Well, if your acne is hormonal acne, not much you can do about that. People who have taken accutane and not even become pregnant or have hormonal acne have had thier acne return. Everyone is diffrent, You say you cleared up in your third trimester, not sure why you chance in taking such a harsh drug. Though Roche denies it many have had infertility issues after taking accutane and even more hormonal issues. Besides there is worse things that pregnancy can do to a women then acne. However, I am sure you already know that the bundle of joy is worth it in the end

if you have hormonal acne i would stay away. my doctor told me yesterday that there are studies and evidence that accutane causes the androgen receptors in skin to become even more sensitive, and many women get more hair in places they didnt have, and i'm guessing, acne. I doubt doctors tell their patients that but my doctor is just very honest, she said its marvelous for clear skin but only for severe systematic acne (and usually all over the chest and back and face) that has failed EVERYTHING. doctors don't know enough about the future fertility issues, im sure you would be able to get pregnant with no issues but what if something comes up one day on the news a few years after you take it saying it causes issues with fertility ?

Also the doc says it can dry you out down there, sorry if its too much info but it is a possibility.

also, you cant try to get pregant for at least 6 months after youur course one of my friends docs told her to wait 1 year.

Oli girl - Thanks for your response! I should have clarified, my acne ONLY cleared up in my third trimester. Now it's back again. I've been dealing with it for the last 12 years. The thing is that it became much more severe in my first trimester than it's ever been and I'm now dealing with scarring, which is so devastating. I do believe it is hormonal, as it is all around my chin area ONLY and I also have facial hair problems. The thing is that all my hormones are normal, with androgens being on the low side of normal. So is it stll considered "hormonal"? I think so, in that I have too many androgens at the skin level that can't be measured through a blood draw. Anyway it is good to know it will most likely come back.

LilyRose - Thanks for sharing what your derm says. I will have to look up about the androgen receptors become more sensitized - that would pretty much be the worst case scenario. It sounds like you have a really good derm; you are very lucky. I just started Spiro again, and am hoping it will work for me. The thing is that it requires a certain amount of testosterone in order to block the androgen receptors - otherwise it actually activates them more. The last time I took it for a week and I got a huge under the skin nodule, which has never happened before! I am hoping even though my testosterone is very low, that it is enough for Spiro to be the drug for me - there just aren't a lot of anti-androgen therapies out there. I tried Reclipsen birth control - it worked when I was on it for a month before - and this time it broke me out! Hormones are so wacky. So I guess if Spiro doesn't work, then I will try another bcp. And in either case, that means I'm never stopping the drugs and our daughter will be an only child - which makes me and my husband extremely sad. My skin problems have really hurt my life in more than one way...

if you have hormonal acne i would stay away. my doctor told me yesterday that there are studies and evidence that accutane causes the androgen receptors in skin to become even more sensitive, and many women get more hair in places they didnt have, and i'm guessing, acne. I doubt doctors tell their patients that but my doctor is just very honest, she said its marvelous for clear skin but only for severe systematic acne (and usually all over the chest and back and face) that has failed EVERYTHING. doctors don't know enough about the future fertility issues, im sure you would be able to get pregnant with no issues but what if something comes up one day on the news a few years after you take it saying it causes issues with fertility ?

 

Also the doc says it can dry you out down there, sorry if its too much info but it is a possibility.

 

also, you cant try to get pregant for at least 6 months after youur course one of my friends docs told her to wait 1 year.

 

hi Michi13,

I understand your pain about the acne and skin affecting you trust me, i have had days when i didn't want to leave the house (and it actually happened a few times ) and i get the cysts that hurt really bad like they are under the skin. I am 100% sure they are hormonal as i have PCOS. I decided to go back on BCP pills because they also bring down the LH level (which can also cause breakouts because of the 'surge' of hormones). You're blood tests for testosterone can come back normal. Mine came back on the very low end, and my doctor told me (and you can look this up) that although it doesn't show up in 'tests', the results of the imbalance within your body show up in your andogen receptors (such as Acne and extra hair etc).

if you get them on your chin its 100% hormonal and even if you take accutane you run the chance of them coming back. but ultmately the decision is yours.

there is BCP that really helps, for example, YAZ and Belara (not sure if its available where you are but its considered the 'beauty pill' as it helps skin and hair and doesn't affect weight). Look up studies on google, Belara and acne for eg.

i dont think they will affect your fertility either, to be honest within a few weeks off the pill you may ovulate and be able to get pregnant. My mom used to get hormonal acne, and went off the pill. when she went off them to have babies she had no isses and back on them within 3 months of delivery i think. Dont worry too much. you don't have to suffer with the acne, there are solutions but accutane is the most extreme option you know. I feel like with that drug you have to really suffer for to get the clear skin and there is no guarantee it won't come back. I even said to my doctor, I just want my acne gone and accutane can cure me . She was like "Who said it will cure you?". I then told her its the only permanent cure and she said POTENTIAL, and its NOT a cure, it provides long term remission and if you are VERY lucky it will never return but skin regains its oil producing abilities and she has patients come back up to 12-18 months later when they see acne return. if there is underlying hormone problems its best to tackle it on that end.

