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tracy521

Deciding If I Should Take Spiro

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So I decided to stop doxy and my face has been breaking out a lot so i went to my derm today and they prescribed me spiro for 8 weeks and if that doesnt work then they will give me low dose accutane. they wanted to try the spiro first but they dont even know themselves if i have hormonal acne so i dont know if i should even take this or not. i have had all my hormone levels checked and they were all normal and when i breakout lately its been on and around the cheek area and around my nose with all types of acne and once a month or so i get a cyst. i have had acne on and off since i was 19 (i am 34 now) and been on every antibiotic and topical you can think of. the antiobiotics work very well and will have me clear for 6-8 months and then they stop working. so how do i determine if my acne is definitley hormonal? i am so torn because i really would rather do the low dose accutane but then again if this works then this could be my answer as well. also i like to go out once a week and have some beers and i have heard that drinking on spiro is bad news as well as accutane. does anybody here drink on spiro or low dose accutane?

Edited by Karen Howz

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Just know that if you take spiro and it works, that you will need to take it forever. If you take accutane and get to your cumulative dose and it works, you may never need to take it again.

Spiro carries risks as well. People have become tired, depressed and some have had abnormal labs (creatinine and potassium) so it's not without risks. You can get periods every two weeks (spotting) and you can't become pregnant while on it. I don't know if you're planning on having children. It's a good drug for acne, but it isn't 100% risk free like it's being touted.

Spiro also carries a black box warning for cancer.

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I would go with Accutane. I was on Spiro for a year and then wanted to come off to have another baby. I came off and after three months my skin is back to horrible. I am going to postpone the baby thing to do another course of Accutane. As for the drinking, I drank on it, sometimes (girls weekend, etc.) quite heavily. I did get my blood checked and all was good, but I know that drinking should be somewhat limited on Spiro. I would just go with Accutane. While the first course lasted about 8 months for me, sadly, it was the best skin ever and Im happy/excited to get there again!

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thank you both for your replies. i was leaning against not taking spiro anyway and you just made up my mind. that is the thing is that if it does work i dont want to take it forever thats for sure. my blood pressure runs low sometimes anyway so i just dont know if this pill would make it worse. i cant be on any hormonal birth control so i guess i need to get an iud if i plan on being on accutane. i wanted my hubby to get a vasectomy but he wont even think about it even though we are not planning on having any kids. he is more worried about the embarrassment of it than anything but it would be so much easier only because i have read that iud's can make that time of the month even worse but i guess i just have to suck it up and do it. i know it will be worth it in the end. anyway thanks again i appreciate the input!!

now my derm told me to let her know if i am having any problems with taking this pill like getting light headed and things like that so i wonder if in the 2 week stretch if i can call and say i am having isues and then get the accutane sooner than the 8 weeks. i hate to lie but sometimes you gotta do what you gotta do.

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For some reason I thought you couldn't get an IUD if you havent had kids, but maybe I'm mistaken. The pill is what triggered all of this for me, so I am going on Accutane pill-free. We just have to be super careful, which we did last time as well. (The pill is the devil for me, and an IUD is not an option - I'm on Canada so we skip the whole i-pledge thing)

I got super light-headed when I first went on Spiro. I aslo got headaches, etc. It does go away after a few weeks, but the thought of being on that forever is not ideal. I loved Accutane becuase, although the first month was seriously horrific for me, after two/three months it was smooth sailing. I long for the day again where I wake up and don't have to wince in the mirror. I loved leaving the house with just mascara - not a drop of cover up!

Accutane was a breeze for me. You just have to be smart and drink lots of water, use lip balm and a good moisturizer. I put off going on Accutane for years becuase i was so scared. If i could turn back time I'd have gone on it when my skin went crazy at 28!

Good luck!

