Hey guys, so I've had mild acne since I was like 14 and I went on accutane when I was 16 for mild but persistent acne. The accutane cleared me up like a charm no initial breakout, but I'm 18 now and breakjng out again. It is not on my jawline really at all and the majority of it is on my forehead and inner cheeks (as in around my nose). I also get pimples on my chin and nose. I attribute this new breakout to oil coming back after accutane, but a lot of them are pustules and red pimples that do not come to a head. I do tend to flare quite dramatically around my period, but I do not have cysts. My dermatologist put me on spiro and retin-a (again) because I'm an adult now and acne around this age is usually hormonal. My periods are always extremely regular and I don't have any real reason to think I have hormonal issues aside from an acne flare on my period. I have read online that if your acne is not hormonal this drug will break you out even worse and not help. I asked her if I would have any sort of initial breakout and she said no but it takes a while to work. Should I take this drug?
photo attached is acne on period next to acne on a good day usually 2 weeks after period.
Hey guys, so I've had mild acne since I was like 14 and I went on accutane when I was 16 for mild but persistent acne. The accutane cleared me up like a charm no initial breakout, but I'm 18 now and breakjng out again. It is not on my jawline really at all and the majority of it is on my forehead and inner cheeks (as in around my nose). I also get pimples on my chin and nose. I attribute this new breakout to oil coming back after accutane, but a lot of them are pustules and red pimples that do not come to a head. I do tend to flare quite dramatically around my period, but I do not have cysts. My dermatologist put me on spiro and retin-a (again) because I'm an adult now and acne around this age is usually hormonal. My periods are always extremely regular and I don't have any real reason to think I have hormonal issues aside from an acne flare on my period. I have read online that if your acne is not hormonal this drug will break you out even worse and not help. I asked her if I would have any sort of initial breakout and she said no but it takes a while to work. Should I take this drug?
photo attached is acne on period next to acne on a good day usually 2 weeks after period.
Hey fruit loops.
Your story sounds a bit like mine. I did Accutane and it cleared me up nicely. I've never been oily though. 4 months after stopping my Accutane course, acne started to appear again. I started spiro and haven't looked back. I've been taking it for 14 months or so and I didn't have an initial breakout. I never figured that I had any hormonal issues either. My period was always on time also. I never explored hormonal treatments because my derm didn't think my acne was hormonal. After taking the Accutane and it failing me so soon after stopping the drug, I decided it was time to tackle it from a different route. I then talked to my OBGYN and she thought my acne was indeed hormonal. She started me on spiro and I've been clear ever since. So I think that your body doesn't have to be displaying hormonal issues, in order for your acne to be hormonal.
It can take awhile to work for ladies. Some even up to 6 to 8 months before real good results are seen. For me it was right away, I think that was because I was just on Accutane 4 months earlier and my skin hadn't had a chance to get real bad again. I say give it a go, it's a safe medication for most. No real side effects like Accutane. I have no side effects from the medication at all. If for some reason you do change your mind about taking it, spiro has a life of under 24 hours before it's completely out of your system. So that's a plus!
I have had spots since the age of 15, but 10 years on, I found my skin had become so much worse than it ever had been before. It all got too much this year, when I regularly ended up in tears whilst putting on my make up in the morning - as it was so painful to touch my face, and it just looked so angry and inflamed. I'd constantly be back and forth to the bathroom at work, just to make sure my spots weren't on display - and to also apply pressed-powder to get rid of the constant shine I had, from having such oily skin. I put it down to a stressful job, lack of sleep, a busy lifestyle in London, and not being happy with my life - and that perhaps one day it would get better. I just didn't know what to do...
