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I called my doctor, and she upped my script to 100mg once a day. Cysts are gone. Face isn't too bad. I think taking the Niacin with the Spiro for another month or so is the best way to go. Because I think it is keeping my face from going out of control. These big bumps will slightly surface and then immediately go away or not get as bad and painful as they did with the initial breakout.. Which is all tolerable right now.. I am also trying very very hard not to use any chemicals or unnatural cleansers or anything like that on my face right now... so here's to hoping 100 works!
Hey Shells, my derm is one who believes in the 100mg to 200mg dosage with this med. She said you may have more side effects if I start on 200mg and less side effects if I was on a lower dosage so she put me on 150mg and so far (day 4) no side effects at all. I've read a few (not many) starting on 150mg or even 200mg.
aww i see well good luck to you!! I started on 50mg a month ago and it was just upped to 100mg. I had an initial breakout with the 50 and a smaller one with the 100 too.. So i hope you don't have that problem. Also the only other side effect I have had is peeing more often... and being more thirsty than usual not a big deal. but again good luck!!! So far I am waiting for results...but its seems real results can take anywhere from 1 to 3 months to see marked improvement. I am over a month now so we shall see.
Thanks and good luck to you too... I really hope this works 4 the both of us 
I'm kind of worried though, I have more Pustules then cysts acne going on and all I read is this med helps woman with their cysts. I never read anybody say pustules, blemishes, whiteheads or blackheads just cysts so i'm thinking will this work for me. I mean I pretty sure it's hormonal i'm 24 never had acne as a teen then in my 20's I started to get some blemishes and last July my face went crazy with this pustule acne it's all over my cheeks, jawline and upper neck!
Sunshine,
Go here and take a look. http://www.acne.org/spironolactone-reviews/305/page1.html
over 600 people have reviewed spiro and they give you acne type etc. You will see that many of them don't have cysts..in fact some of them had really mild acne.. and only broke out before their period. I read this to keep me going because this stuff literally takes months to work. And I am not only trying to get rid of the cysts I want to be clear! And most of my acne isn't cystic just some and it was getting more cystic as of late.. So I think if your hormones continue to get out of whack that's how bad it can become. I tried everything under the sun and nothing nothing helped..SO I am keeping my fingers crossed.. I hope it works for us too! Today is actually day 30 for me!! But I went from 50mg to 100mg a week or so ago..And I got another initial breakout from that and now a smaller one a week or so later..but none of the cysts are like they were they are more on the surface instead of DEEP..in fact I am beginning to feel like everything on my face is on the surface..just need to give it time to clear now I HOPE!! but could take another month or two!!
I've had acne for over 25 years. I've been on BC, been pregnant, gone veggie, gone whole foods...and none of those things stopped my cystic acne.
So I gave spiro a shot...AND I AM SO HAPPY I DID!!! 
I started about 6 weeks ago after my period was over. I initially tried it a few months ago, but couldn't handle the fatigue, so I stopped. This time around, I'm on 50 mg once a day, with tetracycline that I take twice a day. I cleared up in a matter of weeks. I know this is not typical, but this is what happened to me. I had two pimples last week when I got my period. But that's about it.
I take spiro at night to offset the fatigue. I sleep pretty well until I have to get up to go to the bathroom (but I've been waking up in the middle of the night since I had my son, so this is no biggie for me). I need a lot more water then I did before, but I don't mind. I take calcium, vit d, B-complex and fish oil with breakfast, and sometimes fish oil, iron and Vit C with dinner. They aren't necc acne fighting, just what I do to fight the fatigue that comes with spiro.
I also cut back on what I put on my face. I went from Pro-active, then Murad acne complex, to plain old Oil of Olay Complete Lathering Cleanser. I stuck with Murads Skim Perfecting Lotion daily and Proactiv's Refining Mask from time to time.
All in all, I'm happy with the results thus far. I suggest any woman with hormonal acne give spiro a shot. It may not work the same way for everyone, but I prefer it over the numerous side effect of accutane.