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yeah since i got a phlebitis (sp?) in my arm when taking yaz 4 years ago i am able to get paragard the copper iud. they just said it might hurt a little more than normal. i was going to get it a few years ago but chickend out. the copper iud has no hormones so i dont think it will mess anything up but i dont know for sure. i would like to do the accutane without the iud but i am so paranoid about getting pregnant. i mean how can you tell if a condom has broken? if there is a way to tell for sure please let me know because if my derm doesnt push the iud for the accutane i wont bother with it. you figure they prescribed me the spiro knowing that i am not on anything.

ugh spiro doesnt sound that great. is it keeping you clear now? that is one thing i am afraid of with accutane is that my face will get like 10 times worse and that totally freaks me out but i guess i have to take that chance because who knows what my skin will look like in another 10 years. i had the script for accutane about 7 years ago and i decided not to take it. i am kicking myself though thats for sure! i long for the days of not having anything to cover up on my face even though i know my acne isnt severe it really screws with my self esteem and just my general happiness and the thought of waking up and not worrying about a zit sounds so good. so you didnt get any side effects from accutane? that is awesome! my hubby took it about 20 years ago and he said his lips would crack and bleed but that was about it. he still has good skin to this day so its a good thing he took it when he did. i also wonder too with going on a low dose if i will have to take it longer than the standard 6 months or if that will be enough. anyway thanks for your input i appreciate it!!

one more thing when i got off birth control in 2008 my face was clear for about 2 years just using benzaclin everyday but then it stopped working and my face slowly but steadily got worse. for years though i do believe the pill was making my skin worse because it only would be clear the week i took the sugar pill. ugh if only i could figure out if my acne is hormonal because my derm swears if it is and i take accutane that my acne will come back.

Edited by Karen Howz

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If you're worried about an IB, start with a low dose and slowly work up to a normal dose.

There are so many horror stories about 'tane, but I think they're overhyped. I had little to no side effects with it and i kept me clear for almost 5 yrs. Then I had reproductive sx and it came back.

I wish I didn't listen to all the horror stories about it and went on it years before I did. I had more side effects on spiro....and you have to take spiro forever, so the risks are higher due to sheer length of time on it.

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hey thanks again for the info, i really appreciate it. i think my derm wants to only do a low dose of accutane say 10-20mg a day max since they dont think my acne is severe enough to do a higher dose. it was my fault for going online all those years ago and reading the horror stories. if i would have just sucked it up and taken the accutane then most likely i wouldnt be in this situation right now. i totally agree about not wanting ot take spiro forever. i will pass on that. i have taken freaking antibiotics on and off for years and i wont do that again. the derm asked me about a low dose antibiotic and if i was interested and i just kept saying no because all those stupid things get me clear for a bit and then the acne came back and its not worth it. screw that. i think its awesome that you were clear for so long with the accutane though. i had a friend at work that did two rounds and her acne came back but she had a kids in between so i think that is why it came back. anyway i am going to wait until next week and then call the derm and tell her i cant tolerate the spiro and that i want the accutane now. cross your fingers for me and thank you for all your advice.

Edited by Karen Howz

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No problem, I'm happy to help!

I hear ya about wishing you didn't read horror stories. Ugh. I do believe it's a serious drug, but all drugs have potential side effects and not everyone gets them. I think we you being on so low of a dose, you should be fine. When I was on it, I took omegas. I don't know if it helped, but I didn't have any joint pain. I ate very healthy. With that dose, you may not need moisturizer, you'll have to see. You may not get dry.

One thing I wish someone told me earlier in my course was that you can use topicals to spot treat if you need to, like if you get a cyst. I wouldn't use bp for anything but a cyst or something you think can scar, but no one told me until the end. I had a really green PA, which is why I didn't find out until later, when I saw the MD one time.

Don't wait too long to call, because with IPledge there's a month wait after your period -- I think it's your next period. IPledge is so annoying.

Seriously? Tell your MD you fainted so you can get on track asap for tane. Some people do pass out from it.

Edited by Prettywords

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Totally! I was SO light headed on spiro and just like @prettywords, I found accutane to affect me less! I had little to no side effects, seriously. Yes I was dry but nothing that a moisturizer couldnt handle. I know you said your hubs was on it and had a bad time. So did mine, hence why I waited so long to go on it. I only found out after asking him about it hat he didnt drink nearly enough water OR moisturize. I would ask your hubs, I'm willing to bet that he didn't take "proper" care of himself. Everyone I know that drank enough water, moisturized, stayed out of the sun and was generally smart about it, has been totally fine. Everyone is different, but I wouldnt believe the hype. I started on 10mg and had a crazy IB so my derm bumped me to 40mg right away. For me, I'd want to start higher to try and avoid that kind of IB. But again, everyone is different and I knoe people that only got better from their first pill. Lucky ducks.

