You're around the 1 month mark- exactly the time when I experienced the WORST breakout of my life I was literally getting several new cysts every day. I'm at month 2, and although my skin is still far from clear I'm past the worst of the initial breakout and I'm no longer getting cysts.

As to why spiro would cause an initial breakout well I was curious about that too. You have to understand how acne forms in the first place. It's caused by the skin producing either too much or too sticky an oil, and/or from hyperkeritinization (skin produces too much keritin). These things together cause plugged pores, which turn into zits when they burst and get infected. The plugs take up to several months to form. These things (keritin, oil ect) are determined by hormones but because it's a culmative(sp) process unfortunately the acne will not go away as soon as you balance your hormones. Your hormones may be balanced but all the clogged pores that formed when your hormones were not balanced are still sitting there (yuck).It's like your whole skin needs to be 'restructured' by the new hormones which takes months if that makes sense? And that's when the purging happens. My theory is that the spiro shrinks your pores, forcing all the gunk trapped deep in your skin to the surface hence the awful initial breakouts.

don't get discouraged! i've been on spiro for about 5 months now. i started breaking out bad after 1 month, and it didn't start really really working until into my 2nd month. but it made my cysts go away & took care of all my oil. however- during my 1st IB- i got breakouts where i NEVERR had before! above my lip, along my jawline, eyebrow area!!?? weird and annoying i know, but stick through it because mine didn't last long. also- following my IB- i got REALLY REALLY dry. like flaky. like when i talked flakes of skin would fall off. but now my skin is not too dry & definitely not oily. stick with it!! if you get annoying pimples or cysts that bug you, ask your derma about cortisone injections.

I asked my dermatologist this very question and he said that his patients never experienced a breakout with Spiro, or at least they never told him about it at and at the 3 month mark most of his pts saw an incredible improvement. He said that there is no scientific explanation as to why this would occur. I experienced an initial breakout as well and my derm put me on 200mg of Doxycycline as well. Like Pink said, that one month mark was the worst. I never had worse skin in m life.

My skin is clearing up nicely now. I would stick to the doxy / spiro for awhile longer because I do believe it can work.

Thanks for all of the input. So help me, all of this suffering had better result in wonderful skin! I am trying to focus on that, for if I concentrate on what's happening now, I will make myself crazy.

I had been taking the Doxycycline 100mg for a week when I noticed a reaction that I have gotten before. For the past few years, any time I've taken a "cline" (tetracycline, minocycline) antibiotic, I have broken out in an acne like rash, usually on my chest. This confused me, as weren't antibiotics supposed to make skin better?? I mentioned it to my doctor a while back, and she just said I probably have a slight allergy to that particular family of antibiotics. it was a different MD who prescribed the doxy, and stupid me, I took them in desperation to try and control the Sprio IB. When I started to see the tiny pimples again, I immediately stopped the doxy. I know now from searching these boards that it is follicitis. I saw a photo of it, and I was like, "That's IT!". So, instead of the doxy helping, it did a little harm. I popped a Diflucan that my MD had prescribed when she prescribed the doxy, and I think that prevented things from getting worse.

I *think* (knock on wood, fingers crossed, holding rabbit's foot) that I *may* be passed the worst of the IB. I still have some lingering blemishes, but its not quite as horrific as it was last week at this time. I do have terrible red marks, especially above my upper lip, and there also seem to be a lot of blackheads that keep appearing in that area. Its so strange, as I've rarely ever broken out there. I fear the blackheads will become inflamed. I definitely see a reduction in oil, though, which is great. I was extremely oily.

So that's the update..here's hoping things improve SOON!

I was on bactrim and Spiro. Off bactrim almost 2 months on Spiro and now having break outs. On my mouth and chin . -_- I guess I'm experiencing initial break outs

This gives me some hope. I am on spiro and into it about a month, acne seems worse than it has been in months. I am hoping it's just an intial breakout.. I think I started on the 25th or so of last month? I didn't expect intial breakout to be this far in though, I was expecting like the first week or something, so that's what is making me nervous that it's not taking effect at all, and it's just failing.

Thank you pinksushi for the taking a stab at the scientific reasoning behind the IB. I got off of BC after taking it for 10 years due to wavering health issues from a weak immune system. After discontinuing BC my skin immediately broke out in deep hormonal cysitc acne on my chin, which I knew was coming. I refused to go on antibiotics and accutane so my derm recommended spiro. I am have been taking 50mg of Spiro for 25 days now and at first my skin looked great. The 3 cystic acne spots on my chin immediately shrunk and went away. Then a week later I started getting tons of whiteheads all around my mouth and chin and a few in really strange areas like my cheeks, neck and forehead, chest and upper back. Three weeks in, my skin is the worst it's ever been. I called my derm up a day ago and explained that what was going on and she recommended I bump up my dosage to 100mg (50mg in the morning and 50mg at night). I have been doing that for two days now and I am seeing cystic acne in the exacccctt same places as before I started the prescription. I'm worried that my skin won't clear up and ill have major scarring.The only side effects that I have experienced so far is that my skin is super dry (i live at 9,00') which I'm sure is another reason why I'm flaky. I'm headed to the salt water and humidity for the next two months which has always helped my skin but I really really hope that in two months I'll be seeing clear skin for the first time since I was 19.

I didn't have an IB from spiro it seemed to help my acne immediately. I have no idea if this is true or of this is nonsense but in my many hours of researching the med I read somewhere that at a certain dose and depending on your body, spiro can act androgenic. It is a very weak androgen (or just looks a lot like an androgen) , 1/15 the power of testosterone. At the right dose it will block testosterone from binding to the androgen receptor but if your own testosterone levels aren't elevated, spiro will work as an androgen. At the "lucky" dose spiro fits into the androgen receptor (blocking testosterone from getting in there). I'm not sure why people get an IB, from this I would think that if people broke out at first from spiro they would continue breaking out and it just wouldn't be for them! Hormones are very tricky. Again, I have no idea if this is true but this is what I read on a transgender board when I was researching stuff about spiro before I started it

I didn't have an IB from spiro it seemed to help my acne immediately. I have no idea if this is true or of this is nonsense but in my many hours of researching the med I read somewhere that at a certain dose and depending on your body, spiro can act androgenic. It is a very weak androgen (or just looks a lot like an androgen) , 1/15 the power of testosterone. At the right dose it will block testosterone from binding to the androgen receptor but if your own testosterone levels aren't elevated, spiro will work as an androgen. At the "lucky" dose spiro fits into the androgen receptor (blocking testosterone from getting in there). I'm not sure why people get an IB, from this I would think that if people broke out at first from spiro they would continue breaking out and it just wouldn't be for them! Hormones are very tricky. Again, I have no idea if this is true but this is what I read on a transgender board when I was researching stuff about spiro before I started it

Yes, you are right. I research several medications too (just so I can offer educated disses on this forum ), and the wrong dosage (i.e. TOO MUCH) can trigger the opposite result that what you're hoping. Same goes for herbs - too much of something can actually exacerbate your hormonal imbalance, that's why I don't believe in megadosing or high dosages of something. Just the fact that transgendered people take this drug should be enough to scare people off..it can seriously mess with your hormones, especially if you are self-experimenting with the dosage.

My acne got way worse on Spiro. It was when I increased my dose from 25mg to 50 mg, my skin went insane. It makes sense, since I am trying to balance out my hormones. It was hell. After trying spiro I went on accutane- still best decision of my entire life. I even tried a second course but my body couldn't handle a second course.