and she up'ed by dosage of sprionolactone to 100mg. She said she sees the most effectiveness at this dosage. But I think since your hormones are fine, 50mg is probably all you need.

I also had a saline treatment done on my kenalog atrophy

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that's great that you got 100 mg. im sure you will clear up on that dose soon. you most likely needed the higher dose eventually cus your testosterone levels are a bit elevated and mine were not. the spiro will def. help those bad painful cysts from the hormonal imbalance.

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that's great that you got 100 mg. im sure you will clear up on that dose soon. you most likely needed the higher dose eventually cus your testosterone levels are a bit elevated and mine were not. the spiro will def. help those bad painful cysts from the hormonal imbalance.

I hope so! I honestly wouldn't mind little zits! But I HATE cysts!! I start the 100mg tomorrow! So we will see!

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I hope so! I honestly wouldn't mind little zits! But I HATE cysts!! I start the 100mg tomorrow! So we will see!

I completely know what you mean. I HATE the cysts. I hate when you can feel one before it's even noticeable. I've been on 100mg/day (I take 50mg 2x/day 12 hours apart) for just over a month now, and I really hope it's starting to slow down. I'm also on OTC which my docs think is helping too.

I think this medication works differently for everyone -- while it's supposed to work a certain way in theory, there are so many variables between people, it's hard to say one person will represent everyone else's experience. This is my second time on it, and so far - thank goodness - I've had no weird side effects. I've actually noticed my hair getting thicker again (this happened last time too). So I guess that's a side effect, but I'll take that one!

The doctors I've been seeing say they've noticed most of their patients showng drastic improvement at 100mg/day, but obviously everyone is different. While I'm one 100mg/day now, I hope some day I can decrease the amount.

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I hope so! I honestly wouldn't mind little zits! But I HATE cysts!! I start the 100mg tomorrow! So we will see!

I completely know what you mean. I HATE the cysts. I hate when you can feel one before it's even noticeable. I've been on 100mg/day (I take 50mg 2x/day 12 hours apart) for just over a month now, and I really hope it's starting to slow down. I'm also on OTC which my docs think is helping too.

I think this medication works differently for everyone -- while it's supposed to work a certain way in theory, there are so many variables between people, it's hard to say one person will represent everyone else's experience. This is my second time on it, and so far - thank goodness - I've had no weird side effects. I've actually noticed my hair getting thicker again (this happened last time too). So I guess that's a side effect, but I'll take that one!

The doctors I've been seeing say they've noticed most of their patients showng drastic improvement at 100mg/day, but obviously everyone is different. While I'm one 100mg/day now, I hope some day I can decrease the amount.

Totally!! I HATE cysts!! It would have saved my skin so much damage if I never got cysts!!

I really hope the 100mg works. I will seriously cry if it doesn't. I've tried everything.....but accutane.

Thicker hair!!? I would take that side effect too!!

I didn't see much of a difference while I was on the 50mg for the first month. So hopefully the 100mg will.

What manufacturer is yours? I've seen some women say that some manufacturers work better than others!

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Totally!! I HATE cysts!! It would have saved my skin so much damage if I never got cysts!!

I really hope the 100mg works. I will seriously cry if it doesn't. I've tried everything.....but accutane.

Thicker hair!!? I would take that side effect too!!

I didn't see much of a difference while I was on the 50mg for the first month. So hopefully the 100mg will.

What manufacturer is yours? I've seen some women say that some manufacturers work better than others!

I agree. Luckily my derm has been wonderful and I've always been able to stop by the office the same day to get injections. If I wasn't able to do that, I don't know what my skin would look like.

I don't know what brand of spiro I've used and I purposely haven't looked. I read the post about different brands and didn't want to psych myself out. Whatever brand I'm using *seems* to work at the moment so I'm sticking with it. :) I think the 100mg will work for you, especially if it's hormonal. I'm in the same boat as you. If spiro doesn't work for me, I'll be taking Accutane. I hope it doesn't come to that, but I haven't ruled it out.

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Yes!! Those kenalog injections are great....but I had one that pitted!!! I had to get filler put into it since it can take 6months to go back to normal! This past 6 months has been a nightmare with my skin. I'm sooooo ready to see results.

But yeah, when I saw that board about the different manufacturers and how some don't work as well...I seriously wanted to cry! It's like, what else?!?! I am trying to stay positive that the 100mg will give me some improvement.

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Wow Masked One! You're lucky your derm is so accommodating! The last few times I've needed an injection I've had to wait weeks, despite having gone to my derm for over ten years! Plus they don't seem to be working as well lately. Had one injected and it's still there days later! As far as them pitting, I would rather that than the cyst. Just take lots of vitamin C to boost collegen production. I wish I could just inject them myself.


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Oh my gosh no. My pitting was horrible!!! I literally had a hole in my face! Looked like someone had taken a chunk out of it' and it can take 6 months to go back! And my derm said it might not ever be the same

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Oh. Well I just had one injected today. Hopefully it will smooth out and not pit!


