Well I'm a hypocrite because I took spiro for one week and quit. Basically it gave me a deep under the skin cyst that is still there 2.5 months later. I have never had that happen before and it has not happened since I quit. I think that because spiro is partially androgenic it may cause these awful breakouts before its anti-androgen properties take over. I read that it works by competing with testosterone for the androgen receptor. So I went to an endocrinologist and did all sorts of bloodwork and a urine analysis. All my androgens are really low. So I thought that maybe spiro is not the answer for me. However I have facial hair problems so I know the androgen receptors at the skin level must be overactive, therefore I am contemplating biting the bullet and going back on it and weathering the IB. But first we have to decide that we don't want a second child. The endo was very adamant that we decide this before going on Spiro - since it takes so long to work it's not worth going off of it to conceive.
I seriously doubt your cyst was due to Spiro. They say acne takes months to form... I don't think your cyst was because of it!
I don't see why people get an initial breakout on this drug. I've heard it can be androgenic for some, but then I don't think that would change later in the treatment. I don't understand what justifies it scientifically...
Anyhow, in my case, there wasn't an initial breakout, there is just so much junk in my pores it all has to come out first.
I 100% agree with you. I cannot understand the scientific explanation for an IB. People say it's clearing out your skin but this makes no sense. It's an internal medication - it's not doing anything to your skin it's just blocking androgen receptors. Plus people say they get acne during the IB in places that have always been clear. So I figured it wasn't true and went on it but it appeared to be happening to me too. I asked the endo why this would be and even he just shrugs and says you're just sensitive to change. This is hardly the physiological reason I was searching for. And he's a really good endo! I hope you're right that the Spiro didn't cause it, but then it's a really crazy coincidence because I have never had a deep cyst in my life..they are all surface. Then I was reading that brand matters - mine is Qualitest generic which some say isn't the best. Which one are you on?
Mine is called Spiron, I think brands are slightly different in Europe. Yeah I don't see a reason either why it would purge you.
If I was you, I'd start Spiro again for a week. If it has such a radical androgenic effect on you, you could always just quit after that week. Also, if your skin would react so quickly in a negative way, that would also mean the opposite for others: we would clear quickly, but we don't. I really think it takes weeks to "make" a pimple (unless you react to food allergy etc, but that's a different type of acne I guess).
Right now I'm so broken out I'm even ashamed to go to my endo today (let alone going back to uni next week), but through the despair, I rationally see that these pimples were created BEFORE I started Spiro. Anyhow, if this is not the last major flare-up, I'll quit and go Accutane. I am very tired of being a monster I know I should wait it out, but I can't live like this really.
That's an interesting thought. If Sp was purely anti-androgenic, that wouldn't be of concern.
I am really clueless.
Do you think I should start an antibiotic instead? I was prescribed Tetracycline but I'm in two minds about it.
Now it's very erratic... leftover acne is flaring up in cycles. My skin is still purging out all the crap. After some clearish days, today one side of my face is completely inflammed again.
Edit: forgot to mention that I've started Dan's regimen as well, only evenings as I do not want to overdry my already dry skin.
I think it can interact. It just makes sense that it would. It works in a different way and may be competing with the spiro.
If it were me, I'd take the antibiotic to get over the hump. Make sure you take probiotics too.
Do you limit carbs and sugar? That's really important with hormonal acne.
End of week 8.
Not sure what to say. Right cheek is looking good, only a few whiteheads present. Left cheek is BADLY broken out - from the chin, and all the way up in a line to my ear. That is discouraging as a month ago my chin was AWFUL, but there was hardly anything coming out on my cheek. I have like 3-4 actives but the red marks make it look all horrible.
I started tetracycline (as much as I hate the idea of damaging my stomach). I also started using an AHA peeling and ordered some salicylic acid. I need to get rid of inactive whiteheads as I have tones of them, just waiting to flare up - after a facial it'll only look worse.
Sigh... it's a long road. Thought I'd be acne free by now. I'm not happy to cancel so many activities but I hate the idea of hiding under my cakey make-up. Remember this feeling all to well from my teens. It is also a pain to go to work... feels like everyone is staring.