35 days on Spiro..and like two weeks at 100mg.. I have noticed some differences in my actual skin... I mean it has been way less greasy almost dry even, could be from the products and exfoliating though (the dryness)..but today I really am noticing than my skin feels well more normal for lack of a better term.. things that would have turned into pimples or huge cysts aren't anymore and I am eating a horrible diet right now.. I do plan to eat more healthy again soon its was just vacation..Anyway.. I will keep ya posted I am not holding my breathe here.. but this time it seems different...=)
This is the first time I have joined this kind of message board but was doing some research on Spironolactone for Adult Acne and found this discussion.
I had terrible cystic acne all during my teenage years and it continued into adulthood. I did see different Dermatologists over the years but never really had success. The outbreaks did get less and less severe as I aged but they were still troubling to me, especially around period time. After moving to where we are living now I decided to go back to a Derm and see if anything could be done. My Derm put me on a combination of 50mg Spiro and 500mg Amoxicillin (a low dose anitbiotic) once per day many years ago, I would say 13 or so. I am 51 years old now and the combination has been working for me really well. I have been pretty much outbreak free for many years. Last month, the Spironolactone prescription ran out and I decided to go without it until I got in to see the Dr again. Within a week I had a blemish on my chin. My Derm refilled my prescription but has suggested that I double the Spiro (to 100mg per day) and stop the Amoxicillin to see of that would keep me outbreak free. I have been on just the Spiro for 1 week. So far I haven't noticed any extra side affects. The chin blemish is clearing up (it would clear a lot faster if I could keep my darn hands off it). I have not had any new ones crop up and I am hoping this will do the trick.
Anyway I was just wondering if anyone else had been prescribed the 2 different drugs together and if they had any success with it. One positive to the Amoxicillin was that I very rarely got sick, even colds seemed to not affect me and if they did they were very short lived.
Thanks for reading my story. I am just wondering if the combination might be something for some of you to investigate. I know it has worked for me very well.
Sliving
Silving...Do I have this correct, you have been on Spiro since you were 13? I am curious because I think (I hope) this is working for me..and I am slightly scared that I can only take it for a few years...I am 27 years old and honestly I don't plan on having children of my own..and at the very least not in the next 5-7 years as I am in graduate school.. So if I don;t have children there would be no need for me to go off of this.. but I am afraid one day my dr. or a dr. will tell me I have to stop..
On the other note I am not helpful as I have only been on Spiro now at 100mg. I also take some vitamins and niacin. Niacin I think helps with my energy level and is also very good for the skin.
SO glad you were able to find something that has worked for soo long!!
Hey guys! I was just prescribed 200mg of spiro for my acne. Yes, 200mg right off the bat. Yesterday was my first day, and it made me excessively thirsty and I had a terrible headache. Plus, I felt sleepy all day. Will these side effects go away as I get used to the drug?
Do you have PCOS or a hormone imbalance? Have you been officially tested? When my daughter started out on Yaz and spiro it was just 25 mgs. the first month to see how she tolerated it. Then upped to an additional 25 mgs. the 2nd month and she did very well on that although she is still tired and thirsty. She also took Doxy with it but was able to wean off. The highest she was ever on was 100 mgs. but the extreme thirst and lethargy has made she and her doctor decide on the lower dose again. She seems to be doing fine on a lower dose. So I would have to say she never got used to the higher dose and she was on it from last June till just recently. I have heard that 200 mgs is usually indicated for those with a true hormone imbalance/hormone disease and some others whose skin is just affected by testosterone can get by on a lower dose.
Hey Jen! I have Been on Spiro for 41days now! And I must say the thirst stays there but I don't think it is as extreme as it was the first week. But The headaches go away when you get hydrated. THe lethargy, for me also went away. But I also started taking my 100mg pill between 8 and 9pm every evening in order to side track any side effects that might occur.. It also may bother your stomach at that high of a dosage so be careful. Also just to warn don't be surprised if you get a TERRIBLE initial outbreak.. Seems some people do and some don't.. I had the worst two breakouts of my life when I started at 50mg and when I was upped to 100mg.. But stick with it.. this pill may not show results for some time. I am clearing but its slow and steady. And it keeps pushing "out" the existing stuff that is in my skin.. I need a few facials when finals are over LOL!! GOOD Luck! Reading these posts and reviews of others taking Spiro really kept me going!!