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Oh. Well I just had one injected today. Hopefully it will smooth out and not pit!

I'm sure you'll be fine. I made the mistake of not seeing my derm, because he wasn't able to fit me in, and went to a med spa. The doctor there doesn't have nearly as much experience with kenalog as a derm. Thought I would be ok. But guess not! It's evened out somewhat, but still looks like shit. I'm sure I have a few more months to go until its better. If it does heal back 100%

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If you have the cash you could try a laser genesis treatment. In Canada it costs between 100-140. It is completely painless. It just heats up the skin to increase collegen production. Helps even out scars and red marks. I had a few sessions because I had terrible scars.

Also, try to stay positive about spiro. Visualize your skin healing! :)


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Oh my gosh no. My pitting was horrible!!! I literally had a hole in my face! Looked like someone had taken a chunk out of it' and it can take 6 months to go back! And my derm said it might not ever be the same

I'm sorry to hear that! I will say I've had so many injections that there are a few spots that are slightly... pitted, I think? They're hardly noticeable though, and I would certainly be the first one to say if it was a problem, ha! She wouldn't even use the standard amount sometimes; she's use less, and luckily it would work. I'm not too worried about it. Cysts are waaaay worse than a slight indentation/discoloration. I'm hoping they fade and plump up again eventually. I can only worry about so much, ha.

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If you have the cash you could try a laser genesis treatment. In Canada it costs between 100-140. It is completely painless. It just heats up the skin to increase collegen production. Helps even out scars and red marks. I had a few sessions because I had terrible scars.Also, try to stay positive about spiro. Visualize your skin healing! :)

Laser genesis? Is that similar to an IPL in the United States? Are u a little red for awhile then the pigment comes up and looks like coffee grounds?

I know. I'm really trying to stay positive about the sprionolactone. I just started my first day of the 100mg.

Oh my gosh no. My pitting was horrible!!! I literally had a hole in my face! Looked like someone had taken a chunk out of it' and it can take 6 months to go back! And my derm said it might not ever be the same

I'm sorry to hear that! I will say I've had so many injections that there are a few spots that are slightly... pitted, I think? They're hardly noticeable though, and I would certainly be the first one to say if it was a problem, ha! She wouldn't even use the standard amount sometimes; she's use less, and luckily it would work. I'm not too worried about it. Cysts are waaaay worse than a slight indentation/discoloration. I'm hoping they fade and plump up again eventually. I can only worry about so much, ha.

Ughh it was horrible until I pit filler it it!! Sooooo bad! I'm just really praying that it will heal back to what it was. Your lucky it never happened to U. It's very traumatizing.

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No laser genesis is different. You could put on a little powder and go right out- no recovery time. It takes a few days to see some improvement and in bad cases a few sessions. Contact medical laser centres in your town for prices and/or reviews.


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No problem JennaBean! It really helped me, I had a ton of scars and this treatment improved my skin in time for a wedding I was part of. This is the place I got it done in Victoria: http://clearskinvictoria.com/services/face/.

I'm also a big fan of Josie Maran Cosmetics for covering red marks.

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So I posted on here last month, I've now been on spironolactone for a month and 1 week. I've been using cetaphil just like my dermatologist recommended and my skin has only gotten rougher and bumpier. I know that there is an initial breakout that may come with taking this but is it suppose to be this prolonged? I've been very careful with not overdoing anything and all I'm getting is more clogged pores :( Any recommendations?

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So I posted on here last month, I've now been on spironolactone for a month and 1 week. I've been using cetaphil just like my dermatologist recommended and my skin has only gotten rougher and bumpier. I know that there is an initial breakout that may come with taking this but is it suppose to be this prolonged? I've been very careful with not overdoing anything and all I'm getting is more clogged pores sad.png Any recommendations?

Hang in there! This drug takes time to work, depending on the severity of your acne. For me, I definitely started seeing results after the first month and now after two months, my skin has really improved greatly. A gentle skin care regime will help the current acne and maybe your derm can prescribe a compoud Rx to help. It seems that the three month mark is the magic time frame for this drug to really kick in, although it may take 6 months for others. Don't give up hope just yet.

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So I posted on here last month, I've now been on spironolactone for a month and 1 week. I've been using cetaphil just like my dermatologist recommended and my skin has only gotten rougher and bumpier. I know that there is an initial breakout that may come with taking this but is it suppose to be this prolonged? I've been very careful with not overdoing anything and all I'm getting is more clogged pores :( Any recommendations?

Oh no. Really? That's how long I've been on it too! I honestly haven't noticed any difference really. Maybe less oil. But I wasn't too oily to begin with. I know it takes a while for this medication to work. Give it more time. My derm immediately bummed me up to 100mg last week when I told her I haven't noticed any difference and haven't had any side effects with the 50mg. Have you asked your derm what his/her thoughts are?

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