[[TW: for discussion of disordered eating and depression/anxiety]]
This is a saga of pain and confusion that needs telling. If only because, I know I am not the only one.
When I was fourteen, I began to get a few more than the occasional teenage pimple. Of course, what with American beauty standards for women being what they are, this made me feel insecure and inferior, and intensified my introversion and shyness from other peers. After countless failed topicals and antibiotics, a dermatologist prescribed me Yaz: a hormonal birth control. Yaz cleared my skin so slowly and surreptitiously that I hardly noticed it. I can still recall a moment, years later, when a friend remarked to me "But you're lucky - you have such clear skin!" and the sense of shock I felt, rippling all through my body, and going home to stare in the mirror; it was clear, but I'd had oily acnegenic skin for as long as I could remember, and I'd learned to simply avoid mirrors, to avoid the pain of starting down a face that I never wanted to claim as my own.
But Yaz, I suspect now in retrospect, had other, more insidious side effects than clearing my skin and preventing me from impregnation from all the sex I wasn't having. Around the same age, I developed depression for the first time in my life, and began a six year embroilment with therapists, psychiatrists, pills and hospitals that nearly took my life on more than one occasion. The depression was soon kept company by panic attacks that smoothed out into a generalised anxiety disorder, with an eating disorder to match. I was looking in good shape! But at least I had clear skin. This continued, more or less unabated, until age 19.
I find myself in college, in a committed relationship and surrounded by friends, but once again suicidally depressed. At this point I am on at least five different psychotropic drugs to both mask and alleviate my psychotic symptoms. I am still on Yaz, or at least, it's generic twin. Over the course of three months, my pharmacy in collusion with my insurance company switched me without my knowledge or consent to Gianvi and then Loryna. During that last month on Loryna, I became suicidally and absolutely depressed. I was afraid of everything and could barely leave my bed. My partner, already bearing the brunt of a prolonged compassion fatigue, coaxed me into therapy and off all of the medications, including Loryna, one by one. Detox was brutal. One evening, we considered going to the E.R. because my tremors and shakes were starting to look suspiciously like a seizure, and I was getting the strangest zaps richocheting around my brain. It was a hundred times the flu. I suspect that particular incident was caused by Lexapro, an anti-depressant. But by my 20th birthday, I was off all the drugs, and feeling more normal than I had for practically my entire adolescence. I felt in control. I felt happy. But I also had acne.
The acne arrived slowly and steadily, giving me time to relinquish the firm grip on my fleeting happiness and recoil back into a terrible shame and isolation. It is remarkable to me even now, the ironic depths of my shallowness and superficiality. I became obsessed. No longer bed ridden with depression, I instead stayed home from parties and social events with a blossoming sense of embarrassment and shame. I became neurotically intent on curing my skin. I moved from product to product, topicals like Proactiv, Carley's, and benzoyl peroxide and natural remedies like tea tree oil, honey and lemon masks and sugar free diets. Nothing made any difference, and my skin got progressively worse along with my self confidence for the next year. I started wearing make up, and progressed to the point where I absolutely could not leave the house without it. I cannot even let my parents see me without foundation on. The most horrible part about the psychological damages of acne is the overwhelming sense of shame I feel for my feelings of shame. I know my appearance ought not have an ounce of the importance I imbue it with. And still.
As my skin gets worse and my neuroticisms find a new target in the world of the Internet's various forums, how-to guides and shady advice for acne sufferers, I begin to realise my period isn't coming back. It disappeared with the hormonal birth control and neglected to make another appearance. Additionally, around this same time, I become vegan for ethical reasons and begin cutting out all but the most basic fruits and vegetables from my diet. I lose weight, dropping about 15 pounds over the course of the next year, less from the previous kind of disordered eating I'd been afflicted with and more with a paralyzing fear that anything I ate that wasn't "pure" would come right back out my pores. I developed particular food phobias to things like wheat, and demand a food allergy test from my doctor, which obviously does little to ameliorate my fears. It might have even qualified as fully fledged orthorexia nervosa. So as my food obsession supplemented my skin obsession, I found a diagnosis (or two) that could unite all my symptoms: underweight, high stress, a theorised glucose resistance, secondary amennorhea and acne: PCOS and HA.