For years, GP's told me that I would 'grow out of it', and that 'it was my age'. They prescribed me all sorts of creams, and antibiotics, but nothing ever worked. 2 months ago, I was so fed up that I decided to go private. I had an initial appointment with a dermatologist, who said that he could put me on Roaccutane, but he felt that it was more deep-rooted than just being skin deep. He then referred me to an endocrinologist (hormone specialist) - as he suspected that I may have PCOS (polycystic ovaries). The endocrinologist had a look at my face, we had a good chat, and he sent me for blood tests. When these came back, he then referred me to get an ultrasound. During the ultrasound, they discovered that I did in fact have PCOS (harmless cysts on your ovaries, which increase your Androgen levels - male hormones i.e. Testosterone). Some women have a few cysts on each, but if you have 12 or more on each side, you are considered to have PCOS (I had about 18 on each!). The symptoms of this - as well as a number of other things - are oily skin and acne. On communicating with one other, and myself, my Dermatologist and Endocrinologist then decided that the best thing going forward would be to start me off on Spironolactone (to balance the hormones), and Roaccutune a month later - once I'd returned from a holiday in the sun (your skin becomes photosensitive on this drug, so it's not ideal to take it before a holiday) to double whammy it, and sort out the infections in my skin.
I have been taking the Spiro since Saturday, and plan to start the Roaccutane as soon as I return home at the end of this month. I feel as though my skin has slightly improved already - which I know can't be down to the drug this fast - however, I think because I finally see light at the end of the tunnel, I am a lot more relaxed about the situation, and I know that after 10 long years, I have finally discovered what has been wrong with me.
I am writing this, because I know for a fact that I will not be the only one in this situation, and I just wish that I had read something like this many years ago, so that I didn't spend the first half of my twenties going through emotional turmoil because of my skin. It's effected so many more parts of my life then I have ever realised - relationships, sporting activities, holidays, work, friendships - and to know that I am finally on the right path, has been a huge weight off my shoulders.
Good luck.
Thanks Crisp89, very glad that you have truly found the root cause of your acne and that you are on a promising route treatment wise! I know not a lot of people, including myself, have really even tried to look into the cause and are more focused on just getting rid of acne ASAP. I'll be honest if I was given the chance initially I probably would have just taken the second course of accutane, but now I'm thinking maybe this could be the medication that settles things for good.
Anyway, I guess I could describe my acne in the past and present and then maybeee post updates on my spiro treatment every week or so. I figure it's worth a try and I don't see a lot of people on spiro with my type of acne and predicament in general... although apparently there are more in my shoes than I imagined.
I'll try to go through my acne history as fast as I can to give an idea. My freshman year was when I actually started to get real acne, it resembles a slightly milder version of what I am dealing with now (the more severe of the pictures I posted). I was put on doxycycline and tetracycline as well as clindamycin gel for a year and it cleared me up 100%. Sophomore year things came back and I continued taking antibiotics of all sorta which had no effect anymore, went on all of the topicals you could imagine, and it actually got it's worse that summer. It was all of my face but rarely clustered, which was what I was used to. Beginning of junior year I went on accutane and cleared up 100% the second month. Stayed clear all throughout junior and senior year, then started breaking out this summer. Breakouts now resemble what they had been when I first got "real" acne. All in all, my acne was never severe but always teetering between mild and moderate and ultimately never really went away.
Whew.. sorry this is so long and sorry if I repeat things. Now onto the present. Dermatologist told me to take 50mg spiro for the first 2 weeks, then 100mg spiro for the rest of the time I'll be on it (which hopefully will be for a while if it works out lol). In addition to that she prescribed atralin, I've been on retin-a before so idk if this is gonna do much... but my acne has come back different and involves a lot more clogged pores and blackheads this time around so who knows. I'm just gonna put that on at night every night and see how it goes, I'm not going to mention a lot about topicals or makeup or washing regimens cause they don't seem to make a difference to my skin.
I've been taking spiro for 3 days so far and my skin looks the same, feels just as oily if not more (atralin is probably causing that), getting a few new pimples but that's not out of the ordinary. My body, however, is already feeling it. I'm having issues dealing with stomach cramps, nausea, and bloating 5 hours after I take it with a meal, but I could probably fix that by taking it closer to bed time (and going to bed at a reasonable time hah). Also peeing a lot but that's not an issue.
Gonna try my best to be consistent and do pictures maybe every 2 weeks or farther apart cause I know it works slow. Dreading the possibility of an initial breakout but I'm trying to eat healthier and just calm down so maybe it'll mellow things out. Going to college in 2 weeks so if things get bad they're probably gonna get bad once I get there.. what a bummer 
edit: realized I kind of say retin-a and atralin interchangeably, both are roughly the same thing though
I think it's a little bit silly to try to say that one person's acne is "hormonal" and one is "non-hormonal."