If i can say one thing, it's that I shouldn't have waited so long. My derm told me that woman over 30 who take accutane have a higher chance of relapse. Hence where I am now. If at 28 I would have filled that RX, maybe I wouldnt have to do a second course. My acne isnt that bad either, but I get whoppers and then I have to get them injected and blah blah. It is costing me too much $ so back I go for round two!

As for the birth control, without going into TMI, we use condoms and VCF (brand) spermicide. I used that while on spiro and we were fine. I'm not a risk taker with pregnancy on these drugs, so we are just very careful.

Good luck!

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thanks so much prettywords!! yeah i am hoping with a low dose that the side effects wont be as bad. that is a good idea about taking the omegas. thanks for the tip! that is good to know about being able to use topicals while on accutane. i didnt know that either. now i wonder if i get a cyst if i can get it injected because mine dont go away otherwise and then they will leave a nasty red mark. ooh thats a good idea about calling now because my period is due this week so does that mean i will have to wait another month then after this period? i hate that ipledge thing but i guess they have to do it. i wonder for now if i can tell them my 2 methods of birth control are condoms and the sponge until i decide if i am going to get the iud. lol i was going to tell my derm that i fainted but then i am afraid they will want me to get checked out at the hospital or something. i think i will just say the spiro is making me way too dizzy or something like that.

Edited by Karen Howz

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hey 2yearoldmumma thanks for your input as well. that is good that you only needed moisturizer so i can deal with that for sure. my hubby didnt have any side effects except that his lips would crack and bleed and i think he had really dry skin but thats it and it was the best decision he ever made and to this day if you saw him you would never know he had acne. i feel bad though he said he missed out on dances and all those fun things in high school because of his skin. yeah i drink a ton of water already so that wont be a problem and i try to eat pretty healthy. i do like to go out and have some beers once a week so i guess i will have to curtail that a bit but i know it will be worth it. oh no you got a bad ib when only taking 10mg? that has me worried now i was hoping with a low dose that i wouldnt get an ib or if i did that it wouldnt be bad. that was always my biggest fear is that i get a really bad ib and that it leaves me with even more scars. did you scar from that breakout? i guess i will just have to see what dose they want to do for me and then go from there.

ugh the chance of relapse scares me too and i am so mad that when i was about 27 and had the script that i didnt take it. i had all the bloodwork i just didnt get the pills. the thing is my acne was very mild then too but after my derm trying all sorts of things she said 'i give up here is the accutane'. i didnt even ask for it so i think that is why i was so against it. so as far as the sun with me being on a low dose is it ok to go out for walks if i wear a high spf? i go for walks everyday at work in the spring/summer and i would hate to stop those. yeah i hear ya there with having to get the cortisone shots. i have spents years getting those as well as chemicals peels, ipls for the red marks and then i have tried microderm as well as recently i had 4 acleara acne treatments. all these things will clear my skin but it keeps coming back and i told the derm i cant afford to keep spending money on this stuff because its killing my bank account!!

thanks for the birth control info too. i think i will probably get the iud to be safe only because i worry so much!!

Edited by Karen Howz

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thanks so much prettywords!! yeah i am hoping with a low dose that the side effects wont be as bad. that is a good idea about taking the omegas. thanks for the tip! that is good to know about being able to use topicals while on accutane. i didnt know that either. now i wonder if i get a cyst if i can get it injected because mine dont go away otherwise and then they will leave a nasty red mark. ooh thats a good idea about calling now because my period is due this week so does that mean i will have to wait another month then after this period? i hate that ipledge thing but i guess they have to do it. i wonder for now if i can tell them my 2 methods of birth control are condoms and the sponge until i decide if i am going to get the iud. lol i was going to tell my derm that i fainted but then i am afraid they will want me to get checked out at the hospital or something. i think i will just say the spiro is making me way too dizzy or something like that.

Yeah, omegas are good for you. I use Nordic Naturals Omega. There are other good ones, but that's the one I use.

