michi31

Hi guys. I went to see my endocrinologist today to check up on my blood pressure/electrolytes with Spiro. I have basically been obsessed with hormones and how they effect the skin lately, so I thought I would ask him all my questions. He has been a very good doctor and he went to Harvard med school so I trust in what he has to say. So here are some Q and A's for anyone who is interested.

 

Q: I'm afraid that Spiro won't work because my testosterone is so low and so Spiro will make it worse.

A: Well we don't know what's happening at the skin level. There could be higher levels of testosterone and DHT in the skin that don't show up in the blood. Spiro would compete with these to block the androgen receptors in the skin. We just don't know though and have to wait and see.

 

(This is good news - but wouldn't this ALWAYS be the case for women with acne whose testosterone levels are normal - or low? If so, why wouldn't Spiro work for ALL women?)

 

Q: But what if it's not that I have higher levels of testosterone and DHT in the skin, but rather my androgen receptors are just really sensitive to low amounts?

A: This would be extremely rare, and a genetic fluke.

 

Q: What if the problem is that my estrogen is too low?

A: You would have elevated FSH and you don't. Also you were able to carry a pregnancy which shows your body isn't in premenopause or something. (He didn't say or something, I just can't remember how he finished that thought)

 

Q:What if my progesterone is too low?

A: Again, you were able to carry a pregnancy.

 

Q:What about the theory of estrogen dominance, that there is bad estrogen due to low progesterone?

A: This is "fringe thinking". There just hasn't been any work done to prove that or how it would effect the skin.

 

Q: Why do women have an initial outbreak? Why does the pill work for some and not others?

A: There are many variations that have not been studied, many genetic variations. No one has looked at this. There has to be the money so someone can study what happens in the skin. We just do not know.

 

(Freaking UNBELIEVABLE! Are you KIDDING me that no one has wanted to study how variations in the skin are impacted by hormones? I feel like this is gender discrimination or something. I mean, I've seen clinical trial with rat skin and what not but maybe that's not the same thing or they didn't puruse it enough. Ok, rant over)

 

Q: Why does Spiro take so long to work?

A: No one knows. But it takes 6-9 months. Although adverse effects would probably be seen sooner.

 

(Awesome)

 

I find this stuff super interesting. If anyone else has these types of conversations with doctors please fee free to share! I'd love to hear what others have to say.

 

I am wondering what the effect of Retin-a has been on your scars? I have read that it can make atrophic scars look worse, as it thins the top layer revealing more scar, which makes sense. I've been using RAM for a couple weeks and the last few days I felt that this might be happening. It may be that I lost a couple pounds, or because I was staying at my parents' house with different lighting - but I'm afraid it might be the RAM. So I am wondering if this is a permanent effect, or if I continue to use it will it look better over time through the building of collagen? And does the top layer "re-thicken" if you stop using it? If anyone has some long-term experience I'd appreciate it.

Thought I'd share this journal on acne. I found it very informative and helpful in understanding the underlying science to our problems/treatments. It's got something for everyone:)

 

 

http://famona.sezamp...its therapy.pdf

I am wondering if anyone has gotten pregnant after Accutane, and if so if the acne returned at that time? I broke out bad during my last pregnancy and didn't clear up until third trimester. If we have another baby, I do not want that to happen again. Any hormonal acne treatments would have to be ceased prior to pregnancy, so I would be back in the same boat. I am wondering if I did a course of Accutane - if that would stave off the acne if I were to get pregnant within a few months of stopping. If you got pregnant after Accutane, did you stay clear or break out? And if so, how long after Accutane did you become pregnant! Thanks so much - this is just so stressful trying to choose between clear skin and having the family we want.

Hi girls. As I've posted before, I tried Spiro for 1 week and I believe it caused me to start to break out much worse than I already was. My acne is relatively mild, and I do not get cysts or nodules. However 5 days on Spiro and I got a deep nodule that is still there after 3 months - this has never happened to me before. So I took a 3 month break to get all my bloodwork done and do tons of research. I've decided to give it another go, however I know that I cannot tolerate an "initial breakout" that may last for 5 months with scarring type acne that I am not currently having. On top of this there is no gauranteeing the Spiro will eventualy work, as my testosterone is quite low. So that being said, I am doing everything in my power to prevent another serious IB. I am on antibiotics (which are currently working very well - I have zero actives), Retin-a and am going to use my duac again. I am eating paleo. I am also paying $100 more a month to get the brand name Aldactone as some have reported that works better. Does anyone have any advice for me? Both my endo and my derm want me to start on 100mg a day. Do you think this will bring on a worse IB? Or would starting lower just make me have an IB everytime I increase my dose? I am so desparate for this to work - I really want to start scar treatments by the end of this year and I need to be 100% clear to do so. I'm fine with waiting 6-9 months for it to work, but I am not fine with my acne getting a thousand times worse. (I still don't understand the science behind why this happens).