Tell me, why does any little whitehead/blocked pore on my face INSIST ON flaring up? What causes this overreaction?
Anyhow, early feb I'm seeing the derm and if no significant improvement > back on the 'tane. Yeah, I know I have to give Spiro time, but it feels like my life is passing and my face is getting worse and worse with red marks and scars.
So I pray Spiro will show some amazing results very soon as it is a so much more tolerable drug / reasonable cure.
I'm not saying there was 0 improvement, I just want to see my complexion clear already!!!! But I'm sure y'all know the feeling.
i can totally feel your pain and can relate to you for sure. i am on week 4 of spiro and not seeing any change as of yet so i am trying to be patient but i am not going to wait months and months and keep having these bad cystic breakouts thats for sure. my derm told me they will never give me accutane since they think its hormonal and that it could come back but at this point i am willing to take that risk if i dont start to clear up from the spiro. i have seen another derm recently and they told me to stay on the spiro but that if it doesnt start to work soon that they will put me on accutane so i guess i will have to go through them to get it. its very frustrating waiting for this med to work and then i am left wondering what if it just doesnt work for me and i wasted all this time and could have been on the freaking accutane already ya know? i am on 75mg now and will be going up to 100mg next week per my doctor so we shall see. what is the dosage you are on now?
i was on doxy before and then it just stopped working so they switched me to zithromax and then erthromycin with no luck so i guess no antibiotics work on me anymore which totally sucks because i am so sick of getting cortisone shots but my cysts never go away. i hate them!! keep me updated on your progress. i just got a tca peel now to try and clear some of this out a bit. i hope it does something.
I really know what you mean, I feel the same: what if it is not working AT ALL? I am on 200mg-s which is the highest possible dosage for acne, and still have things popping out a little comfort is that they seem to be old ones. Trust me, after 5 years of crystal clear & smooth skin I can't get used to the mysery of cystic acne again
BUT, what keeps me going is that 90% of the Spiro reviews are SO positive, and the rest is basically those who gave up on it after a week/had an allergic reaction or a bad side effect etc. no more than like 5% of people claimed it to be REALLY ineffective.
Trust me, if Accutane wasn't poison, I would've been on it for months now and would be clear again already but after taking it 2 times, I know the risks that come with it. It has really taken its toll on my body and mind too (severe depression for like a half year after the 2nd course, dry eyes, creaky bones, vision issues and God knows what else!) My rational self tells me to avoid this drug like the plague and rather endure a few more months of bad skin than totally ruining my health!
But, then again, I feel I just can't put up with acne. How unsighty, unpleasant and embarrassing it is.
Hard choice. And knowing that even after 2 rounds acne came back (thought the 2nd one was a short 'maintenance course'), I know I'd had to be on a maintenance dose FOR GOOD, even if that meant 1 pill/week, but even that is TOO MUCH.
If I start it again, I won't take more than 10mg-s and won't stop the Spiro, even if that sounds foolish - people have done this, some doctors recommend this. I see no other way to stay acne-free than addressing my hormone issues.
Anyhow, I still have like a month to decide and it might kick in in the meantime.
For you, I know it's a hard choice but please consider that if you have hormonal acne, it's highly likely that your results will not last, and you could be back to square one in a few years/months, just with more damage done to your body.
I'd say let's try and stick with Spiro. Clear skin may not be far away at all...
It's hard to repair your skin after breakouts but it's harder to repair your liver, bones, or brain if damage is done.
that was so very well said. thank you for your input i really appreciate it. so how are things going for you today? i have a few more cysts that need injected so i will be calling the derm again tomorrow praying they can squeeze me in tomorrow sometime. i have a meeting at work on tuesday and i really dont want to be coverd in cysts for that. i just wish they would go away.
And does this injection flatten them out & take away the inflamation completely? Sounds so good. I've never heard of something like this here in Europe.
Well now I'm struggling with some stubborn whiteheads and wondering how to remove them, but I pray to get no more cysts. I'm at the 2 months mark so it's high time to see improvement. We'll get there, gradually 
And does this injection flatten them out & take away the inflamation completely? Sounds so good. I've never heard of something like this here in Europe.