Poly-cystic Ovary Syndrome. I become absolutely convinced that this is what is wrong with me and schedule to see a gynecologist immediately. We run blood work, and she finds that my androgens are slightly elevated. Eureka! I think, with all my Internet knowledge. Now she can just give me Spironolactone and this will all finally be a bad dream. Not so much. The doctor doesn't buy my underweight BMI and tries to convince me that this is a hypothalamic issue: Hypothalamic Amennorhea, to be specific. I do not believe her. My years of disordered eating have absolutely distorted my sense of normal body size. I am adamant that my weight is not the issue, that instead, my hormones are. She tells me to gain 15 pounds and sends me on my way.
Obviously, for a person in my highly advanced state of distress and obsession over superficial qualities like skin and weight, gaining 15 pounds is about as likely as winning the Tour de France. I vacillate: should I just go back on the Pill and pretend this never happened?
I started taking Loryna again three days ago. I am terrified that I am going to lose my mind again. The trouble is that I'm already losing my mind from the crippling phobia, stress and pressure I'm putting on myself about my skin. You'd think I'd killed someone, for how guilty I feel all the time about this. I'm absolutely ashamed of myself. And I can't talk to anyone about it in more than just a passed explanation, "My hormones are messed up." So I leave my story here, where I have lurked without participating for a long time, in the hope that at least one other person can know that they are not alone in this hellish struggle for the proper balance between self-esteem, survival, and long-term health.
I suspect this could mostly be solved by
1) Staying off the Loryna
and
2) Getting a prescription for spironolactone solely for acne.
You don't have to go in with a sob story and claim that you have PCOS and HA. If you try to diagnose yourself, they won't take you seriously. If you go tell them anywhere near the amount of information you shared in this essay, they will be very wary of prescribing you anything lest they get sued.
You can get spiro just for acne. My derm didn't even test my levels or have any bloodwork done. I walked in and a half hour later I had a script for spiro. I had a friend who got clear on spiro. All I said was, "I have had chronic acne for years, I've tried antibiotics and topicals, I don't want to go on birth control or Accutane. I have a friend who got clear on spiro and I want to try that." There was never any mention of PCOS or testing. 8 months later I was completely clear.
All you have to do is research some derms, find one who has prescribed spiro before, and then go in and say, I've heard a lot of success stories with hormonal acne and spiro. If you must talk about your past history, you can merely say that you've tried birth control and didn't like the side effects.
I think you'll get a lot farther with that approach. You do have options besides going back on Loryna, which I wouldn't recommend since it may have caused your depression.
And I would be very matter of factual anytime you see a doctor. Your style of writing shows you place a lot of emphasis on feeling and emotion, which scares most doctors shitless. Non-psychiatrists don't want to deal with emotion. Direct and to the point is the only way you'll earn their respect. Even I felt a little uncomfortable reading your post, felt like I was reading someone's journal if you know what I mean...
Hey cats cradle,
whilst your story might seem complicated to an outsider, I've gone through a lot of simliar things u've mentioned. birth control -> ssri's -> off ssri's/bc -> acne gets worse -> obsession with raw natural foods -> still acne gets worse. I am also blessed with some ezcema which was been worse than I remember having as a kid. Anyway the commenter above seemed to have made a great recommendation and I would also recommend that you might be deficient in something contributing to your acne. I started taking probiotics and magnesium and they have helped tremendously. FIrst of all, when you are stressed a lot, it can mess with your stomach bacteria and digestive system, which I'm sure you're aware of, which has for me definitely exacerbated acne. Magnesium is something that many people, particularly with anxiety and hormonal imbalances, are deficient in, and it honestly changed the way I felt completely and is starting to change my skin already (I only started a few days ago). Hope that helps and let us know what's going on....also you could try green smoothies to gain a little bit of way but in a very healthy way.
weight*
There are several things that I'd like to say.
1. This dermatologist is not entirely wrong in dismissing your concerns. I'm not saying that you don't have PCOS, I don't know, I haven't seen your test results and I'm certainly not claiming to be a doctor. BUT think about it this way: you are a young woman, underweight, clearly troubled by many things, you go into that office and say 'I think I have PCOS'. What kind of impression does that give? That you've diagnosed yourself before the doctor. Doctors do not like working with patients like that, trust me on that one. It's like saying I know what's wrong with me, just give me XYZ medicine, totally defeating the purpose of a doctor's visit.
