You are being impatient. Try not to stress so much; it took me 6 months before I was completely clear from spiro.

Impatient for sure. Hormonal fixes don't happen over night. It takes months and months up to a year even for some unfortunate people

Ha, thank you LikeMoonlight and Paigems When I looked at my calendar to see when I started, I couldn't believe it was two weeks ago! It feels like it's been months! When I took last fall, it took a few months, then I stopped getting cysts altogether, and only had minor breakouts. I should just mark my calendar two months from the start date and not stress. Ha, easier said than done. The good part is I KNOW it works; I just need to find the right dosage.

Paigems, you said it took six months. Can I ask what dose you were taking? Did you find anything else helpful? I feel like I'm taking all these supplements and not sure they really are doing anything: 50mg Zinc, 2 Cod Liver Oil pills/day, probiotics, multi-vita. I take Calcium and Magnesium but that's for other reasons. When I had blood tests done, my D3 and B12 were normal.

Like Moonlight, how long did it take for you? Did you start at 100mg right away? Did you take anything else like an antibiotic or BC pills?

I don't know whether to try to switch to Yaz or just change one thing at a time...I feel like I should minimize the amount of changes I make so I can see what works, but the impatient side of me want results now.

You really need to mentally prepare for the long haul. My endo says it can take 6-9 months to see results from Spiro. I am just over 6 months and still oily. I am on 100mg of the brand name Aldactone. Stick with it! Also, doxy never worked for me but minocycline did!

Yeah, I'm impatient in general, which doesn't serve me well here. I kept track of my breakouts last time I was Spiro and it was the two-month mark I saw a real improvement. I saw my derm this morning and she I can call the office anytime and they'll fit me in for cortisone injections if I have cysts. She actually encouraged it since they'll scar otherwise. That gave me a little peace of mind.

You are being impatient. Try not to stress so much; it took me 6 months before I was completely clear from spiro.

I agree and same here, on 100mg. I had cysts on my jawline and severe cysts on my back and it took 6 months to clear on spiro. I didn't start seeing results until month 4. It took that long to start breaking out again after I stopped, too.

All hormonal methods take a long time to see results. If you're thinking about changing to birth control, you'll still have to be patient. I would strongly advise trying only one thing at a time. If you don't see results after 6 months, then add to or change your plan. That way you know what is working and you don't have to waste your money or put your body through the wringer more than you need to.

Ha, thank you LikeMoonlight and Paigems When I looked at my calendar to see when I started, I couldn't believe it was two weeks ago! It feels like it's been months! When I took last fall, it took a few months, then I stopped getting cysts altogether, and only had minor breakouts. I should just mark my calendar two months from the start date and not stress. Ha, easier said than done. The good part is I KNOW it works; I just need to find the right dosage.

Paigems, you said it took six months. Can I ask what dose you were taking? Did you find anything else helpful? I feel like I'm taking all these supplements and not sure they really are doing anything: 50mg Zinc, 2 Cod Liver Oil pills/day, probiotics, multi-vita. I take Calcium and Magnesium but that's for other reasons. When I had blood tests done, my D3 and B12 were normal.

Like Moonlight, how long did it take for you? Did you start at 100mg right away? Did you take anything else like an antibiotic or BC pills?

I don't know whether to try to switch to Yaz or just change one thing at a time...I feel like I should minimize the amount of changes I make so I can see what works, but the impatient side of me want results now.

I believe the highest dose I ever took was 25mg. It worked great and got rid of my acne and oily skin completely, but I had to stop taking it because of hair loss, fatigue, and dry mouth. I have PCOS so I know my acne is from high androgen levels. Right now I am keeping it in check with Zovia birth control, vitamin C, green smoothies, and watching my diet. I don't get much inflamed acne like I used to, but I do still have some uninflamed acne. I've tried about every hormonal treatment there is, and most of them didn't work out for me. I'm having much better luck with diet and things, and I think I may try juicing next.

I started at 100 right away and I love the dosage I am on. It's my perfect dosage. I wasn't on antibiotics or anything. I am indeed on bc though I am on depo which some people have their acne blow up on this bc yup mine seems to settle.

Thanks again to you both. I went to the derm yesterday morning, AGAIN, to get more injections. We discussed dosages and my derm recommended staying at 50mg for another 6 weeks (!) to give my body time to adjust, and she extended the Doxy but at a lesser dose. I don't even know if it's working ...

Every morning I seem to wake up with another cyst, not whitehead mind you, but a true inflamed cyst or papule. They're leaving marks, and it's so unpleasant.