I have no idea if you can get a cyst injected on it. You'd have to ask them.

Your period is important regarding when you can start, so I'd call them asap and tell them when it's due, and that you want to get the ball rolling.

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thanks prettywords for the info on the brand of omegas you are using. i appreciate it! i called my derm earlier this morning and am waiting to hear back. hopefully she calls me back today.

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so the derm called me back and she said to make an appt for the accutane clinic they have there so i made an appointment for tomorrow at 2:30. i have to meet with another derm to ensure that the low dose accutane is ok and if so then they need to do the bloodwork and other stuff as well as figure out the birth control issue. i work in the oakland section of pittsburgh and there are a ton of doctors offices and hospitals near me that if i need to get an iud it wont be a problem getting in and getting that done. my only worry is that they told me i would be meeting with the derm i have seen there before who said i wasnt an accutane candidate so i am afraid she will say no and then i will be back to the beginning again. oh well i guess if its meant to be it will happen and if not then i will need to try something else.

Edited by Karen Howz

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Good luck. If she says no, just be persistent. Some md's will give it to you for milder but persistent acne, but some won't. You may need a different dr.

How bad is your acne?

In order for accutane to be a cure, you need to reach your cumulative dose, which would take a long time on a low dose.

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Good luck. If she says no, just be persistent. Some md's will give it to you for milder but persistent acne, but some won't. You may need a different dr.

How bad is your acne?

In order for accutane to be a cure, you need to reach your cumulative dose, which would take a long time on a low dose.

yes i plan on reminding her i have had it since i was 19 and that if it wasnt for me having chemical peels and ipl's done fairly often that my scarring would be much worse. the other derm had no problem with the low dose accutane due to the fact that i have tried everything else and nothing has worked. so we shall see i guess. my acne is strange in that one week my skin will be ok and then the next week i will get say 5-10 new zits. it seems when i got chemical peels, microderm, or the acleara acne treatments that my face will be nice and clear and then the acne comes back. my face already looks better from the bad breakout that i got over the weekend so i will just need to explain to this derm that even though my acne might not be severe it is persistent and when i get cysts they leave nasty red marks that can take years to go away. i cant deal with that and i cant afford to get ipl's anymore either. its costing me way too much to keep this up ya know? i do see another derm every so often and if i can get on birth control they seemed ok with giving me the low dose accutane so i guess i can try that if i have to. yeah i figured to reach my cumulative dose i would have to take it for at least a year which doesnt sound great but if it works then i think it will be worth it.

if you want to see a recent pic of my last breakout check out the adult acne forum under the heading red bumps on cheeks. i thought it was an allergic reaction but nope my derm said it was just acne. how nice?! ha ha

Edited by Karen Howz

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I wonder if you just need to exfoliate? You say it's good after exfoliation. You can get Dan's AHA or a face wash with glycolic. Do you use topicals at all?

I'll try to find your photo.

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I wonder if you just need to exfoliate? You say it's good after exfoliation. You can get Dan's AHA or a face wash with glycolic. Do you use topicals at all?

I'll try to find your photo.

i do use my clarisonic mia every single day so i would think that would exfoliate enough right? i have tried a face wash with glycolic as well as salicylic acid before and it made my face so dry and irritated that it broke it out even more. the laser place i go to had me switch from my olay regenerist face wash to glytone redness relief cleansing milk a while ago so i know its not the cleanser breaking me out. does dan's AHA have salicylic acid in it? i do find that my skin is ok with using mandelic acid so i can try using that every few days for a few minutes to help exfoliate more as well. what do you think or do you think the clarisonic is enough?

as far as topicals i use benzaclin and now as well as aczone but i find the aczone does nothing. i have tried probably every single topical out there its crazy how nothing works to keep me clear for even say a few weeks because even when my skin looks clear there are always under the skin bumps or something on it.

Edited by Karen Howz

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Ok, you may be exfoliating too much. A clarisonic can be harsh. A lot of people break out from them. I couldn't use mine, and I tried it while I was on AA's and totally clear -- no breakouts ever, and it broke me out. Plus on your other thread I mentioned it all may be too much. Personally, I don't recommend the clarisonic and I wouldn't use it again.

