Hey all, after trying a number of treatments and seeing a lot of improvement on the top half of my face, but ONLY the top of my face, I decided to visit my doctor again and ask for a more aggressive option, short of accutane. After some deliberation we settled on spironolactone 25mg 2x/day. Today is day 1. The pictures are from 3 days ago during my latest pms breakout, and since then the smaller spots have subsided so it doesn't look quite as bad, I just have the big ones left. My forehead and nose are completely clear. Hopefully I'll have improvement by next month's breakout!
Some background -
As a teen I had pretty normal mild-moderate acne on my face, and occasionally on my chest & back. My skin started getting really oily (this is genetic unfortunately). I went on low-dose birth control (Alesse) and that helped initially but then after a few months made it worse. I tried switching to sprintec (generic ortho cyclen), but the estrogen in it not only made me feel like crap but it decreased the effectiveness of the lamotrigine I'm on as a mood stabilizer and it was such a mess that I settled for a mirena IUD which is estrogen free and has been AMAZING all around (super low fail rate, no worries, no periods). BUT it made my acne so much worse again. The summer after I had it put in (last summer), my acne got so, so bad (it was all over my face, cysts on my jaw and painful ones all over my back) that I finally slunk over to the dermatologist and was prescribed retin-A and clindomycin. Now a few months later my forehead, nose, cheeks are almost completely clear with retin-A and the regimen, but not the rest of my body, so after 6 months and with summer and my wedding looming, my body acne started really really getting me down and I am very frustrated with the stubborn acne on my jaw. I'm in my early 20s, not cool!
Since I'm absolutely convinced that whatever is left is 100% hormonal, I talked to my doc again and after taking a look at my skin and my history agreed fixing my hormones was the way to go. I had the option of going back on birth control or trying spironolactone. Spironolactone would allow me, if it works, to keep my IUD, avoid the side effects of high estrogen pills, combat the negative effects of hormonal imbalance, and be ok to take long term, so I'm giving that a good try first. She seemed confident this was the best option.
Edited by hedgehogcatcher, 15 April 2014 - 07:24 PM.