Due to an insurance change, I saw a new dermatologist on 5/7/2010. She advised that Spironolactone should NEVER cause an initial breakout as sizable as mine and also noted the possibilty that I may be immune to doxycycline since I've taken it before. She had me stop the Spiro/Doxy regime immediately. My new treatment will last 30 days until next evaluation. If my condition plateaus or worsens, then accutane it is.
New Treatment as of 5/7/10
65mg Solodyne / day
Ziana Topical (Clindamycin/Tretrinoin) PM
Aczone Topical (Dapsone gel) PM
Cleanse AM & PM with Cetaphil for sensitve skin
Moisturize with Cetaphil lotion 50spf
Okay, you'll probably think that four days isn't enough to tell a difference, but ever since I stopped the Spiro and started the Solodyn, I haven't had one new blemish. For the two weeks that I took Spiro, I got a new one or two each day. After starting the new regime, the inflammed pustules and papules have begun drying up and are going down fast. Redness still remains, but is better and more easily covered with mineral powder. For the first time in my history of dealing with acne, the topicals I am using are NOT breaking me out or drying my skin. Both Ziana and Aczone have a nice consistency and absorb well. The Cetaphil cleanser and moisturizer have already become a bathroom staple! So far so good. I will continue to update on a weekly basis now. Here's hoping I don't have to go on accutane!