That is so interesting that you were diagnosed with PCOS even though your testosterone is low. Even though I have acne, facial hair and irregular periods the endo sad I do not have PCOS because all my hormones are normal/low, I am thin (not insulin resistant) and do not have ovarian cysts. What other symptoms of PCOS do you have? I 100% agree about it showing up in your skin instead of your blood - that is what my endo said is happening too. My only fear is that Spiro won't work because my testosterone is so low. On a normal scale of 8-48, it is a 7. Free testosterone is a 0.2 on a normal scale of 0-2.2. Do you know what your numbers are? Because I believe the progestin in Diane works the same way as spiro - it needs a certain amount of testosterone to compete against. So if that worked for you then that is a good thing.

They do not offer Belara where I live, or Diane for that matter. My next move after Spiro is to try Ortho Cyclen. I don't really want to go on the pill again - I was on it for 12 years straight - not even realizing I was on one of the worst kinds for acne. When I came off I didn't regain a normal period. I ended up doing IVF to get pregnant. I REALLY want to try flutamide because it is a "pure" agonist so there is no chance of it having androgenic effects, but every doctor is afraid of it's side effects; liver hepotoxcity. Why won't they develop an anti-androgen for women for this purpose? They would make so much money..

I think what you say about Accutane is true. I am going to try to resolve this hormonally first. What topicals do you use? I'm glad to touch base with someone else with LOW testosterone because I think that makes a difference in what treatments will work.

hi Michi13,

 

I understand your pain about the acne and skin affecting you trust me, i have had days when i didn't want to leave the house (and it actually happened a few times ) and i get the cysts that hurt really bad like they are under the skin. I am 100% sure they are hormonal as i have PCOS. I decided to go back on BCP pills because they also bring down the LH level (which can also cause breakouts because of the 'surge' of hormones). You're blood tests for testosterone can come back normal. Mine came back on the very low end, and my doctor told me (and you can look this up) that although it doesn't show up in 'tests', the results of the imbalance within your body show up in your andogen receptors (such as Acne and extra hair etc).

 

if you get them on your chin its 100% hormonal and even if you take accutane you run the chance of them coming back. but ultmately the decision is yours.

 

there is BCP that really helps, for example, YAZ and Belara (not sure if its available where you are but its considered the 'beauty pill' as it helps skin and hair and doesn't affect weight). Look up studies on google, Belara and acne for eg.

 

i dont think they will affect your fertility either, to be honest within a few weeks off the pill you may ovulate and be able to get pregnant. My mom used to get hormonal acne, and went off the pill. when she went off them to have babies she had no isses and back on them within 3 months of delivery i think. Dont worry too much. you don't have to suffer with the acne, there are solutions but accutane is the most extreme option you know. I feel like with that drug you have to really suffer for to get the clear skin and there is no guarantee it won't come back. I even said to my doctor, I just want my acne gone and accutane can cure me . She was like "Who said it will cure you?". I then told her its the only permanent cure and she said POTENTIAL, and its NOT a cure, it provides long term remission and if you are VERY lucky it will never return but skin regains its oil producing abilities and she has patients come back up to 12-18 months later when they see acne return. if there is underlying hormone problems its best to tackle it on that end.

 

Hi michi13!

I have some facial hair, i got my periods very young (10), and my acne started around age 14. It was never bad, just a few pimples, mostly on my chin area. I never really got properly treated for pcos till i saw an endo in 2010 who gave me metformin. it helped SO much, especially with my weight.I struggled to lose weight in high school no matter how active i was and i am now at my lowest weight thru lifestyle changes and exercise and the met helped me a lot.

The thing is my periods, although regular, got a bit funny on a high dose of metformin (1500mg) and my DHEA levels went up. DHEA is the 'acne' hormone and apparently, too high doses can cause the DHEA to rise so i took a lower dose.