Has anyone ever had a cortisone injection where it stays red for a long time? The area treated is now dark reddish and almost dry. I can't tell if it's just healing or if it's a bad scar. All I know is have some really wicked looking marks on my face. I used to be able to face my husband without make-up. I know I didn't have perfect skin, but at least it wasn't THIS BAD.

I'm trying to stay positive, but waking up in the morning is the worst. Lately, the cysts are all lower chin and jawline. Although, I've had one on my forehead and by my nose -- and I NEVER breakout on my forehead and it's been a long time since I've broken out on my nose.

ahh you sound exactly like me back in february. i was at the derm all the time though getting injections at least once or twice a week. ( i think i had 23 cysts injected in total and i had nodules as well) i eventually went up to 100mg of spiro and then they added in keflex and 3 days later my cysts were gone and i didnt get another one. i am weaning off the keflex now though because i want to stop taking it since i dont think i need it anymore. also i use the proactiv toner which has glycolic acid in it and it works pretty well. you would be amazed at what comes off on the cotton ball after you have washed your face. if you use makeup at all i highly recommend this toner or any other toner to use after cleansing. good luck to you and just try to be patient. i almost went on accutane i was so impatient but then at the last minute i decided against it. it will get better i can promise you that!

I would strongly advise trying only one thing at a time. If you don't see results after 6 months, then add to or change your plan.

You are absolutely right on with this. I tried changing BCPs and added Spiro all at once last fall, and increased Spiro dosage rapidly. I had really bad side effects, to the point when I finally had to stop everything, which has now put me back at square one: cystic hormonal acne. So I'm really going to try and wait it out. I never had any major side effects with the Seasonale, until the cysts. So, I'm back on that now but with Spiro.

LikeMoonlight, I used to get a Depo shot. LOVED IT. Never had any of the side effect that were typically associated with it either. Then when I turned 30, my doctor wasn't sure if that was so good for me (bone density loss after 30). I wonder if it's worth it to revisit Depo as an option. It's progesterone only, right? I should look into it.

Tracy123, what's Keflex? I've heard it mentioned on the boards, but I'm not familiar with it.

Thank you for the support

keflex is an antibiotic. i took doxy and mino and had good success with them but the keflex kicked in super quick and worked way better than mino and doxy too. it really saved my skin because i started getting some scarring from all the cysts i had so thank goodness i took it when i did or things would have been way worse. my derm was all ready to start me on accutane so i had the bloodwork and the pregnancy test and filled out the paperwork and then a month later my skin was so good that i told her i didnt want to do it. thank goodness i said no because things have been so much better but for me. i was having a ton of clogged pores and now that i use the toner i dont get them anymore. i never realized how much makeup and dead skin was still on my face after washing it!

Yeah depo is progesterone only. I love it too, most people have kind of nasty side effects like huge weight gain and inflammed acne. I have the opposit effects. I was taken off it once before by a doctor who didn't like it as a birth control and refused to prescribe it. A couple of years later I got put back on it and I am thankful. It's my favorite birth control.

Also I agree with Tracy about the toner. I use witch hazel seriously is only .75 for a huge bottle and it's like magic on my skin. Removes makeup that you think your face wash is getting.

I was on seasonal for a couple of years and I was ok with it but I had weight gain which of course I am not fond of

An update: after going to my dermatologist for the THIRD time since Monday, she has bumped the Spironolactone to 75mg. I've had EIGHT injections in the last five days. This is by far the most I've ever had. She said even though I was 25mg for two weeks, it's such a low dose that it was really not doing anything, but if I can eventually get to 100mg, she really thinks it will make a difference.

In 4-6 weeks, she also wants me to get labwork done just to make sure everything is okay. I'm hopeful, but I'm definitely going to try to at LEAST give the 75mg two weeks, before I even consider 100mg. I also don't expect to clear right away, but hoping in a few weeks I'll be at least getting less.

I'll keep you posted. I'm so grateful all the support and information.

awe try to hang in there if you can. that is what i went through when i was breaking out bad and i hate to believe that anything could cause an initial breakout but when i started spiro and every single time my dosage was upped i would get wicked breakouts with bad cysts and nodules. it was terrible and made me a freaking basket case. I lost like 10 pounds and i am already thin it was awful! it seemed like every single clogged pore i had turned into huge dime size cysts and i can honestly tell you the only thing that made that go away was the keflex and then always using a toner. i was on doxy at the time this all went down and then my derm put me on zithromax which did nothing and then i was off the antibiotics for 5 weeks until i asked her about keflex. best decision ever because it saved me skin. you should call the derm and ask for it.

