I went to my OBGYN last week to either try out Spiro or BCP. I told her that I wanted a pill good for acne. She prescribed me Loestrin. After researching a bit about it online, I see that this pill has a higher androgen level, which is NOT good for acne prone women! I told her I'd rather have a pill with higher estrogen but she insisted that Loestrin was good for acne.
Why does it seem like doctors prescribe BCP's that are typically 'bad' for acne? I know pills work differently in different women, but doesn't it make more sense to NOT prescribe a pill with higher androgenic activity?
In fairness, most dermatologists seem to not really stay up to date on the facts and research. They just don't know. For example, many still argue that diet and acne are completely unrelated, a concept that has been widely refuted for the past 20 years or so.
Did you explain your knowledge of androgens to her?
In fairness, most dermatologists seem to not really stay up to date on the facts and research. They just don't know. For example, many still argue that diet and acne are completely unrelated, a concept that has been widely refuted for the past 20 years or so.
Did you explain your knowledge of androgens to her?
Honestly, I don't think it's that they're not up to date (they've gone through like, more schooling than any other profession requires) but that some derms just believe different things about the skin from other derms...as in, they form their own conclusions, such as claiming whether or not diet and acne are related. Also, it depends on how knowledgable the derm is too, obviously, since not all derms are good doctors.
I did tell my OBGYN that I knew higher androgenic activity = acne, and that Spiro is an anti androgen. And that higher estrogen in BCP's usually = less acne. But I didn't want to explain it in full because I don't want to annoy the doctor and "upstage" them I guess. I don't want to make them feel like I don't trust them. I guess there was no point in going to her though if I'm going to doubt what she prescribes me. That's why I made sure the next derm I'm seeing is familiar with Spiro. 
Not every acne friendly pill is going to work for everyone. I went through extremely clear years on the highest androgenic pill there is, but I had no idea of the "connection". Then I got pregnant, and the soaring levels of estrogen gave me the most severe acne I'd ever had. When I went back on bcp, I used the nuvaring (high androgen again) and I'm now clear. Regulating your hormones is more important in my opinion, not the BCP itself. The internet is way too full of information, and personally, it was the self research that put me in this position to begin with (trying natural "remedies", masks that did nothing, changing pills, changing diet, listening to other people on this board when everyone's skin is different). If I had just listened to my derm in the first place, I wouldn't be so horribly scarred now.
Not every acne friendly pill is going to work for everyone. I went through extremely clear years on the highest androgenic pill there is, but I had no idea of the "connection". Then I got pregnant, and the soaring levels of estrogen gave me the most severe acne I'd ever had. When I went back on bcp, I used the nuvaring (high androgen again) and I'm now clear. Regulating your hormones is more important in my opinion, not the BCP itself. The internet is way too full of information, and personally, it was the self research that put me in this position to begin with (trying natural "remedies", masks that did nothing, changing pills, changing diet, listening to other people on this board when everyone's skin is different). If I had just listened to my derm in the first place, I wouldn't be so horribly scarred now.
Interesting the way different BCP's work for different women. Hopefully the route I'm going (anti-androgens) will lead me to clearer skin.