Geoffrey Redmond stated in one of his published articles in American Medical Association that "without androgenic action on the pilosebaceous unit, acne does not occur."
The easiest way to think of androgens is testosterone, which directly affect your sebaceous glands.
ALL acne is hormonal in that sense. Now, acne is a chain reaction, so there are is a pathway of androgenic action -> sebum production / blockage -> sebum mixing with dead cells -> bacteria feeding on dead cells -> acne. So if you are getting acne that has no connection to hormones, then it's not really acne. There are disorders like folliculitis which often look like acne but are created through a different process.
It's a lot easier to clear acne when you start at the root of the chain instead of at the end.
For example, spironolactone starts at the hormonal root.
Accutane starts at the sebum production step by systemically drying you out (there is some research that says that Accutane temporarily lowers testosterone as well).
Benzoyl peroxide is exfoliative and antibacterial, which is the end of the chain.
I will also mention that my skin has never done well on retinoids. Retinoids make the skin regeneration cycle faster. They are not exfoliative per say (exfoliative means we are sloughing off the top layer to reveal newer skin underneath)...instead of exfoliating, retinoids sort of "push" the bottom layer up at a faster rate.
What I've concluded is that retinoids work great if your skin "sluggish" at this natural regeneration cycle. HOWEVER some of us with acne have regeneration cycles that are already too fast. People like me get clogs because the skin is regenerating faster than the dead skin cells fall off. If you add retinoids and make that process even faster, you're just creating more opportunities for blockages and acne.
For people like me, the last thing you want is a retinoid, but you do want regular exfoliation. When "normal" skinned people exfoliate every day and they basically rub their skin raw. I can exfoliative everyday and it makes my skin look great because I have so much daily dead skin buildup to scrape off.
Just something to consider if you keep breaking out. It is probably not the spiro. You may not have the right skin type to be using Atralin or another retinoid.
Thanks, Green Gables.. it is very reassuring knowing that I'm getting at the root of things. I am hopeful that the atralin will do something for my skin this time around, but I am thinking that my skin, like yours, just may not be compatible with retinoids.
Anyway, hello again... not sure if this topic should be in the hormonal acne section or if I should rename it because I'm going to turn this into a progress log type thing.
Day 6 on Spiro:
Not a whole lot is really happening with my skin, which is to be expected. I'm still getting a few pimples here and there. I'm quite flakey cause of the atralin, albeit not really dry..? If that makes any sense lol. Wondering if I need to start exfoliating somehow now, but I really don't want to add more to my regimen. Right now the only effects of spiro I'm seeing/experiencing are peeing frequently and diarrhea which is kind of annoying. The nausea I felt towards the beginning went away, so I'm hoping the same will happen with the diarrhea... can't really imagine managing that during college.
Pic taken after washing my face at night. I'll try to be consistent with this.
On a related note, I have been trying to make some changes to my diet. I have been sparing with the dairy products for most of my life as I'm lactose intolerant, but ever since my breakout I've adopted a strict no-dairy diet. Consequently, I've also limited most if not all junk food since most of it contains milk in one way or another. Another added diet restriction I've added after reading on here is low sugar. I notice my skin looks a good bit less inflamed and I don't get as many new pimples when I stick to this diet, but I am not seeing huge improvement and, in my opinion, it is not worth it for me. I cannot afford to be picky with my food in the household I live in and especially not in college, not to mention I can't afford to lose very much weight and the recent diet changes I have gone through have made it hard to keep it on. I guess what I'm trying to say is that, to me, clear skin isn't worth the paranoia and unhappiness that surrounds such a constrictive diet. I realize that I sound like a baby, but I just can't change my whole lifestyle over a few pimples.. after all my acne is quite mild right now.
