1. When I was considering spiro I researched it a lot and don't remember seeing liver damage as a possible side effect (that is more the case with accutane). You will have blood work done but they are checking things like your potassium. You will have to reduce your potassium intake while on the drug. If you already have pretty low blood pressure than that could be another issue as the drug was originally prescribed to treat high blood pressure. You will need to go back on birth control because this drug blocks your androgen hormone receptors (male hormones) so if you were to get pregnant with a boy, he would not develop properly. Also you could potentially have very irregular periods since you are messing with your hormones.

2. I'm not in the UK but I believe the only way you can get prescribed Spiro is through a dermatologist.

3. There is a hormone test you can take but I have heard that it is very inconsistent as your hormones are continually fluctuating throughout the day. But, if you do take the test I believe doing so first thing in the morning is when you will get your best results.

Again I'm not in the UK not have I taken spiro but I did research it pretty heavily when I was deciding between it and accutane.

Hope this helps.

Have you asked to be tested for PCOS? I have similar symptoms to you which I thought pointed to PCOS, so I asked my dr and they sent me for a scan. Mine came back negative, but it's worth getting it checked out.

Just thinking if that is what's causing your problems then they could give you appropriate treatment for PCOS rather than just trying to treat your skin. Symptoms of PCOS can be helped by diet changes, there's lots of info online if you haven't given that a go yet it might be worth a try.

If you want your hormone levels tested your doctor should be able to arrange that for you. I had mine done, but when I asked to be referred to an endocrinologist because I thought addressing the underlying hormonal issues was better than treating acne symptoms I was told no, but they did eventually refer me to a dermatologist instead who wants me to start roaccutane.

Hello, looking for some advice.

I am 23, and was recently prescribed Dianette for hormonal adult acne. After almost two months of taking Dianette, a blood test showed it had already damaged my liver (raised ALT levels). My doctor immediately took me off of Dianette.

The doctor said I would have to use an antibiotic treatment instead. As I believe my acne to be hormonal (I have excessive facial hair that I have to shave off, which appears to be getting steadily worse, extremely oily skin, jaw line acne. My mother had PCOS and believes I'm suffering from the same thing.) antibiotics will not help me long term, or with my skin's extreme oil production (?). I have been given Zineryt, which I have to apply to my face twice a day, and was told that once my liver recovers I might be able to try another birth control pill.

Having read about it online, I asked the doctor about spironolactone. He had never heard of it being used for acne. He looked it up in the BNF and said it is not licensed for acne treatment. Dismissed it entirely. Wouldn't I be better off trying spiro than another birth control pill?

My questions are:

1. Is spironolactone likely to damage my liver in the same way Dianette did? If not, isn't that a good case for me to try it as an alternative?

2. Who might I approach (and how?) about being prescribed spiro in the UK? I'm desperate for help and willing to consider private healthcare.

3. Are there any tests I could have done to show conclusively that my skin problems are hormonal? How long would I have to wait after ceasing Dianette before having a hormone test done?

Thank you in advance for any suggestions.

 

Spironolactone is usually the first treatment for PCOS, at least in the U.S.

Spiro is not in the book as an acne treatment but it is prescribed quite often in the states off-label for hormonal acne. You could show your doctor this document: http://acne.about.co...d_Skin_Care.htm Which explains how spiro is used for hormonal acne. It's reviewed by the U.S. Health Board and cites a few medical journals to boot.

Spiro is not going to raise your ATL levels/damage your liver.

You do have to watch your potassium levels because spironolactone is potassium-sparing. My derm recommends testing your potassium every 3 months for the first year. If there are no issues that first year, then you need to be tested again unless you up your dose. It is VERY rare for anyone to have a serious problem on spiro. Less than 1% of patients retain too much potassium while on it. Just don't eat bananas all day long and you'll be fine.

You can do an androgens test. The androgens in particular you want to look at are testosterone and dihydrotesterone (DHT). Remember, though, that this is NOT conclusive. Some women have a genetic sensitivity to their own normal levels of testosterone and break out, even though on the charts their hormone levels are fine.

Some people have more success with ob-gyns and endocrinologists who actually study hormonal issues. Many dermatologists are quite ignorant when it comes to the connection between hormones and the skin. If your derm is really ignorant, they may not know that the reason Yaz/Yasmin is prescribed for acne is because it contains spironolactone (equivalent to a 25mg dose).

Something that has worked for me is to call the office and ask if they have treated hormonal acne with spironolactone before, and if not, if they would be open to that treatment. This lets you know if they're going to help you BEFORE you pay for an appointment. If they seem iffy about it, move right along to the next doctor.

I asked myGP for Spiro and I like in the UK and it was a no go im afraid, As you mentioned its not liscensed boo and if you ask your derm they will tell you the same thing as there are other alternatives that are liscensed and it seems the only thing you may be able to go on is an Antibiotic, they do work the same as a BCP but the effect can stop working and the spots return which I did find. You will never be allowed to go on Accutane if your liver didnt respond well to Dianette.

So sorry to hear that I hope you find an alternative or I hope they give you Spiro cause its actually used to treat liver disease such as cirrohsis etc. If you get it please message me I so want to try it xx

Is dianette the bcp with spiro or is it the other anti androgen in it?

Anyway, I've heard of people having liver problems from spiro but it's not a common side effect.

Is dianette the bcp with spiro or is it the other anti androgen in it?

Anyway, I've heard of people having liver problems from spiro but it's not a common side effect.

 

Dianette has cyproterone acetate, which has a much higher risk of causing liver damage.

is it possible to continue to take things such as dianette but also pay extra attention to your live to prevent damage? As mentioned elsewhere I've been on diane35 for 2 years now but bcp for around 5 or so ..I had my liver tested the other week and it 'came back normal'.. although for 2009+2010 I was drinking quite heavily and feel like I damaged my liver then (ironically the same year my acne came from no where). Are there ways to really really look after your liver? to the point of reversing any damage? ...even damage that doesnt show up on 'normal liver tests'?