Tracy123, your story sounds familiar to mine: I've lost weight since this has happened. Between not knowing what to eat (that could potentially cause breakouts), and feeling so down, I have no appetite. Thank you for the Keflex information, btw. I forgot to ask her about it, but I will next time. I'm hesitant to start another new dose of antibiotics just because of the potential impact it can have to an immune system. I'm also trying to keep it to one change at time. If there are too many variables, I won't know what actually worked!

yeah its awful! i wouldnt wish it on my own worst enemy. i was the same way i was afraid to eat anything i pretty much lived on plain oatmeal and then veggies and chicken. ugh! oh yeah for sure i get that with the antibiotics when i was off them for 5 weeks (i was 2 months into spiro then) i was determined to not go back on them but my face just kept getting worse and when i saw that i was getting more scars that was what did it for me. i hate antibiotics but they work so well for me. i am just praying now that i will be ok when i go off the keflex but if not i will take them probably forever because i would rather look normal than be stuck with bad acne and more scars. i know that sounds terrible but i couldnt handle anything else at this point. i just try to be positive about everything and workout at least 5 days a week. when i was breaking out so bad i stopped doing everything i would go to work and then when i got home i would lay on the couch and cry and that was it. i stopped enjoying life but i forced myself to go back into working out and to do things and it did help me a bit. just know you will get through this and you will be stronger for it. if you ever need anything pm me n here.

So after I got the injections today, I came home and just put a dab of makeup over them and convinced myself I could go out. I did. People still noticed. But when I got home, I had another inflamed pimple (not a cyst yet) just to the side of my nose. Front and center. It's the worst I guess I do feel like the Doxy isn't doing a thing. Or geez, what if it is and it's even worse? I'm supposed to go on vacation with my husband in two weeks and I really don't want to go. People will just think, "Why is that hot guy with such an ugly chick?" I'm going to cry ... ARGH! I'm trying not to because I'm afraid crying will make me breakout.

Tracy123, ha, oh my gosh, just add air-popped popcorn to that diet and that is exactly what I've been eating, but I am drinking coffee too. I've had coffee for years so I don't think 2 cups in the morning are causing this. But I've cut out all diet soda, which I drank for YEARS and was fine, but now I'm worried it too causes breakouts so I stopped. Oh, and I have eggs because they're supposed to be good for you. I eat more healthy stuff than anyone I know, yet I see these people (friends, family) who eat just garbage yet have perfect skin! I'm just soo depressed. I feel so ugly and so gross that people will just be so disgusted by me. I just want this to stop. I'm forcing myself to have some vegetables and chicken right now so the Spiro gets absorbed, but I have no appetite. I may PM you. Thank you.

I try not to look in the mirror, but I keep thinking maybe I'll "catch" something before it literally pops up. I just don't understand why I'm getting this (ha, well, I do. My hormones are jacked up). People get upset about sagging boobs and wrinkles. That's normal when as you age. I'd welcome that any day over this. Wrinkles? Psh. That's nothing.

Edited to add:

Hearts

I agree and same here, on 100mg. I had cysts on my jawline and severe cysts on my back and it took 6 months to clear on spiro. I didn't start seeing results until month 4. It took that long to start breaking out again after I stopped, too.

(((((sigh))))) Another day, another cyst. There has to be record for this. I think the worst feeling is beyond seeing a new cyst is feeling that you have one deep below the surface and there's really nothing you can do to get rid of it. I just have to wait it out and see my derm tomorrow. I really don't think the Doxy is working. I'm at the point where I'm anticipating one or more every day now. I wish there was an on-call dermatologist you could see for emergencies. I know I know I know this so silly and superficial, but it's a cyst. It's not a little pimple/whitehead. Those are manageable.

Something interesting I came across while doing my copious research on hormonal acne... from the U.S. National Library of Medicine (as of Jan 2013):

Researchers from the Cochrane Collaboration an international network of researchers took a look at the effectiveness of contraceptive pills in the treatment of acne. They did a search for trials that compared the pill with a dummy drug (placebo) or a non-hormonal acne medication. Their analysis included 31 trials with a total of about 12,500 women. Most of the trials compared different contraceptive pills with each other or with a placebo drug. Hardly any of the trials compared the pill with other acne medications.

All of the contraceptive pills studied in the trials reduced both inflammatory and non-inflammatory acne. They often had to be taken for several weeks or months before the participants skin got better. The pills that reduced acne had ethinyl estradiol in them, combined with one of the following drugs: levonorgestrel, norethindrone, norgestimate, drospirenone, cyproterone acetate, chlormadinone acetate, dienogest or desogestrel.