Hello guys! Today is day 14 on spiro and the atralin and things are looking better! I'm not clear by any means but I've been able to skip the liquid concealer and just pack on a powder foundation nowadays.. thank goodness just in time for college classes. I was actually more clear than ever yesterday, the day my cycle started, and I thought "wow I'm going to have a period without a breakout!". I must have jinxed myself though cause today I have a small breakout on my forehead and a few spots on my mouth/chin, but nothing bad at all. Anyway my body feels like it adjusted well to the spiro, no longer running to the bathroom because of the runs (or to pee for that matter). My skin has also stopped peeling from the atralin which is nice. I'm still oily but I definitely don't mind that as much as the spots I had. I know it's probably too soon to talk and when I raise my dosage to 100 mg tomorrow I may take a few steps back.. but I am very hopeful!
I'd also like to add that I'm still cutting out dairy, but eating a bit too much sugar lately and lots of gluten. I'm trying to limit myself in all those departments but still allow myself all of it (aside from milk). I think, for me, it's all about balance.
Anyway, progress picture time. Day 14 at night right after I washed my face
edit: Also would like to mention that the initial breakout I experienced was probably 3 larger and painful pustules in my hairline and one really obvious on my chin. These, to me, seemed to be an ib cause they were huge and painful and something I never had gotten before. I can tell you that my smaller inflamed pimples and clogs that I had at the beginning of my treatment went away really fast though, maybe due to the atralin but I doubt it did all of it. The larger, painful ib pimples took a few days to go away and the hp mark I have on my chin is pretty obvious but I don't mind it. Just a warning I guess, I'm lucky cause my acne is mild but I'd imagine for someone with more severe acne and more of a hormonal imbalance it may be a little rougher in the beginning.
Well thank the Lord you don't have cystic acne, most woman who are prescribed spiro have awful skin. You have moderate acne, or just a bunch of pimples that can be easily covered with make up from what it looks like! I'm on the same boat, except I get that more on my cheeks and jawline. If your breakouts are along your cheeks and jawline, it is hormonal. You should really go see an endocrinologist and get some blood work done and see why your breaking out. You could have PCOS, or something along the lines of that. The reason I recommend you get your blood tested is because if you have elevated testosterone levels then spironolactone would be perfect for you. One thing to know is that it takes up to 3-6 months to see any real results so it takes patience! But from what I've read it is well worth it!
Hello all! Today is day 23 on spiro (from 50 to 100 mg for about a week now). Things are still improving and I'm stressing less and less about makeup and what I'm eating 
. Again, still not sure if it's the atralin or the spiro but I'm gonna keep on both to be on the safe side. Only side effects experienced at all with spiro anymore is having to pee a bit more around the time that I take the medication. If I take it after a very moisture heavy meal and with a full bottle of water, I will be peeing like crazy for an hour or so lol. Because of this, I take it before bed when I haven't eaten or drank anything too heavy in the past few hours. Anyway, progress picture and I'll check in weekly or when needed.
Hello all! Today is day 23 on spiro (from 50 to 100 mg for about a week now). Things are still improving and I'm stressing less and less about makeup and what I'm eating
Skin is looking good!! Smart to keep up on them both for now. In a few months when you are able to predict your skins behavior better I would drop the Atralin and see if the spiro keeps you clear. It should. I'm on 100mg too, that's been my dosage the whole time. This seems to be the most common dosage with good results and little side effects.
I had to pee a lot when I first started Sprio too. After a month or so that side effect when away. Hopefully it does for you too. Keep up with the updates
Hello again! Sorry for the shameless 10 month old thread bump, and sorry for not updating. I'll give a quick run through of my spiro experience for the past almost year, and my reasons for why I'm coming off of it.
My skin pretty much remained clear, barring a few odd flare ups, for the past 10 months of treatment. Obviously cause of college and stress and stuff I wasn't very consistent on taking it, so that was a big part of why I had an odd flare up every few months. Another reason being that a few months into treatment I decided to lower my dosage to 50 mg a day rather than 100 mg because I was having 2 periods a month. I didn't flare up near like I did before treatment, but I definitely still get pimples and stuff during my period.. but its not enough to bother me anymore. As far as the retin-a and clindamycin go, I barely even remembered to wash my face in college and noticed no real significant difference in my acne when I did/didn't use those. All in all, skin looks alright as of today, could be better could be worse... but point is it's no longer a priority. However, the weight gain that I -suspect- spiro has caused has now became a new one. Obviously the freshman 15 is common, so when I went from 115 to 130 second semester I didn't think much of it. Now that its the summer, however, I've been trying to work it off. And let me tell you, it is SO much harder than I remember it being. I've been exercising and eating less than ever and I can't get the scale to dip below 130 still. To make a long story short, it may not be spiro, but it could be, and either way eventually I need to wean myself off. So starting today I'll be taking 50 mg every few days and seeing how my skin looks for a month or two, then less and less, hopefully. I'll try to update things as far as acne goes, and I guess maybe weight stuff if it's relevant. I seem to be in a minority with the weight gain thing.
