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Days on Spironolactone: 9
Days without Picking: 0
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 3 actives
Left Side of Chin: 6 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Background:
I had acne on my forehead as an early teen. When I was 17-18 my acne transitioned to my cheeks and chin and my forehead completely cleared. At this point, my forehead never breaks out but I do have enlarged pores due to scarring. When I was 17 I went on Yaz and I believe this helped regulate my skin a lot. I still had breakouts pretty consistently but they only consisted of 1 or 2 cysts that were very manageable. Finally, last year, I got an IUD (Mirena) and my skin has been horrible since. To be fair, I also moved across the county and have undergone a lot of stress in that time period, so I think my increase in acne could be related to that as well.
I always have had irregular periods when I am not on birth control. Since my skin has been getting progressively worse, I decided to get my hormones tested. I am still waiting to get some of the results back, but I have been prematurely diagnosed with PCOS. My Lutenizing Hormone (LH) and Follicle Stimulating Hormone (FSH) ratio was 4:1 and it should be 1:1. Since I am not overweight (I've lost 30 or so pounds in the last few years), my doctor said it is no surprise that my androgen levels are normal. Androgens are what often cause acne and extra hair growth. Anyways, I'll update more on my blood work when I get the rest of the results back. I am still trying to interpret them. Since my androgen levels are normal, I'm also curious if Spironolactone will help since it works as an androgen blocker?
In the meantime, my Dr. (an endocrinologist) has decided to put me on 100mg of spironolactone. I take 50mg in the morning and evening.
Preliminary Results:
It has been 9 days so far and I feel like there is no visible improvement in my skin, but I feel like the inflammation under the skin has decreased.... if that makes sense. These results could be meaningless, since spiro is not supposed to take much of an effect until after a few weeks/months of use.
My major problem is picking. In fact, I just had a 10-15 minute picking session in the mirror about an hour ago. It makes me feel horrible and I know that I am not doing any favors for my skin. I wasn't always that bad, but the last year or so has put me to the test. My picking is the main reason why I have decided to post a log here. I know that documenting my results with spironolactone will help others, but posting here might also help me be more accountable when I'm in front of the mirror.
I'd like to somehow replace the habit with something that is good for my skin, but I am not sure what. Ideas? I'm also thinking about controlling how much time I spend in front of the mirror, since I know that it is a really big trigger for me.
The Rest of My Routine
I have gone on and off Proactiv for about 7 years. I am not the biggest fan, but I find that when I use it after discontinued use I get good results for a short time. Maybe 1-2 weeks. Then my skin declines and gets overly dry and new breakouts start. I know that i can use it safely for one week, so I will go ahead and do that now to try and clear up my skin a bit more. Then, I'll use a gentle cleanser (CeraVe) and moisturizer for the remainder of the spiro trial period.
In April I will see my endocrinologist again. I might request a larger dose of Spiro then if I do not see a lot of improvement. I'm also planning on seeing a dermatologist at some point. I would like to get Retin-A micro. In fact, I'm dying to get my hands on some. I feel like it is a great alternative treatment to benzoyl peroxide because it is known to actually improve the quality of the skin, whereas BP just dries it out.
My plan is to update ~daily to help control my picking, and maybe ~weekly to talk about the spironolactone results.
Thanks for reading!
xx Shawna
Days on Spironolactone: 10
Days without Picking: 1
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 5 actives
Left Side of Chin: 5 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Update:
My skin is slightly worse today. A lot of stuff came up on the right side of my chin. I don't think its really "new" it just came up to the surface. I got rid of 2 white heads in that area. One is now flat, so I know it was ready to go, but the other is a little swollen. I have a cyst on the left cheek that is bigger today and it hurts...
I don't really count getting rid of the whiteheads as picking... but I probably should leave them alone.... I think I can go the rest of the day without picking, so hopefully I wont have to update this later.
Blood work Results:
I got the rest of my blood work results back. Everything was normal except for my testosterone levels. They are at 71. Technically, 0-90 is considered normal, but above 70 is elevated. My concern is that if all of my androgen levels are "normal", will spironolactone help?
xx Shawna
I just wanna say, HANG ON!
I've never been on Spiro, but I've been taking Yasmin (which is supposed to have Spiro in it) for about 5 months now.
My first 2 months were brutal. My forehead stayed the same, all the clogged pores on my cheek were pushed out (luckily I only had 3, but they all became sore pustules), but my chin was a warzone. Cyst after cyst after cyst after cyst. I never had cysts in my life!
But with the starting of month 3, everything went away. Now, my forehead and cheeks are clear all the time (maybe 1 pimple in 2 months), and my chin doesn't get cysts anymore. My chin still has some pimples from time to time, but it's 2 at the most.