The trials showed that most of the pills had a similar positive effect on acne. But some types of pills seem to be somewhat more effective than others: In one trial, pills that had cyproterone acetate in them were found to help reduce acne somewhat better than pills that had levonorgestrel in them. Another trial found this to be true for pills that had chlormadinone acetate in them. Cyproterone acetate has not been approved for contraceptive use in Germany, but it can be prescribed for the treatment of acne. So any claims that a certain pill will lead to much better skin than others pills should be taken with caution.

Just an update here: 3 new cysts. One Saturday, two on Sunday. Calling derm this morning for injections. It's every other GD day. I can't believe it. I was so depressed yesterday. These suckers are painful, both literally and emotionally. As of today, I will have take Spiro 50mg for one week, and the last 3 days at 75mg. I'm essentially disregarding the two weeks I was on the 25mg since it is too little to do anything.

I'm going to ask if they'll switch me to another antibiotic. I'm supposed to go on vacation next week, and I really don't want to. Can you imagine? If I'm going to get injections every other day, how is my skin going to look after a week?

Can someone please please please tell me they still had cysts after initially starting? I know you've already told me, but I need to hear it again so I don't feel like a freak. I hear theses stories of "it disappears immediately" or "I never had an IB." That is not the case with me.

It was not this bad last fall! I had maybe... 5? I've had five in 48 hours. I don't want to leave the house. I haven't been. Just feels like such a hopeless situation.

Edited to add: Has anyone also felt like they have no idea how to treat their skin anymore? I used to have a regimen and it was great. Now... I'm wondering if my jawline is TOO DRY. It's scaly and has lots of flaky skin. I try to exfoliate it gently, but I just keep thinking that's it better to be dry than oily. Doesn't seem to matter.

Most people with cystic acne seems to have better luck with keflex. Ask your derm for a new antibiotic until the spiro kicks in

I can also tell you people break out for months with cysts still taking this medication. Have a chat with dizzyabby. Or read her log anyways I think you'll get insprired

I'm trying so hard not to get depressed. Another two cysts today and front and center on my face. I thought jawline was bad, but front and center is the worst (forehead is right up there too). I went to the derm yesterday, and she said that the brand name of Doryx is actually better than generic doxy (what I had been taking) so we're trying that. The doxy worked last year, but this year, ha, it's not even close. We'll try this for a few weeks I guess, and if it still doesn't work, we'll switch to Keflex. I wonder what it is about Keflex... she said she'd prescribed it but really thought as strong as Doryx is, I'd have better luck with that.

If I step back for a moment, this started in the beginning of July and it's end of July now. It's only been four weeks. I just can't believe how much activity I've had in that time. I know people have dealt with this far longer than me, but the idea of having no control over your own body is so upsetting. I feel like all my scars from high school were looking good a few months ago -- best I've looked in awhile and the cysts are just destroying my skin all over again. And I'm not 17 anymore so it's not like my skin recovers as fast.

I bumped Spiro up to 100mg. Starting today I'm going to take 50mg AM, and 50mg PM.

Edited to add: Thanks Like Moonlight. How do I find her blog?

Have a chat with dizzyabby. Or read her log anyways I think you'll get insprired

Thanks, LikeMoonlight. I have a different antibiotic I started yesterday and I hope that helps. I'm getting three more injections today though.

I'm also starting Ortho Try Cyclen. That really helped last time too. I'm just...to the point I can't even cry anymore. Or, ha, I'll start balling. I feel so much empathy for anyone who has cystic acne. It's such a different beast than a blackhead or whitehead. I've had maybe one of those this entire time, and I laughed when I saw it. Otherwise, it's all cysts.

Edited to add: I stopped taking all supplements. ALL of them. I'm only taking what the doctor has prescribed. I've never been out of range with my bloodwork and the supplements so clearly aren't making a difference, so I'm done with that. It actually brought some relief because I was taking so many pills a day.

Edited to on Aug. 1: I did get a new antibiotic. It's not Keflex (cefaflexin is the generic I think), but it's in the Keflex family. Called Duricef (cefadroxil). I started taking 1000mg/day on Tuesday. I pray this helps. I had a smallish cyst that I thought was on its way out, and this morning it has become HUGE. It's so painful. Right on my chin.

I know there's a birth control thread, but I'll say it here too: I never thought going off the pill such a radical consequence. I think some women are fine stopping, but for me, it has been a mess. I don't mind being on it, but had I known this was going to happen, I never would've stopped.