For ladies that had success with spirnolactone; I suggest getting tested for PCOS (polycystic ovarian syndrome) ... the reason I say this is because spiro works by blocking androgen's. If your body is producing more than normal amounts of androgen's this could be a sign of PCOS. PCOS comes in all shapes and sizes; you don't necessarily have to have every symptom outlined on WEB MD(excessive hair, obesity,etc.)...around 30% of women with PCOS don't even have polycystic ovaries, and some ladies only symptom ishormonal cystic acne. Getting your hormones checked is really quite simple; I suggest doing so through a naturopathic doctor, as most Western doctors are not too keen on testing for hormonal issues when its related to acne. You can also get tested through your OBGYN, but it typically takes awhile to get an apt with these people. <3
On December 16, 2015 at 944 AM, CNA7 said:For ladies that had success with spirnolactone; I suggest getting tested for PCOS (polycystic ovarian syndrome) ... the reason I say this is because spiro works by blocking androgen's. If your body is producing more than normal amounts of androgen's this could be a sign of PCOS. PCOS comes in all shapes and sizes; you don't necessarily have to have every symptom outlined on WEB MD(excessive hair, obesity,etc.)...around 30% of women with PCOS don't even have polycystic ovaries, and some ladies only symptom ishormonal cystic acne. Getting your hormones checked is really quite simple; I suggest doing so through a naturopathic doctor, as most Western doctors are not too keen on testing for hormonal issues when its related to acne. You can also get tested through your OBGYN, but it typically takes awhile to get an apt with these people. <3
Ive beenchecked for pcos and everything came out fine. Im still not convinced, but Ill check in maybe a year. My question is, if you have it, what then? Theres no cure, and its the same treatment (birth control, spiro, etc)
There are a lot of factors that go into "curing" PCOS, although it's something you can always have, you can get rid of the symptoms -- I have a few friends with PCOS who have dramatically changed their lifestyles -- they don't use anything that can cause hormonal fluctuations; chemicals in everyday products can alter your hormones, this includes BPA, plastics, certain cleansers, moisturizers, foods, etc. My friend has 45 cysts on her ovaries but was able to rid herself of all the symptoms of PCOS; cystic acne, excess hair, etc. just by changing her lifestyle and supplementing with Saw Palmetto, Red Clover, Spearmint tea, and eating very whole foods. Sure, it can't work for everyone, but there is always hope! I got my blood work back and my testosterone levels are low (which is great), but my androgen are high, but still within normal range, so I am dealing with that right now and working with my ND so that we can lower the androgen levels.
27 minutes ago, CNA7 said:There are a lot of factors that go into "curing" PCOS, although it's something you can always have, you can get rid of the symptoms -- I have a few friends with PCOS who have dramatically changed their lifestyles -- they don't use anything that can cause hormonal fluctuations; chemicals in everyday products can alter your hormones, this includes BPA, plastics, certain cleansers, moisturizers, foods, etc. My friend has 45 cysts on her ovaries but was able to rid herself of all the symptoms of PCOS; cystic acne, excess hair, etc. just by changing her lifestyle and supplementing with Saw Palmetto, Red Clover, Spearmint tea, and eating very whole foods. Sure, it can't work for everyone, but there is always hope! I got my blood work back and my testosterone levels are low (which is great), but my androgen are high, but still within normal range, so I am dealing with that right now and working with my ND so that we can lower the androgen levels.
Thanks for the reply! Still trying to figure out my own mess. Im vegan, eat mostly organic, very conscious of what im using and consuming due to a million allergies. It will be a miracle day for me when I figure out why I have acne. Currently doing the birth control and spiro route which I hate but im going to give it some more time