Between all the topicals and chemical peels and that laser, you're skin is probably irritated out the wazoo!

Dan's AHA doesn't use SA, AFAIK. I'm pretty sure it was glycolic. I don't like SA.

Edited by Prettywords

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yeah this week i decided to only use the clarisonic once a day now to wash off my makeup at night but i have used it since november and i was breaking out before that so i dont think it has too much to do with it. i do like how my skin feels after using it. i might buy the sensitive brush head though to make it more gentler on my skiin but the deep pore brush head does a good job at getting rid of my blackheads at least. yeah as far as the chemical peels i havent had one in a few months (and dont plan on doing another one anytime soon) and i was doing the laser treatments once a week for 3 weeks and then gave it a rest for 2 weeks and then did my last treatment a week and a half ago. i have completed those laser treatments so i wont get them anymore so we shall see how my skin is in a few weeks but for now i am going to try and get the accutane and if by the time i actually get the script it clears up then i wont take it. i pray that happens actually because i dont want to have to take it thats for sure! thanks again for all your help and that is good to know about dan's aha.

Edited by Karen Howz

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hey prettywords, so i just got back from the derm and she wont give me the accutane. she looked at my skin today which has mostly cleared up and then i showed her the pics that i took of my red bumpy skin over the weekend and she thought that i have more acne roscacea and that a low dose doxy and metro gel might really help that. i did mention about how i get a few cysts every month or so and she said for me to be a candidate of accutane that my acne would have to be mostly all cystic. she said she wouldnt feel right about putting me on it because i could end up with colitis or something else later on that it just wasnt worth the risks. she also said that she believes that most all acne in women over 25 is hormonal so that my acne would clear while on the accutane but that it would breakout as soon as i stopped taking it. so anyway i didnt fight the derm on it because i could tell she wasnt going to give it to me and because i felt that if i was meant to take it then i would get it. so i will try the low dose doxy and this metro gel as well as continue on not eating sugar and drinking caffeine as well as cutting back on my wheat consumption to see if that helps too.

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Yeah, she doesn't sound like she'll give it. I took it at 35 and it got rid of mine for 4 years, when I had an ovary removed, then my acne came back so it can work.

Is your skin still red like that? It looks like it was from the laser? I wonder if you even need metrogel? It would depend if you are like that often. At one point, they had me take metrogel. It did zilch. I didn't have rosacea, my skin was just over irritated from the harsh topicals they were throwing at me.The doxy should help either way.

I agree that it's probably hormonal. FYI: Caffeine helps my acne. It raises estrogen a bit which is good for high androgens, which causes acne. It also increases SHBG, which helps hormones. I figured this out after I noticed I get more hormonal acne when I'm not drinking coffee, so I wondered if it affects hormones.

One link on coffee and its effects on SHBG & it helping IR.

http://www.science20.com/news_articles/shbg_how_does_coffee_protect_against_diabetes

You could be allergic to wheat, so maybe that will help you. I'd still take omegas, because they can help acne. I'd also take a good probiotic since you're on antibiotics. You should ahve asked her for a hormone panel while you were there, since she said it was hormonal.

Edited by Prettywords

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I've been on Accutane MULTIPLE times and it works for about a year or two at a time then the acne creeps back... So, IMO it's not worth it - and my acne is persistent yet mild (like 1-2 cysts and scattered clogged pores all the time).

Currently I'm on Spiro for almost 2 years now and still have cystic acne. At first it made me breakout worse, then it cleared me up about as much as birth control did (80%) and now I'm back, active on the boards and trying another shot at the regimen + diet to really kick this acne to the curb.

Spiro can be good for hormonal acne (which is totally what I am also plagued with, btw) but it is by no means a god send. It doesn't make me totally clear, and now my cystic acne seems overall worse. I also suffer from depression and spaced out feelings - not sure if the spiro has been adding to that but I'm definitely wanting to wean myself off it, so that's my two cents. I'm 28 and after soooo long with all this stuff, I'm finally realizing I need to treat it like a lifestyle thing and Spiro is ok but it comes with side effects so you need to consider how you want to live your life when you're battling adult acne (ugh, I know!)

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