I'm beginning to feel a little hopeless and not sure what to do.
I've always had "meh" skin, until I started birth control in college. My acne pretty much disappeared. A few years ago, though, I started noticing some facial pigmentation that the doctor later told me was melasma. It's mostly above my upper lip so, despite having pretty much no hair there, it looks like I have a mustache. It's very embarrassing, to say the least.
Two years ago, my doc switched me to a different BC to see if that'd help with the melasma. It didn't, but it did give me progressively worse cystic acne (which I'd never really experienced before that). It took me a whole year of topicals/antibiotics to realize it was the hormones from the pill switch that was the problem. I switched back to my original BC and started taking 100 mg of spiro. Within a few months, my acne was totally cleared and stayed that way.
Unfortunately, going back on this regimen (in addition to moving from Chicago to Florida) caused my melasma to increase tenfold. I tried everything... lightening creams, peels, etc. Nothing worked. So I decided to see what would happen if I gave up the BC and spiro (since hormones are a huge factor in melasma). Well, I stopped the pills two months ago and so far, the melasma is the same if not darker, and my face is breaking out (which I guess is to be expected). For what it's worth, I also continued using a retinol product I'd been using for a while and started taking some supplements (MSM, vitamin C, pycnogenol, and zinc mainly).
I don't really know if I'm looking for advice or someone to vent to, but I just feel so hopeless. I feel like, in terms of BC, I'm damned if I do and damned if I don't. I guess the melasma is better than the acne because at least the melasma doesn't hurt, but I'd still look at the mirror and cry sometimes because of the melasma, so it's not great.
I'm going to my doctor in a few days but honestly, I'm not expecting much. I don't want to give up, because I'd love to look at myself and not feel like crying, but I'm beginning to lose hope that that will ever happen. 
Hugs. I am so sorry you're going through this. Birth control also ruined my life, I took an androgenic based pill and it gave me horrible skin and it's just become worse since going off of it. Now I'm on Spiro and still struggling. It just sucks so badly, I almost always feel depressed looking at myself. You are not alone.
I think hormone ups and downs can cause these things. I have even heard of pregnant women developing melasma. I am sure you can use a mild skin lightening cream to help. It will take time, but it does work, especially if you gently derma roll your face beforehand. [I had success doing this with hyperpigmentation scars on my chest.]
Just hang in there and know there is more to you than your skin. Your pic is so pretty. If you're in coastal Fl [?] you could try going to the beach regularly, too. Salt water always clears me up. I am actually moving to FL soon and looking forward to that.
So yeah. If you ever need a BC venting buddy I am here.
On 11/14/2016 at 0:53 AM, cloudydreamer said:Hugs. I am so sorry you're going through this. Birth control also ruined my life, I took an androgenic based pill and it gave me horrible skin and it's just become worse since going off of it. Now I'm on Spiro and still struggling. It just sucks so badly, I almost always feel depressed looking at myself. You are not alone.
I think hormone ups and downs can cause these things. I have even heard of pregnant women developing melasma. I am sure you can use a mild skin lightening cream to help. It will take time, but it does work, especially if you gently derma roll your face beforehand. [I had success doing this with hyperpigmentation scars on my chest.]
Just hang in there and know there is more to you than your skin. Your pic is so pretty. If you're in coastal Fl [?] you could try going to the beach regularly, too. Salt water always clears me up. I am actually moving to FL soon and looking forward to that.
So yeah. If you ever need a BC venting buddy I am here.
Thank you so much! (And I'm sorry for the late reply.) When I started taking BC, I had no idea how much it could affect... well, everything, but particularly my skin. I mean, I was 17 and a doctor told me that the pill would help my PMS. She didn't mention anything about the potential side effects and I didn't think to ask because... 17 haha.
How long have you been on Spiro? I think I am going to start back up on that, and see if I can keep my acne under control using only that instead of that + BC (and hoping my melasma will fade at the same time). It's just so aggravating that doctors don't help, though! I've gone to 3 doctors in the past three years... two just wanted to throw topicals at me (which I know by now don't do anything) and one didn't have much to say about the acne, but told me that you can't anything about melasma. Once you have it, you have it. So it's just like... well, that's helpful haha. 
uggghh!
You're welcome. 
I've only been on it about 19 days at 50mg and I'm currently experiencing an initial flare up in certain areas (mainly jawline). It's super frustrating and I also feel using an irritating wash and makeup made it way worse, foundation in particular seems to love to aggrevate any preexisting spots and make stinging papules. I feel so sad that I can't really cover this up without making it worse. And even the noninflamed spots just make my face look lumpy in general. Do you know if laser treatments are good to get rid of that bumpy texture or cc's? I hope spiro does the job for you. Def don't quit if you get the IB like me...I figured accutane would've probably done the same thing since I'm so sensitive, we just have to stick it out. I'm also taking it for oily skin and some hair growth issues so that's also why I picked it over Accutane. I sympathize about bad docs, the deem only made my skin even worse ironically.