Hi everyone. I have been a constant cruiser of these boards for years and have finally decided to reach out for myself and everyone else going through the living hell of acne. A little about my history with acne...
I never had acne growing up, just the occasional breakout or small pimple that would go away in a day. During my teen and high school years I was a ballerina and constantly wore makeup to class where I would be drenched in sweat. I'd then come home and work another few hours, exercise more, and eventually take a shower after midnight. The make I used was just cheap drug store whatever too, nothing oil free or non-comedogenic. Yet, I never had skin problems. Just the occasional zit that would come and go in a day. After high school and during college I continued to have mostly clear skin. I'd have a pimple a week pretty much, but nothing major and they would leave as quickly as they came. They were just normal zits that were easily popped and healed overnight. Then I became the mother to three boys! My skin just progressively got worse throughout all three pregnancies. At my worst, I had solid cysts all under my jawline, along my jawline, across my cheeks and clogged pools all across my forehead. I couldn't even look in the mirror because I felt like a monster. I used Jane iredale makeup and so many expensive remedies that it was beyond ridiculous. I even became a pure vegan for a few years, and then I adhered strictly to a macrobiotic diet for another few years. I cleaned my diet and juiced like crazy. But nothing worked. Things would get better for awhile and then just straight downhill. There wasn't anything my derm could do for me except recommend a BP wash and put me on eurythromycin, which is safer during pregnancy and breastfeeding. After I finished breastfeeding my last little monster, my derm then put me on Tretinoin 0.025%, Mynocycline 100mg 2x/day, and Benzaclin Gel. She also recommended Cetaphil and Cerave for washing. I would wash my face in AM, apply Benzaclin, apply moisterizer, and then makeup. At night I would wash my face, wait thirty minutes to an hour and then apply the Tretinoin. However, the Tretinoin took almost a year for my face to stop being beet red and peeling. It was awful. When I got used to it, my derm upped it to 0.05%. This was killer on my skin and the redness was extreme. My breakouts and purging lasted a full year before I saw any results for the better. I then moved out of state and changed derms. This one kept my old regimen because it was working, however she switched the Tretinoin out for Refissa 0.05%. This is the Obagi version of Tretinoin. It is much more emollient and creamy, although there is a learning curve to using it correctly. It cleared up the redness and irritation almost overnight. I also switched to mural face products during this time, as the Cerave just seemed to never fully clean. I started using Murad's AHA/BHA in the mornings and Murad Vitamin C cleanser at night. This combo worked like a dream. It cleared everything up and made my skin for the first time ever, something I could stand seeing in the mirror. I went from new pimples and cysts every day to just a few a week, and I even had a few month stint with not one. But I still was getting the occasional cysts...and when they come it's bad and they spread. It is only really on one side of my cheek, and during bad days I wear a bandaid to hide it. I get a stray one every now and then but those don't bother me. It's the huge cysts that seem to come from nowhere and stay forever that tear me up in every way possible.
So I went to my derm again and we are switching it up...she has put me on 100mg of Spiro once a day to stop the cysts. When I questioned her, she swore there would be no IB, however from reading reviews and stories on here I doubt that is the case. Maybe because of my regimen and antibiotic use she thinks I won't have this issue, but I am skeptical and so scared. She also prescribed me Aczone to use before my Refissa 0.05% at night. I will detail my regimen below.
Morning
1. Wash with Murad AHA/BHA cleanser
2. Apply Benzaclin Gel all over
3. Wait for it to soak in, 20 mins or so, and the gently wipe with wet cloth to get rid of residue that it leaves.
4. Apply Murad Skin Perfecting Lotion (way better than Aveeno and so light)
5. Take 100mg Mynocycline and 100mg Spiro
Evening:
1. Wash in shower with Murad Vitamin C Cleanser.
2. Towel dry face and apply Aczone.
3. Apply Murad Skin Perfecting Lotion
4. Wait an hour
5. Apply Refissa 0.05% before getting into bed.
6. Take 100mg Mynocycline and BCP and my Xanax as needed to leave things alone.
I stopped using washcloths and I instead buy the disposable Kleenex hand towels, and it makes me feel much more clean. I also stopped wearing any foundation or powder, and only seldomly wear eye makeup. I used to be all about cover up and looking flawless, but I think I've reached a point where I just don't care anymore because I love not wearing it more. I just got tired of having to cover up things every day that you could,still tell were there. My skins would always itch and feel greasy too, so it probably exacerbated the situation. Plus, it saves a ton of time for me. So for now the makeup is out.
Week One of this new improved regimen is about over.... I had two huge cysts that had to be injected last Wednesday before the new regimen started and they just now finally went down some, but are still small bumps and red. Plus, now I have developed another one right next to the last one that I will go get injected tomorrow with cortisone before it gets as inflamed as the other two did. I can deal with one at a time, but not several. It is physically draining and mentally hard to handle. I haven't been able to look at someone without seeing my awful face thru their eyes. It's just mentally torturous. I feel like a monster some days. I am in my 30s now and want to wear makeup, dress up, go enjoy my life and I just can't with this awful condition. My last ditch hope is in this new Spiro regimen and I am praying it works. I am also awaiting an IB....
