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Advice Needed On Accutane Or Taking Spiro Or Anything Else?

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Hi all,

I really need advice. I don't want to go into too long of a story but give you a breif history - have had acne ever since I was about 14. Nothing too severe but in my mid-late teens i started to develop the really painful under the skin type of cysts, mainly on the chin. When i was in my late teens-early twenties (i'm 25 now) i started to get acne on my cheeks as well.

I have been on various antibiotics, around 3-4 times (mostly in the tetracycline class of antibiotics), have used every topical under the sun (benzac, Retin-A, differin, zineryt, clindamycin, dr gross acne products, sulfur based products etc). I took diane-35 when i was 16, a derm suggested it to me, but i was losing hair rapidly on it (weird, i know, considering it has anti androgrenic properties), i gained about 20 pounds on it, and i had the most dreaded side effect - thrombosis. I would literally clutch my leg when i used to study in the library it was so bad). I was officially diagnosed with PCOS when i was around 18, the gyno told me to take another pill called belara- it was fine, skin looked good, not so bumpy and stuff but i started to gain weight as well and in my opinion that just goes against everything when it comes to pcos because i was trying hard to lose weight. Anyway, when i came off it my pcos symtptoms just got 1000000 times worse!

I left things alone for a few years just managing with topicals and natural internal remedies, but at this point i had gained a few pounds and was really struggling to lose weight no matter how hard i worked out and ate well (probs due to pcos) so i saw an endo who gave me glucophage(metformin). I've lost about 60 pounds and am at my lowest weight i have ever been. I have been taking metformin since 2011 and while it has regulated my cycles, my acne was actually the worse it ever has been when she ramped my dosage to 1500mg per day. I've since dropped back to 750mgXR and feel fine, everything is okay but the only symptom that really bothers me is the acne. I have a few red marks on my cheeks, and tiny acne scars but my acne is persistant and it is a constant thing in my life. I am very tired of trying to cover up my scars and acne, and feeling self conscious if friends sleep over, or if i have to face ppl first thing in the morning and generally just tired of dealing with this instead of focusing my energy on other things. It is the painful type of acne that when you smile or move your nose you can just feel this huge thing under your skin and it can stay around forever. I mostly break out around my chin and cheek areas and also in the side of my nose. As i write this i have one cyst on my nose(with TWO whiteheads starting to show through) and also 2 on my chin with 2 smaller pimples on my cheeks that will definately leave those nasty marks. It is very difficult for me, mentally and phsyically and i really need advice.

My endo gave me Spiro to try but i never gave it chance - i was in the bathroom like, all the time and something anbout spiro just didnt click in my head - does it actually work? I also have a lot of veg and fruits, green smoothies and the whole 'stay away from too much potassium' scared me. Also the thought of having to take it indefinately concerned me.

I have also tried 1 session of photodynamic therapy but it is so painful i never repeated a second session. I have also done microdermabrasion, chemical peels, and even attempted 2 laser resurfacing sessions (E-Matrix) which i feel sad over because my acne came back and i continued to mark.

I have been seeing a dermatologist for 1 and a half years, who is lovely and has never pushed me to do anything i didn't want to do. She is very honest about the side effects associated with accutane use. I know it is ssociated with dry skin etc, dry lips, but i have heard things about hair loss, joint pain etc. I am very active and the joint issues worry me. What about issues like constipation and dryness in female private areas? Sorry if that is too much to ask but can this occur? I have heard this on some forums. I also love my hair, it is the one thing i love about myself and am TERRIFIED of losing my hair because i think i would just cry my eyes out. Hair loss does run in our family. My hair is just something i am not willing to lose. I take saw palmetto and it lowered my DHEA levels (the 'acne' hormone) and also reduced the acne but not by much.

I do breakout a lot mid cycle (probs due to ovulation) and just before my period so i KNOW its hormonal but i dont know if Spiro will help. I just feel i am at the end of my battle with acne, and it is causing me to have really low self esteem and slight depression if i am honest. I actually cried today in the shower washing my face and having to feel the cyst on my chin and side of nose.

The question is - has anyone with hormonal issues had success with accutane? does the acne return? In my case do you feel it would be suitable to take accutane considering my underlying condition of pcos? or has anyone has success with sprio?

I am not sure where this should be posted - hormones or accutane, feel free to move around if it needs to be (moderators).

I really appreciate your advice in advance, thank you all.

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Try the Spiro! I had been considering Accutane again and opted for Spiro instead. Look at the reviews for Spiro on this site- they are very good compared to the other options. Also, I don't think there is an initial breakout associated with Spiro (not sure) and the effectiveness doesn't wear off with time like antibiotics do. I think it took about a month for me to notice anything, maybe a little longer. But it certainly never got worse while I was waiting for it to work.

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Hello !

Thanks for your reply. I am considering taking it. I only took it a few days then stopped because i didn't like the idea of taking another drug but now im considering going on either spiro or BCP's because my acne flares (cysts) get bad around the middle of the month and just at the end.