So stay strong, and it WILL go better in time!
But with the starting of month 3, everything went away. Now, my forehead and cheeks are clear all the time (maybe 1 pimple in 2 months), and my chin doesn't get cysts anymore. My chin still has some pimples from time to time, but it's 2 at the most.
So stay strong, and it WILL go better in time!
3 months sounds like the magic number for most people. Congratulations and thanks for the encouragement 
Days on Spironolactone: 11
Days without Picking: 1
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 6 actives
Left Side of Chin: 4 actives
Lower Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Update:
Ok, so I'm counting yesterday's whitehead removals as picking because I think I went a little overboard. I have 2 new scabs that shouldn't be there. Discouraging... but the rest of my skin seems ok with minor improvements.
I'm changing the format of my log to "actives" so that its easier to keep track of improvements.
xx Shawna
Days On Spironolactone:13
Days without Picking: 0
Forehead:Clear
Right Cheek: 1 active
Left Cheek: 1 active
Right Side of Chin: 4 actives
Left Side of Chin: 4 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Update:
I have a lot of scabs, so I'm really struggling with the picking. Yesterday I went crazy and spent quite awhile in front of the mirror. It could be worse... but its not good. I'm seeing a dermatologist tomorrow and I am hoping to get a retinoid. I might not be able to start until January though. It might also be good to give my skin a little bit more time with Sprironolactone before I try and incorporate more topical treatments anyways... My total count of actives has gone down, but there are countless scabs right now and because I picked so many blackheads I am sure that in a few days I will have more cysts developing.
I've been using proactiv a bit. I've always sort of ignored the toner but I just realized today that the toner has glycolic acid as its main ingredient. Glycolic acid is supposed to be great for fading scars and unclogging pores. Since my face has been peeling a lot and is very scabbed, I wonder if using the toner more will help. I feel stupid for never really thinking about it before...
My side effects with spironolactone have been mild. Sometimes I feel a little light headed, but I can't tell if it is just all in my head. I haven't really noticed any of the diuretic effects that many other people have, which is good, I suppose. I definitely need to drink more water.
I have also decided to give up milk and sugar. Well, I will give sugar up for the a week or so because I'm going home for Christmas and there is no way I can not have sugar then. Giving up dairy seemed to help my skin in the past, but I later decided it was a placebo effect. Now I figure that it can't hurt. Not eating dairy and sugar also helps me naturally lose weight, so it has an added bonus.
Sorry for the rambling!
xx Shawna
Days On Spironolactone:14
Days without Picking: 1
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 0 active
Right Side of Chin: 4 actives
Left Side of Chin: 4 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Update:
I'm seeing a lot of improvement today! My cheeks are very clear and my chin is healing and a little less inflamed. I've actually noticed that since I have started spironolactone, I have not had a single new cyst on my cheeks. I guess I just had to wait for the ones I had to heal.
Also, can I note that I did not eat sweets or dairy yesterday! Woohoo.
I went to the dermatologist and it was a bit confusing, to be honest. I got 2 prescriptions and I bought a glycolic acid cleanser from the office for my back. My prescriptions are for Aczone (5% dapsone) and tretinoin 0.025%. I'm supposed to use Aczone in the morning and the tretinoin at night. I also got samples for CeraVe. I already use the cream cleanser but they suggest that I switch to the foaming cleanser. I think that I will alternate the foaming and cream cleanser since in the morning all I really need to do is remove the previous night's medication. The foaming cleanser should be better at removing makeup and dirt. When I run out of cream cleanser, I'll consider using the foaming all of the time. I am worried it might be more drying.
The Aczone is expensive!!! I got 3 samples and 3 coupons. For now I will only be paying $25 per tube. I probably one be buying after that though. Anyone have experience with it??
So, starting tomorrow, my regimen is this:
AM
50mg Spironolactone
Cleanser: CeraVe Cream Cleanser
Toner: Proactiv Revitalizing Toner
Treatment: Aczone
Moisturizer: CeraVe Moisturizer
PM
50mg Spironolactone
Cleanser: CeraVe Foaming Cleanser
Toner: Proactiv Revitalizing Toner
(wait 30+ minutes)
Treatment: Tretinoin
Moisturizer: Cerave Moisturizer if needed
xx Shawna
Days On Spironolactone:15
Days without Picking: 2
Forehead:Clear
Right Cheek: 0 active
Left Cheek: 2 active
Right Side of Chin: 3 actives
Left Side of Chin: 3 actives
Back: 3 actives
Scarring: Along my chin, jawline and underneath my cheekbones.