Well now I'm struggling with some stubborn whiteheads and wondering how to remove them, but I pray to get no more cysts. I'm at the 2 months mark so it's high time to see improvement. We'll get there, gradually
yes the injections get rid of the cysts in 24-48 hours for the smaller ones and for my bigger ones it takes a few weeks. without these shots i would be covered in cysts since they dont ever go away. they have been doing the injections here in the u.s. for years but not sure if they do them in europe. you should ask your derm for sure because its a very standard thing here. the derm i see does tons of injections every single day.
i know what you mean with the whiteheads and what i do is i get one of those metal tools for blackheads and whiteheads and then after you steam your face a bit gently press on the whitehead with the tool and it should get everything out of the zit. then just clean the area and apply neosporin or something like that. i find i get less red marks with using the tool then when i use my fingers. you should be able to find those at any drug store but amazon sells them as well as ebay.
Update: I CAN'T BELIEVE it's my second period after 9 days! Oh man, this just can not go on like this. Should I wait till it resolves or just go on birth control?
I am borderline anemiac even without this.
oh no that is awful. i did read that it can make the periods very erratic for a while until the body gets used to it. mine came a week early but thank goodness it was an easy one but i can feel your pain. i would try to wait this out for a few months and see how it goes before going on birth control unless you have good success with it.
Actually, I was thinking about buying this extractor, but I thought it only works on the ones that are "ripe" (sorry, gross I know!). Is it also good to remove the ones that are still non-inflamed and kind of embedded in the skin? I have many of them around my mouth...
i only use the extractor on whiteheads and blackheads. i dont even attempt to use those on cysts because it will just make them more inflamed. i pretty much use the extractor on my skin every few days on the clogged pores around my mouth and on my chin because if i catch them early enough they wont turn into cysts. its hard to constantly keep up with it though. once i am done peeling i am going to start using finaea in the am and retin-a at night (i am going to start slow) per my derm to clear out all these clogged pores. its so odd because i never had this many clogged pores in my life!
yeah i have one that has a lancet but i have been too nervous to try using the lancet part of it. yeah that will work on those whiteheads for sure. i find they come out easier if you get a warm washcloth and hold it over the area first to open the pores. try it a few times and if nothing comes out then i wouldnt try to force it. just make sure to wash the extractor well after each use and i like to wash it again before i use it as well. i am paranoid about that stuff. i get a lot of little whiteheads on my chin and this works very well for the smaller and bigger ones.
When I had acne I would prick whiteheads with a sterilized needle (which is a little better than that lancer because the point is smaller). I'd also use the metal loop extractor for blackheads. Rule of thumb is a tiny bit of pressure is okay. A lot of pressure or any pain is not.
I had my derm show me how to do it if you're worried about safety.
Julisss judging by your gallery pics I would totally prick half of those buggers with a needle and gentle push the pus out. I find the skin actually scars more when a zit just sits there stretching the skin for days/weeks on end than if you use a little bit of pressure to remove the pus.
Then just douse your skin in hydrogen peroxide and/or betadine. I prefer betadine because it's a better antiseptic/antifungal/antibacterial, but it does temporarily stain the skin orange for about 30 minutes so it's a little more inconvenient. Also can't let it get on your clothes.
Thanks a lot for both of you. They are deep though and now that my acne has subsided, I see tones of scars left by the needle (however tiny) 
Also, when I have a facial, the aesthetican never touches these kind of bumps - all of them say they can't extract it. But anyhow, I will get an extractor.
When I had acne I would prick whiteheads with a sterilized needle (which is a little better than that lancer because the point is smaller). I'd also use the metal loop extractor for blackheads. Rule of thumb is a tiny bit of pressure is okay. A lot of pressure or any pain is not.
I had my derm show me how to do it if you're worried about safety.
Julisss judging by your gallery pics I would totally prick half of those buggers with a needle and gentle push the pus out. I find the skin actually scars more when a zit just sits there stretching the skin for days/weeks on end than if you use a little bit of pressure to remove the pus.
Then just douse your skin in hydrogen peroxide and/or betadine. I prefer betadine because it's a better antiseptic/antifungal/antibacterial, but it does temporarily stain the skin orange for about 30 minutes so it's a little more inconvenient. Also can't let it get on your clothes.