Now put yourself in the place of that dermatologist - she's been through medical school and she's probably seen lots of patients before you with similar problems. She takes an objective view and doesn't jump to conclusions. Tests are one thing, interpreting them is another. If anyone could diagnose themselves just by looking at test results, what do you think the purpose of the entire medical profession is? When doctors try and diagnose someone, they do tests and they look at the symptoms. First of all, you do not fit the stereotypical bill of someone with PCOS. The vast majority of women with PCOS are overweight. The vast majority are also suffer from hirsutism - now pardon me if this is too personal - also have high cholesterol levels and excessive levels of androgens, not slightly elevated.
Now, we have you, who is not overweight but underweight, has amenorrhea and has slightly elevated levels of androgens. That's not indicative of PCOS off the bat. There are plenty of women like you who do not have PCOS.
There is no reason why you couldn't take Spironolactone, unless maybe you have other medical problems you have not told the doctor about. However, please do as she says and gain some weight. Being underweight almost always causes amenorrhea, as it did to me. If you can't eat, you need to work on your issues with food. And this leads to my second point:
2. You need to see a good psychiatrist. You obviously have a lot of problems that you will need professional help to get over. Please don't think you have to do without medication, because that doesn't make you a hero, it makes you an idiot. Obviously you have taken ones before that did not work - this happens fairly often and sometimes it takes several tries before you get the right combination. And please, for goodness' sake, don't let others talk you into quitting psychiatric meds cold turkey. That is SO not a good idea. It will cause more anguish and pain than gain. If you indeed have as much insight into your condition as you seem to have, than you must understand that sometimes, we need medicinal help to get over our mental issues and move on.
While I understand that you are obsessed by your appearance to the point where it's not 'vanity' but some kind of disorder, you need to relax as hard as that is. No one is as critical of your appearance as you are. When people see you, they probably think you look fine and may even be worried about how skinny you are. When you are obsessed by weight you gain a distorted view of what is 'normal' - work to gain back your old view of 'normal'. If it takes that you have no mirrors in your house, then do that. If it takes that you stop looking at magazines, then stop looking at magazines, hell, even stop reading the newspaper. Throw out your scales. My point is, whatever distracts you from worrying about your appearance, do it - unless it's something like self harm.
3. If you don't like your doctor, just switch. If you really feel like they're being dismissive and not rightfully. Don't let them tell you that you have too much insight, at the same time, don't force your views on them of your condition.
4. Don't keep taking any meds that you think are making you feel worse. Talk to your dermatologist or psychiatrist and make it known that you don't think the meds are helping.
5. If you really think you have a hormonal issue that goes beyond acne, you need to see an endocrinologist, who specialize in this. The dermatologist won't be much help on amenorrhea and such. They're skin doctors not hormone doctors. But I can tell you now that the endocrinologist will also tell you to gain weight as a lot of hormonal problems stem from either being overweight or underweight. Make it known to the dermatologist that your only concern is acne and you don't expect her to help you with anything else. Only give as much info as necessary. At the end of the day, both an endocrinologist and a dermatologist can prescribe you Spironolactone.
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Nope. Not ever, really. I definitely never had cystic acne. As a teen, I'd get a random little pimple here and there. Nothing that would classify as "acne." Not even during puberty. I did have other skin/health/autoimmune problems such as hives and severe allergic reactions to things. But my face was very nice.
Then I got on the BC pill somewhere around age 19 or 20. Within a very short time, I began getting bad cystic acne. It's the same cystic acne that I have today: Always at least two BIG cysts on my face at any given time. Always two. As soon as one of the two begins healing and scabbing up, another two are cropping up deep under the skin. I don't understand what this is.
Another thing that I never had when I was younger was severe menstrual cramps. That started after the BC pills too, and never went away despite the fact that I've been off the pill for almost ten years now. 
I just don't understand why the pill did this to me when it seems to relieve these issues in anyone else!
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Nope. Not ever, really. I definitely never had cystic acne. As a teen, I'd get a random little pimple here and there. Nothing that would classify as "acne." Not even during puberty. I did have other skin/health/autoimmune problems such as hives and severe allergic reactions to things. But my face was very nice.
Then I got on the BC pill somewhere around age 19 or 20. Within a very short time, I began getting bad cystic acne. It's the same cystic acne that I have today: Always at least two BIG cysts on my face at any given time. Always two. As soon as one of the two begins healing and scabbing up, another two are cropping up deep under the skin. I don't understand what this is.