I know accutane treats the under the skin pimples but two doctors have told me that its not a 'cure' and only a potential cure and because i have an underlying condition, it might come back and there is no guranatee. But i've suffered with this for so long that it really is an option, i'm just scared of the side effects. Might sound crazy but i couldn't care less about the dry skin and stuff, i'm more scared of the damage to my internal organs and the potential of hair loss. Two friends took it, one cut hers really short after her course and the other said she experienced shedding only after finishing the course.

Have you experienced any side effects from Spiro ? What mg do you take? I was given 25mg from the endo but i think you need a higher dose to control the acne from what i have read at least 50mg - 75mg?

I would take the BCP's for purely aesthetic reasons and also because i know my hormones are causing the outbreaks. I have tried the natural route and still focus my diet and supplements on nurturing myself and keeping healthy. I just need clearing of my cysts so that i can focus on other things and not have this acne thing over my head all the time!

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Hi Lilly,

I just started the Spiro a week ago and I was going to immediately start the Accutane but wanted to at least try the Spiro first. I have mild to moderate acne flares but I am 34 and this has been going on since about 14 or so want it to be done with when I get the cysts its very expesnive I always need injections so I was ready to try anything else to shrink my oil glads. What I can tell you is even in the first week for me at 50mg I saw an oil reduction. However sadly I stopped the Spiro last night until further notice. I have been suffering the past 3 days with a brutal migraine. I have had one this bad in 2 years I'd say since starting Topamax which I'm still on. The only thing I can think of its the Spiro since its hormone based and I do sometimes get hormonal migraines :( Just something to think about if you get migraines.. But I certainly would not rule this out.. you can always try this first. Also Sprio from what I understand you must stay on this.. basicially when you stop the acne comes back..

As for Accutane - I have no taken that but may be in Feb since I don't think I can take this Spiro sadly. I have heard it drys you out and for a female. Yes that means everywhere! I heard sex may be a but uncomfortable you'll need to invest in some lube because you'll be dryer than normal but most of this is all supposed to be temporary just while your the accutane. I have a friend on it now I havent heard her complain but everyone is different. As for hair loss they say there could be some but is it rare and the people that do see it is only minor and not noticealbe to other and grows back.

You'll just have to decide what is best for you dear but I think but will prolly work fine. Spiro will take much longer I think to see end results. Just make sure if they put you on Accutane you get on the correct dose do your research, the high doses have more side effects.. Just get on the proper dose for your weight

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hi All,

Thank you for your replies I really appreciate it. I was supposed to see my derm this week, but sh cancelled so will see her on Sat. Like i said she's very against Accutane in terms of using it as a last resort. She says if you have hormonal issues to sort them out because after that your body sorts itself out. I was in my bathroom, looking at all the acne creams and all, half finished and i was like "For F**** SAKE! how long am i going to go on like this ?"

I may go on the contraceptive pill because i know it really helped me while i was on it. Should have just stayed on it. never had problems to be honest just slight weight gain here and there with a couple of brands (except when i took diane 35 when i was 16, all hair fell out and got thrombosis URGH) . I don't know if i will take accutane or go on the pill. Both seem like options. My endo used to say - Accutane may fix the acne, but it isn't going to sort out your hormonal problems, so it might cme back.

But honestly i need to make a decision, i need to sort this out. I am getting acne cysts on my chin which erupt and can get quite painful and stuff, even with concealer and powder they show.

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I haven't experienced any side effects from Spiro. However, I need to drink A LOT of water and pee much more often, but it's not a big deal considering it really helped my skin. I'm on 100 mg a day, which my derm said was moderate. I've taken Accutane as well and I would recommend that too. I didn't have any problem taking Accutane either besides dryness for the six months I was on it.

Really, both medications are great, but you're right- if it is hormonal then Accutane won't be a cure. If it were me then I would like to try and fix it hormonally first, because then you'll know for sure what the problem is. Just my two cents though!

Good luck with your decision!

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I was actually given the option of spironolactone or accutane from my derm in November. I first wanted accutane, then got scared and started spironolactone instead. I'm currently on 25mg a day along with the acne free three step system and my skin is ok now, definitely not clear but much more under control and in all honesty I think the acne free is doing more than the spironolactone. I've decided I'm going to do accutane though and will hopefully start the end of February. I've always been acne prone and have had to deal with mild breakouts for as long as I can remember. My acne didn't get bad until I first stopped taking birth control pills a year and a half ago.

I thought spironolactone would be good since I felt like my acne was definitely hormone related. But then i realized that if it was strictly my hormones the fact that I went back on birth control pills for ten months should have helped my skin and it didn't. Also, spironolactone only helps while your taking it and I don't want to be on a pill indefinitely.

I've decided accutane is the best option for me since I've had some form of acne for years and years now, I've just been lucky enough that its been mild most of my life.

So it's up to you with what you want to do, but accutane seems to be the closest thing to a cure. It's a very personal decision though so definitely think it through to figure out what's best for you.

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