I will post now pictures and try to update on my progress. But right now, I have one large active cyst on my left cheek and a few that are healing from injections in the same area, as well as some clogged pores and a huge pustule that came up last night and just popped tonight in the shower. Tomorrow morning I head to the derm for an injection for the cyst. I will post some before pictures for you to see as I update. Because of the Spiro, I am also experiencing extreme tiredness, headaches, muscle aches and my boobs are killing me. However, it sounds like that is normal.
I should also mention that about 9 months ago I switched to The generic BCP for Yaz, which is Loryna. This caused some cystic action, but it seems to be slightly more controlled now. This BCP also stopped my periods, which I dont know how to judge. My derm didn't seem concerned at all. She was more concerned with my mental state. I used to be a huge picker and squeezer and just wanted this stuff out of my skin...so I also take Xanax as prescribed for anxiety associated with this whole ordeal of acne. My pictures may not be the worst there is, or even bad in some circles, but acne screws with you mentally in so many ways. I have horribly low self-esteem, hide away at times, cover up with band aids and look half crazy I am sure. But now when I have a huge pimple or cyst, covering it up with a bandaid is the only assurance I have that no one can see it and that I won't touch it. It's been months since I have done anything so far as picking or extractions go and it does help with less scarring and post redness, although the relief of getting the junk out isn't there because you have to let it stay. It's a miserable mind game.
So I guess that is my whole story... I'd love some feedback on your own experiences with this combination of medications and the outcomes you received. Maybe it will motivate me enough to get me thru any future IB that is looming out there...
I will post weekly updates in the hope of just getting thru this once and for all!
I could have written most of what you said myself. I did have acne as a teen on, however I am on bcp, have used all sorts of topicals and antibiotics and just now am on spiro.
Currently: 100 mg minocycline, epiduo, and 50 mg spiro.
I can totally relate to the mental part of this and also have been a long time picker. I have tried antianxiety meds in the past to help but not on any now. The hardest part has been how much I feel I am not able to be the mother I want to be. I feel like I've lost myself in this battle somehow.
Anyway, I've been on spiro for 10 weeks. Dr wants me to take 100 mg but I'm trying 50. I didn't have an initial breakout. My dr also said there wouldn't be one but I didn't believe him based on what I read here.
I wish you well. My heart hurt reading your post because I live what you describe. Prayers to you.
Hi likely tempo. I feel your pain in the mom department. I hid from pictures and just couldn't face playgroups, so I know I am not the best mom. It's debilitating beyond anything to feel so awful about the way you look all the time and unfortunately it ruins what are supposed to be the best times of your life. I had bad cystic acne during my last sons' birth and it was so hard to go thru labor and recovery with the knowledge that my face was on full show. It was harder than the birth. I felt so hideous. I wish you luck in your regimen and hope things are getting better for you. 
))
It will be 4 weeks on Wednesday with this new Spiro/Aczone addition to my regimen, the hell week of IB according to some posts....so I am crazy nervous. I have a few whiteheads that have appeared and one small pimple that hasn't formed a head yet on my right cheek. So far it has stayed small, although it is beginning to flatten out. Hopefully this means it's going away and not going to get bigger... Odds are not in my favor here. I am doing my best to just let it be and have decided to try to think about it from a discovery standpoint. How long will it take to go away if I don't touch it? That's the question I keep repeating into the mirror every time I see it. It's only been a few days so far. My left cheek is the cyst cheek and so far things are quiet. I have two very small bumps that are flesh colored, which is how my large cysts always start, but my other areas are healing well. They are just red marks and slowly fading tiny bumps. I am not sure these two bumps will turn into cysts, but I really hope they don't. I've been using the Aczone twice a day since prescribed, even though my dr said just once. The website suggests twice, as well as most posts here. It doesn't seem to dry me out like BP, so I haven't had any problems and don't see the harm. I use it after my BP routine in the mornings and before my moisterizer. It leaves a little residue but nothing the moisterizer doesn't fix easily enough. I will keep this updated as best I can!
4 weeks on Spiro 100mg and Aczone twice a day added to my daily regimen. I went to the derm Monday and he injected the spot on my right cheek, as well as the two small fleshy bumps on my left cheek just in case they start flaring up. I don't know if it helps to inject them when they are so young and non-inflamed, but one of the spots seems to be going away and the other is much smaller. My spot on my right cheek is still there, still somewhat red-ish pink, and to me so freaking obvious it's gross. It is a nice little hard bump now and beginning to flatten, so maybe by next week it will be gone. I have been so patient with it and haven't messed with it at all, even though it's so incredibly tempting to just stab it and squeeze. ugh!