Another thing that I never had when I was younger was severe menstrual cramps. That started after the BC pills too, and never went away despite the fact that I've been off the pill for almost ten years now.
I just don't understand why the pill did this to me when it seems to relieve these issues in anyone else!
I deeply sympathise. I can imagine that decision to take birth control must haunt you. Has any Dermatologist been able to help you at all? or perhaps an Endocrinologist? It seems really unfair that you should have to suffer this way. There must be a way to balance your hormones or at least something that might be able to help your skin - i'm sure though you've probably already looked into this so apologies if i sound like a fool lol! I just know the suffering of acne, and skin. It's very painful both physically and emotionally and draining on a day-to-day basis.
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Nope. Not ever, really. I definitely never had cystic acne. As a teen, I'd get a random little pimple here and there. Nothing that would classify as "acne." Not even during puberty. I did have other skin/health/autoimmune problems such as hives and severe allergic reactions to things. But my face was very nice.
Then I got on the BC pill somewhere around age 19 or 20. Within a very short time, I began getting bad cystic acne. It's the same cystic acne that I have today: Always at least two BIG cysts on my face at any given time. Always two. As soon as one of the two begins healing and scabbing up, another two are cropping up deep under the skin. I don't understand what this is.
Another thing that I never had when I was younger was severe menstrual cramps. That started after the BC pills too, and never went away despite the fact that I've been off the pill for almost ten years now.
I just don't understand why the pill did this to me when it seems to relieve these issues in anyone else!
I deeply sympathise. I can imagine that decision to take birth control must haunt you. Has any Dermatologist been able to help you at all? or perhaps an Endocrinologist? It seems really unfair that you should have to suffer this way. There must be a way to balance your hormones or at least something that might be able to help your skin - i'm sure though you've probably already looked into this so apologies if i sound like a fool lol! I just know the suffering of acne, and skin. It's very painful both physically and emotionally and draining on a day-to-day basis.
Dermatologists never helped. Or rather, they prescribed expensive creams (Retin-A used to cost me over $100 for a tiny tube that lasted a week or two) that brought about minimal improvement and did nothing to stop the actual breakouts.
I don't have health insurance so I was never able to see a specialist about any of my problems. It kills me that there could be some random thing causing all of this and it could possibly be treated, but I'll never know because I'm an American and my government doesn't care if I haven't had access to a doctor for years.
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Nope. Not ever, really. I definitely never had cystic acne. As a teen, I'd get a random little pimple here and there. Nothing that would classify as "acne." Not even during puberty. I did have other skin/health/autoimmune problems such as hives and severe allergic reactions to things. But my face was very nice.
Then I got on the BC pill somewhere around age 19 or 20. Within a very short time, I began getting bad cystic acne. It's the same cystic acne that I have today: Always at least two BIG cysts on my face at any given time. Always two. As soon as one of the two begins healing and scabbing up, another two are cropping up deep under the skin. I don't understand what this is.
Another thing that I never had when I was younger was severe menstrual cramps. That started after the BC pills too, and never went away despite the fact that I've been off the pill for almost ten years now.
I just don't understand why the pill did this to me when it seems to relieve these issues in anyone else!
I deeply sympathise. I can imagine that decision to take birth control must haunt you. Has any Dermatologist been able to help you at all? or perhaps an Endocrinologist? It seems really unfair that you should have to suffer this way. There must be a way to balance your hormones or at least something that might be able to help your skin - i'm sure though you've probably already looked into this so apologies if i sound like a fool lol! I just know the suffering of acne, and skin. It's very painful both physically and emotionally and draining on a day-to-day basis.
Dermatologists never helped. Or rather, they prescribed expensive creams (Retin-A used to cost me over $100 for a tiny tube that lasted a week or two) that brought about minimal improvement and did nothing to stop the actual breakouts.
I don't have health insurance so I was never able to see a specialist about any of my problems. It kills me that there could be some random thing causing all of this and it could possibly be treated, but I'll never know because I'm an American and my government doesn't care if I haven't had access to a doctor for years.
That's not fair at all. I forget about the insurance policy in US. I thought they were planning to bring in an NHS like we have. I wish I could offer you some advice or help but all i can offer is my understanding. I think acne wouldn't be so bad if it didn't leave it's marks, scars all the time. My face has been literally transformed/contorted through cystic acne. It's brutal.