Update:
My skin is looking really nice today! Obviously there are still some scabs, scarring and hyperpigmentation, but I don't have very many actives. The actives that I do have are small and are not too inflamed. Since my skin is looking better I have almost no urge to pick! Its great.
I'm pretty happy and it makes me nervous about starting tretinoin tonight because there are so many stories about it making things worse in the beginning. At least I have a bit of the Spiro in my system, so hopefully that will prevent things from getting too bad. I know a lot of people take an antibiotic with it to help combat the IB, but since I'm allergic to so many of them when ingested my Dr. decided it was probably not worth the risk. So, I'll be using Aczone instead. Does anyone have experience with Aczone?
I tried out the CeraVe foaming wash and moisturizer samples that my Dr. gave me and I really like them.
And finally, I posted some pictures of my skin throughout the year including some from last night. I'll try and post new ones every few weeks with the same lighting and camera.
xx Shawna
FYI, I copied these posts to a new acne.org blog:
http://www.acne.org/messageboard/index.php/blog/6736-spironolactone-tretinoin/
I'll continue to update here, just not as frequently.
Cheers,
Shawna
Days on Spironolactone: 99
Days without Picking: 2 weeks or so
Forehead:Clear
Right Cheek: Clear!
Left Cheek: Clear!!
Right Side of Chin: Clear!!!
Left Side of Chin: Clear!!!!
Back: Clear!!!!!
Scaring: Along my chin, jawline and underneath my cheekbones, back.
You guys, I'm clear. I still have a bit of scarring and I'm working on treating it. I have done a full blog post here.
Before:
Yay!
xx Shawna
Again, my success is continuing. In the last 3 months I have had maybe 2 or three minor blemishes and zero cysts! Scarring and hyper-pigmentation is fading slowly, but well. I've been continuing using Argain Oil, 150mg of Spironolactone, and 3 days a week of tretinoin gel.
It seems like I can do whatever I want to my skin as long as I stay on the spironolactone. To help fade scars and keep my pores small and clear I use CeraVe foaming wash and moisturizer. Occasionally I will use a cleanser with glycolic acid or salicylic acid, never scrubs, to help exfoliate. I try and treat my skin as gently as possible.
I am really happy with everything and I hope the best for all the women who are also going this route!
Love your post/log. Thank you for being bold enough to post pics. I too am a big picker. 
( I hate it!
I'm happy spiro worked for you. I took it along with welbutrine (spelling)...I stopped taking welbutrine recently because of anger fits/ feeling extra frustrated/irritated more often than not.
I also stopped spiro. I'm getting them on my neck now which is new. :-/ blah
We switched to using coconut oil more than any other cooking oil. I do many of the natural treatments like honey and cinnamon. Going to keep at it.
Thanks for posting.
Hi Shawna - Thank you for writing this log; it's been a really helpful and hope-inspiring log, given that I struggle with a very similar problem. I have been on Spiro 3 months now and am still unsure of whether I am experiencing any improvements yet, though I have read a lot that Spiro is a very slow acting drug, despite having great effects once it does start working - and you seem to be a perfect example of that. I was wondering if you've had experience with other cleansers/moisturizers and what you have thought of them. I'm currently using Avene, and I've used Bioderma in the past, and I'm finding that the moisturizer just doesn't feel like it's moisturizing enough - my skin still feels somewhat dry and tight after and I have lately been doing a second application of it. You mention using CeraVe to help fade scars - have you done anything else to help with that sort of healing process? I am hopeful enough that I want to start looking forward and readying myself for that process. Any tips you have would be super welcome! Congrats on it all!
Hi Shawna - Thank you for writing this log; it's been a really helpful and hope-inspiring log, given that I struggle with a very similar problem. I have been on Spiro 3 months now and am still unsure of whether I am experiencing any improvements yet, though I have read a lot that Spiro is a very slow acting drug, despite having great effects once it does start working - and you seem to be a perfect example of that. I was wondering if you've had experience with other cleansers/moisturizers and what you have thought of them. I'm currently using Avene, and I've used Bioderma in the past, and I'm finding that the moisturizer just doesn't feel like it's moisturizing enough - my skin still feels somewhat dry and tight after and I have lately been doing a second application of it. You mention using CeraVe to help fade scars - have you done anything else to help with that sort of healing process? I am hopeful enough that I want to start looking forward and readying myself for that process. Any tips you have would be super welcome! Congrats on it all!
I found my spiro diary.. the last entry was 4 and 1/2 months after i started it and i was breaking out all this time but with less and less frequency and severity.. after that i remember myself saying that this diary has no point any more because i had a clear improvement.. i was so silly i stopped, now i have to wait so long to start working again...