Looks like this is the official Spiro thread...
I was clear of acne after Accutane (15+ years ago). My acne started flaring up in April. I went to a Derm and he recommended: BP in AM, Retin-A in PM. The acne got worse (whiteheads to pustules).
Went to a different Derm yesterday and he prescribed: 50 mg Spiro (if no side effects in 3 days, increase to 100 mg) and continue with topicals. Scheduled for follow-up in 2 mos.
Status: Skin moderately oily in T-Zone, 2 whiteheads on chin, 5 cysts on rt cheek, 2 cysts on left side of jaw.
I'll post updates. 
I've been on spiro for about a week and so far my only 'side effect' is having to pee 150 times a day! I was on spiro a year ago on 50 mg but never took it religiously enough and let the script expire. Now I am having a bad breakout from Topamax and I'm back on it (this time 100 mg and determined to take it religiously). And if it helps anyone, I did NOT get an IB the first time I took it. I guess I'll find out in a couple weeks if I will get one this time! (My derm said it's unlikely)
I have not really noticed it "drying" me out everywhere. And its only oil secretion that is stops or slows rather so I don't think your vag would be affected lol. i have only noticed a difference on my face and scalp.. my back acne has completely cleared but the rest of my skin doesn't seem dry..so no I don't think it drys you out everywhere!
I have been lurking on the acne.org forums for months -- just joined today so I could throw my two cents in on Spironolactone. I have to say that I was doubtful at inception of Spiro treatment, however, I am now a believer. I would not give up this medication for any reason. You would have to pry the bottle from my cold dead hands in order to take it from me!!! I am 38 years ol,d and have suffered from acne since I was 14 years old. I have tried every oral and topical medication out there. including two unsuccessful rounds of Accutane. Spironolactone has been the only treatment to work for me. To me, this is a miracle drug. I started out on 50mg once daily in August and increased my dose gradually to 200mg/day. I experienced an initial breakout in the first few weeks of treatment which was very discouraging, however, reading this thread here on the acne.org forums kept me from bailing on the treatment. When users here say keep the faith, don't give up - Spiro takes time - believe in what they are telling you. It does take time. I would estimate that it took approx 3 months to see the greatest improvement and at 4.5 months my skin is almost blemish free. I had a breakout on my chin one week ago -- big fat cyst on my chin. Outside of that, my skin is in the BEST condition that it has ever been in going all the way back to puberty. I do have a hormonal imbalance and that is likely why Spiro has worked sooooooo well for me. I have elevated DHEA-S which is what the endocrinologist blames my acne on. I originally found out about Spiro from my stepdaughter. I went to my GP and requested a prescription for the same. I discussed the medication further with my endocrinologist who suggested I increase to 200mg. I have since found a new dermatologist and she felt that the 200mg was the correct dose and that my skin looked great in terms of current breakouts and comedones. I am now researching the best treatments that can be done at home to lessen acne scarring.
About the side effects -- I experienced super dry/chapped lips, lethargy, thirst, etc. These side effects lessened over time. I drink LOTS of water and have recently discovered Hyaluronic Acid serum to use as a base under my moisturizer -- and I put it on my lips. I think the HA has cured the chapped lips problem.
I would like to thank everyone who has posted their thoughts and experiences about Spiro here in these forums. Without your input, I would have given up early on. Everyone's input here gave me the motivation to keep on going despite my perception of slow progress and annoying side effects. Anyone out there experiencing those same feelings, take it from me, stick with it. Side effects lessen over time, DRINK LOTS OF WATER, and don't give up. It does take a little time but the results have been AMAZING (for me). My only regret -- Not discovering Spiro sooner.