Thanks a lot for both of you. They are deep though and now that my acne has subsided, I see tones of scars left by the needle (however tiny)
When I had acne I would prick whiteheads with a sterilized needle (which is a little better than that lancer because the point is smaller). I'd also use the metal loop extractor for blackheads. Rule of thumb is a tiny bit of pressure is okay. A lot of pressure or any pain is not.
I had my derm show me how to do it if you're worried about safety.
Julisss judging by your gallery pics I would totally prick half of those buggers with a needle and gentle push the pus out. I find the skin actually scars more when a zit just sits there stretching the skin for days/weeks on end than if you use a little bit of pressure to remove the pus.
Then just douse your skin in hydrogen peroxide and/or betadine. I prefer betadine because it's a better antiseptic/antifungal/antibacterial, but it does temporarily stain the skin orange for about 30 minutes so it's a little more inconvenient. Also can't let it get on your clothes.
Do you think the salicylic acid will work to dissolve them? It'll be 10% or 20% so quite strong.
Yeah contrary to popular belief, on some of my stubborn cysts I had more success with high potency salicylic acid than retinoids. If I used 10% salicylic acid with a q-tip directly on the cyst 3 times a day for a week, sometimes it would eventually dissolve the top layer of skin so the pus could come out and the area could heal.
I am getting concerned with this spotting, that is not even spotting... more than that, but less than a period, still, almost constant blood loss.
Do you guys think I should wait it out or get on the pill? And would the pill definitely fix this?
Please, any replies would be much appreciated.
I am getting concerned with this spotting, that is not even spotting... more than that, but less than a period, still, almost constant blood loss.
Do you guys think I should wait it out or get on the pill? And would the pill definitely fix this?
Please, any replies would be much appreciated.
I don't remember what dose you are on of spiro, but higher doses increase chances of spotting.
Also many women find that the spotting resolves in 1-3 months.
Some women only take spironolactone for part of the month.
If your breakouts only tend to occur around the time of your monthly cycle, your dermatologist may have you use spironolactone for the week just prior to your period.
Also from a study
One long-term study found that the most common side effects were menstrual irregularities (22%), tiredness (16.5%), and breast tenderness (17%), all of which were mild and rarely caused cessation of the medication.[30] Most side effects are dose-dependent, except central nervous system (CNS) symptoms (lethargy, headache, lightheadedness, dizziness), which do not appear to always be dose-related.[24] If menstrual abnormalities do not improve within three months of monotherapy, the clinician may consider the following options: 1) decrease spironolactone to a dosage range of 50 to 75mg daily if applicable, 2) add an OC to reduce menstrual dysfunction, or 3) cycling of the spironolactone with 21 consecutive days of therapy followed by seven days off.
So as you can see your options are
1) Reduce your dose (if your dose is above 50mg)
2) Add a contraceptive pill (see my signature for appropriate options...you want LOW androgenic pill)
3) Take spiro for 21 days of the month and don't take it for 7 days. Typically you would start the 21 day cycle the week before your period.
Thank you! I am on 200mg-s, so no surprise about the spotting. I think I'll wait till month 3 (which is round the corner). I wanna get constantly clear first, before experimenting with lowering my dosage. I just don't wanna add the pill to the mix it can do so much harm and not just acne-wise.
In the past days, I applied 20% salicylic on my whiteheads with the Q-tip like you explained. I see the area getting "frosty" and acne drying up quick, but whiteheads didn't "fall off" yet. Should they just pop at some point?
Thank you! I am on 200mg-s, so no surprise about the spotting. I think I'll wait till month 3 (which is round the corner). I wanna get constantly clear first, before experimenting with lowering my dosage. I just don't wanna add the pill to the mix
In the past days, I applied 20% salicylic on my whiteheads with the Q-tip like you explained. I see the area getting "frosty" and acne drying up quick, but whiteheads didn't "fall off" yet. Should they just pop at some point?
Yeah if you're patient with the salicylic acid, they won't fall off, but the pus will come close enough to the surface that you can prick it.