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
Did you ever suffer with acne before taking birth control? x
Nope. Not ever, really. I definitely never had cystic acne. As a teen, I'd get a random little pimple here and there. Nothing that would classify as "acne." Not even during puberty. I did have other skin/health/autoimmune problems such as hives and severe allergic reactions to things. But my face was very nice.
Then I got on the BC pill somewhere around age 19 or 20. Within a very short time, I began getting bad cystic acne. It's the same cystic acne that I have today: Always at least two BIG cysts on my face at any given time. Always two. As soon as one of the two begins healing and scabbing up, another two are cropping up deep under the skin. I don't understand what this is.
Another thing that I never had when I was younger was severe menstrual cramps. That started after the BC pills too, and never went away despite the fact that I've been off the pill for almost ten years now.
I just don't understand why the pill did this to me when it seems to relieve these issues in anyone else!
I deeply sympathise. I can imagine that decision to take birth control must haunt you. Has any Dermatologist been able to help you at all? or perhaps an Endocrinologist? It seems really unfair that you should have to suffer this way. There must be a way to balance your hormones or at least something that might be able to help your skin - i'm sure though you've probably already looked into this so apologies if i sound like a fool lol! I just know the suffering of acne, and skin. It's very painful both physically and emotionally and draining on a day-to-day basis.
Dermatologists never helped. Or rather, they prescribed expensive creams (Retin-A used to cost me over $100 for a tiny tube that lasted a week or two) that brought about minimal improvement and did nothing to stop the actual breakouts.
I don't have health insurance so I was never able to see a specialist about any of my problems. It kills me that there could be some random thing causing all of this and it could possibly be treated, but I'll never know because I'm an American and my government doesn't care if I haven't had access to a doctor for years.
That's not fair at all. I forget about the insurance policy in US. I thought they were planning to bring in an NHS like we have. I wish I could offer you some advice or help but all i can offer is my understanding. I think acne wouldn't be so bad if it didn't leave it's marks, scars all the time. My face has been literally transformed/contorted through cystic acne. It's brutal.
Hopefully Obama is going to do something about it this term. It's kind of an "I'll believe it when I see it" sort of thing for me. But supposedly, in 2014, the poor will receive medicaid and everyone else is going to have to buy their own insurance plan. I definitely qualify as "poor" so this should help me--if it goes through as planned. However, I'm not sure what exactly will be covered. I assume you'll be able to get basic medical care, but I don't know if it will cover comprehensive blood work and specialists and everything. Hopefully! I'm going to take advantage of whatever is offered, that's for sure.
I suspect this could mostly be solved by
1) Staying off the Loryna
and
2) Getting a prescription for spironolactone solely for acne.
You don't have to go in with a sob story and claim that you have PCOS and HA. If you try to diagnose yourself, they won't take you seriously. If you go tell them anywhere near the amount of information you shared in this essay, they will be very wary of prescribing you anything lest they get sued.
You can get spiro just for acne. My derm didn't even test my levels or have any bloodwork done. I walked in and a half hour later I had a script for spiro. I had a friend who got clear on spiro. All I said was, "I have had chronic acne for years, I've tried antibiotics and topicals, I don't want to go on birth control or Accutane. I have a friend who got clear on spiro and I want to try that." There was never any mention of PCOS or testing. 8 months later I was completely clear.
All you have to do is research some derms, find one who has prescribed spiro before, and then go in and say, I've heard a lot of success stories with hormonal acne and spiro. If you must talk about your past history, you can merely say that you've tried birth control and didn't like the side effects.
I think you'll get a lot farther with that approach. You do have options besides going back on Loryna, which I wouldn't recommend since it may have caused your depression.
And I would be very matter of factual anytime you see a doctor. Your style of writing shows you place a lot of emphasis on feeling and emotion, which scares most doctors shitless. Non-psychiatrists don't want to deal with emotion. Direct and to the point is the only way you'll earn their respect. Even I felt a little uncomfortable reading your post, felt like I was reading someone's journal if you know what I mean...
Yeah, since I have such a high level emotional investment in this, I keep ending up crying in my doctor's offices. It's definitely freaking them out. It's disturbing to me though that they do NOT want to hear the whole story; a more integrative way of healing that actually acknowledged all the facts would seem to me a lot more effective! But naturopaths don't have insurance coverage. At least mine doesn't.