I know what you mean about BCP pills, sometimes its hard to regain a period but its true, some are worse for acne than others. I think the only good ingredients in BCP pills that counteract acne are the one that are in Diane 35, YAZ, and Belara. Some people say Orthro causes tons of side effects and moodiness etc. Diane didn't suit me AT all but omg it made my skin so clear. I had to go off it because i got all the bad side effects and when i came off it all my symptoms got worse.

I would say that the WORSE symptom of my pcos is the acne!!! the hair i can deal with because i am doing IPL now which i am responding very well too. I never understood why i had excess hairs around, because my testosterone was so low (0.006 and the reference range is 0.037 being the highest). I know 100% my acne is homronal because the last 2 weeks of my menstrual cycle i get so many breakouts. have you tested for congenital adrenal hyperplasia (non classical?) the sypmtoms are very SImilar to pcos. i thought i had it because my 17-OH was slightly elevated.

It's interesting - PCOS is really just a collection of symptoms and it's not so black and white, so maybe some doctors would say I have it also. MY DHEA was measured twice a year apart and was the exact same - 122 on a scale of 98-340...so also on the low side. I thought for certain I had the non-classical adrenal hyperplasia but the 17-O and other numbers were normal/low too. I actually was hoping to have it, just so I could have an answer you know? I also tested negative for Cushing's.

Yup, the acne is the worst. I also had laser hair removal - probably 18 treatments over a period of 10 years. After 4 treatments it started becoming quite manageable though. It's still not 100% but much less of a concern now.

I know, birth control pills are such a crap shoot. I'm afraid to try Yaz because it's basically the same as Spiro just a smaller dose with estrogen - so I want to see if the Spiro works first. We don't have those other anti-androgens here. So are you going to start the Belara again then?

Hi michi13!

 

I have some facial hair, i got my periods very young (10), and my acne started around age 14. It was never bad, just a few pimples, mostly on my chin area. I never really got properly treated for pcos till i saw an endo in 2010 who gave me metformin. it helped SO much, especially with my weight.I struggled to lose weight in high school no matter how active i was and i am now at my lowest weight thru lifestyle changes and exercise and the met helped me a lot.

 

The thing is my periods, although regular, got a bit funny on a high dose of metformin (1500mg) and my DHEA levels went up. DHEA is the 'acne' hormone and apparently, too high doses can cause the DHEA to rise so i took a lower dose.

 

I know what you mean about BCP pills, sometimes its hard to regain a period but its true, some are worse for acne than others. I think the only good ingredients in BCP pills that counteract acne are the one that are in Diane 35, YAZ, and Belara. Some people say Orthro causes tons of side effects and moodiness etc. Diane didn't suit me AT all but omg it made my skin so clear. I had to go off it because i got all the bad side effects and when i came off it all my symptoms got worse.

 

I would say that the WORSE symptom of my pcos is the acne!!! the hair i can deal with because i am doing IPL now which i am responding very well too. I never understood why i had excess hairs around, because my testosterone was so low (0.006 and the reference range is 0.037 being the highest). I know 100% my acne is homronal because the last 2 weeks of my menstrual cycle i get so many breakouts. have you tested for congenital adrenal hyperplasia (non classical?) the sypmtoms are very SImilar to pcos. i thought i had it because my 17-OH was slightly elevated.

 

i think i am going to start on the belara because it really helped with my skin. I never had oily skin with it, it was literally poreless. I didn't budge in weight either which was a miracle for me so i am hoping i won't gain again, but i am extra careful now about exercise and food so i doubt I will. I know some ppl say the pill is not a cure but i feel like with these symptoms sometimes the best thing to do is just be able to manage them.

doctors have so many explanations for the breakouts that with all the info out there it is confusing, i have even heard and have been told its not really the testosterone itself causing the issue but the hormonal surges of one or the other that can lead to problems. For eg a lot of people with progesterone deficiency have acne. I tried to get on natural progesterone (its a whole other story i won't go into lol) and i didn't take it in the end. Will you try the spiro??

Yes it is all so confusing. I am back on the Spiro - day 4 today. I am also on minocycline and topicals this time around to try to ward off the initial outbreak. I just don't think I can hang on for months to see if it works, when I already have so many doubts that it will because my testosterone is so low.

What happened with the progesterone cream? I am trying to understand this estrogen dominance thing people are talking about. Since it's not recognized by mainstream doctors it's hard to find anything scientific on it. I was researching progesterone and it seems it can be converted to estrogen or testosterone via different enzymes. I had always thought progesterone was more androgenic - I know I had my worst breakouts when I was using progesterone suppositories in my first trimester - but that could have been due to the surge of hormones in general.