On a side note, I love my new derm Dr. He accepts walk-ins and only charges $50 for the first ten cortisone shots. On another plus side, he knows how to do them really well because the injections he has done for me never left an indent like the others I have gotten before. And he seems to inject them differently than my previous derm. He does inject into the skin like a regular injection, but then fills up the spot as he retracts the needle from skin. My other derm just stuck it in and injected like a regular shot. This method has resulted in a gradual healing and fading of my spots with no marks or indents left behind. The injections my other derm made helped quicker, but always left an indent that stayed for months and months and months. I'm much happier with this new method even though the recovery isn't quite as instant. He probably uses a more dilute solution as well. My new derm placed me on Spiro right away at 100mg and seems to be incredibly proactive with me, even though I am an adult. It seems the other derms I have seen are so passive and just tell you to wait it out for a year. If the regimen I have isn't working in 12 weeks and huge improvement isn't seen, then my new derm says it's time to change it up and try something new. He just seems to care more and actually take my concerns into consideration. I think most derms don't realize the mental issues associated with adult acne and blow it off as opposed to teenage acne. I am glad I finally found one who doesn't. I will keep this page updated in case anyone else is going through the same...
Into week 7 on Spiro 100mg/day and I have noticed a difference in the oil on my face. My face seems oil-free right now all the time. Oil production is definitely lower. I used to look quite greasy by the middle of the day and now I look very matte at the end...even after 12+ hours. I still have the same few whiteheads that popped up at around week two and are just staying non-inflamed, but I'm hoping they will push themselves out soon. I have noticed two tiny blackheads pop up in the last two weeks and I never get these. It's probably from being out in the humidity so much or because my cat lays on my face when I'm sleeping lol. Yuck. I'm hoping they loosen and vanish soon. I'm debating going to get a facial, but just don't want a bad one that leaves marks with extractions. My skin is so paper thin because of the retin a now that even the slightest injury leaves a mark forever. I am tempted though. Other than that I have been getting quite a few really bad headaches and have had to up my water intake to well over 120 oz...and I am still thirsty all the time! Muscle cramps, lack or appetite, etc...but luckily it doesn't affect my days too much. So far so good I guess. Still waiting for the miracle.
Happy to hear you are seeing improvement! I have reached the 8 week mark with the Spiro and Aczone, however I do have a couple of spots that have come up. Two of the spots were tiny whiteheads that have lingered for about a month and finally became inflamed together last night. I tried to drain one, but it bled so much once I lanced it that I stopped immediately before trying anything more. I also had a large cyst pop up on my cheek last friday that I ran to the derm and got injected. Today he injected an inflamed blackhead, the whitehead that is now a red angry little bump because I lanced it, and the cyst for the second time. He used a much lower dosage of cortisone however because there are slight indentations from the last shot he gave me. They go away eventually and ever since the very first cortisone shot that left me with a huge indent that took three months to fill, these don't bother me much. They are so not noticeable and fill very quickly. I would rather have a few small dents that will eventually fill than angry cysts. The big difference today is that my derm gave me the pamphlet and talk on Accutane. I have been to several other dermatologists and they usually tell me my skin is looking great, mostly clear, etc...however this new one is very proactive with treatments. He feels as though my acne is too persistent and that being on Accutane would help with my daily regimen, which has become once again pretty intense with all the meds. I get about a cyst every few weeks, especially when stressed, and have a few tiny whiteheads that sprout up every once and awhile, and that either clear up on their own or turn into angry little bumps. However, they don't happen on a daily basis anymore and sometimes not even weekly. I never get blackheads really, and this one that I have now is an oddity. I assume it has something to do with the Aczone or Spiro pushing things out. So as of right now I am stumped on what to do. I plan on sticking with my Spiro 100mg for at least another 4 weeks so that I can get to the three month mark before deciding on whether or not to try the Accutane. Accutane is so scary to me and I am not sure that it is necessary as my acne is very moderate. However, at this point I may be willing to try even that if it will give me my skin back. Plus, I really need to get off the Mynocycline. I have been on it over 3 years and have noticed discoloration in my eyes, which has depressed me even more because my eyes were always my best physical attribute. Now I feel like they too have been ruined because of this issue I have with my acne. The discoloration goes away once off the antibiotics, but right now I just don't see an end to them...especially with what they could be keeping at bay.
I know it is entirely normal to feel as though something isn't working fast enough, especially with Acne. I know that you have to wait out any treatment at least 3 months to really know whether it is going to work or not. However, i was really hoping that this time I would be that success story where it just worked out and everything was cleared up miraculously....or at least within a few weeks... Once again however, I am back at square one. Waiting out another treatment that most likely won't help me in the end. I have to fly on friday too...all day...and now I am dreading being around people because I once again feel like a monster. I am hoping these shots today really help calm things down so that I can at least be comfortable on my flights. I have a facial scheduled for tomorrow morning to try and do some extractions on a few other tiny tiny whiteheads, just because now I am afraid they will come out fighting for the biggest and reddest award. It is called a Hydrofacial and is supposed to use water to extract everything. I know it will clear up the blackhead that is inflamed and maybe even the whitehead...so here is to hoping that all I have to hide on my flights is my one cyst and my scars that make it obvious that I battle with acne. Ugh, just a bad week I guess and it's only Tuesday! haha!
If I start the Accutane, it is a process. I have to wait 30 days before beginning because of the two pregnancy tests due and bloodwork. So maybe I will go ahead and make an appointment to start the process.... If and when I do start it though, I will start another thread...with pictures this time. I have a feeling that it will be just as much a struggle as everything else has been for me...