I have asked four doctors for spiro now, and they have all refused, and have actually told me that they would only give me spiro if I was on BC because it can cause such terrible birth defects.
It's a difficult path, negotiating and solving all of this.
Your story could be my story. I also developed orthorexia on my quest to cure my acne, and here I sit, totally broken out, miserable... the only difference in my story is that my severe acne began after taking birth control pills, not the opposite.
what birth control were you taking, if you don't mind my asking? i've been reading a lot about the different kinds of progestins that are used and they are all really different; some can be androgenic and some aren't.
Spironolactone can possibly cause problems...but only when you are well into pregnancy. It is a Class C drug, meaning it may or may not be safe during pregnancy. The only proven risks are sometimes it causes placenta issues when you're around 5-6 months pregnant. That's pretty far along, so of course you would know you were pregnant before then and could stop the spiro.
There was also a study that shows it is safe to take while breastfeeding, so it's not nearly as serious as many other drugs. Main point being it is not a "terrible birth defect" drug like Accutane. Not even close.
I'm sorry that doctors have refused you spiro. That's why you do need to research the doctors beforehand Call them up, talk to the nurse, do whatever you can. Don't just blindly go in and waste your money paying them to tell you no. Find out if they've prescribed spiro for acne before you pay for an appointment. Yes, I know it's hard...gosh I hadn't even heard of the drug until a few years ago. It's not very fun dealing with the offices either. I remember when I was trying to find doctors that would prescribe me what I wanted, and I had to go through spades of bitchy staff people who just wanted me to schedule an appointment already. But if you keep at it, you can eventually talk to someone who will answer your questions.
For how effective spiro is, you'd think derms would be prescribing it left and right. But then again remember any docs you see are about ten years behind the curve unless they're fresh out of med school, and the brand-new docs might know the new treatments but they have their own set of problems
Anyway, you absolutely do not need to be on birth control pills while on spiro. It isn't Accutane. Using condoms consistently is enough protection. My derm didn't even mention birth control while on it. I'm sure similar derms out there exist, you may have to drive a few hours to see one, but they're there. Spiro is very mild. You just need to get a doctor who understands that.
I agree with GreenGables, you should definitely look into Spiro and also try to hold back on the emotion when talking to doctors. They're with you to help heal your acne, not heal the emotional scars that comes with it. Telling them too much will possibly confuse them, trip them up, or just plain freak them out. Giving them a simple summary of your acne story will most likely lead you to the right treatment.
Now when I talk to derms, I avoid the emotional stuff altogether. Pretty much just tell them you think your acne is hormonal and you'd like to try Spiro.
Spironolactone can possibly cause problems...but only when you are well into pregnancy. It is a Class C drug, meaning it may or may not be safe during pregnancy. The only proven risks are sometimes it causes placenta issues when you're around 5-6 months pregnant. That's pretty far along, so of course you would know you were pregnant before then and could stop the spiro.
There was also a study that shows it is safe to take while breastfeeding, so it's not nearly as serious as many other drugs. Main point being it is not a "terrible birth defect" drug like Accutane. Not even close.
I'm sorry that doctors have refused you spiro. That's why you do need to research the doctors beforehand
For how effective spiro is, you'd think derms would be prescribing it left and right. But then again remember any docs you see are about ten years behind the curve unless they're fresh out of med school, and the brand-new docs might know the new treatments but they have their own set of problems
Anyway, you absolutely do not need to be on birth control pills while on spiro. It isn't Accutane. Using condoms consistently is enough protection. My derm didn't even mention birth control while on it. I'm sure similar derms out there exist, you may have to drive a few hours to see one, but they're there. Spiro is very mild. You just need to get a doctor who understands that.
You are the first person I've heard say that Spiro is mild! I've only heard horror stories so far about six month skin purges and horrible allergic reactions...have you taken it?
I can't remember what birth control I was taking in the beginning, but I took 3-4 different ones over the course of a year or two, trying to find one that wouldn't break me out or make me feel sick. Pretty much all of them did. The best one that I took the longest made me break out with only mild nausea. All the other ones caused terrible nausea to the point where I couldn't work because I'd be throwing up all day.
I don't remember the names, but they all were different ones that advertised that they cleared skin. BULLSHIT.
It probably isn't the pills. I know they've helped so many other people. I'm one of the only people I've ever heard of that has these intense horrible reactions to them and whose acne gets worse.
I'll never understand it.