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MH14

Trying spironolactone for hormonal acne/clogged pores

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Thanks to this forum, I've been able to do quite a bit of reading about spironolactone and the possibility that it could help treat oily skin, hormonal acne and clogged pores. I started on 50 mg/day this week, surprisingly easy to get from a nurse practitioner, but the idea of an initial breakout terrifies me. My skin is actually almost completely clear of active acne, but I struggle with clogged pores and closed comedones. Those things have driven me to the brink of insanity over the last few years. A bit of background: I am 35 years old and have been battling skin issues for 20 years. The troubles have shifted from run-of-the-mill pimples and cysts in my teens/early 20s, outbreaks of hives after starting to have children in my early-to-mid 20s, then discovering I had mild rosacea in my later 20s and finally, after solving all the forementioned problems, dealing with closed comedones and hormonal acne in my mid-30s. On top of this, I was diagnosed with BDD over my skin about 13 years ago and have been dealing with it ever since. Unfortunately, like many a sufferer on this forum, the state of my skin controls my life.

I am giving spiro a shot hoping that it might be able to lower oil production and keep my pores unblocked. The clogs that I do get are, in my mind, unbearable. They are the kind that will not, in most circumstances, dissolve on their own with topicals. A few do, and when they are blackheads, those eventually make their way out of my skin, too. However, the whiteheads make me miserable because they nearly always must be manually extracted and that process is so very traumatic. I am successful at extracting the keratin plugs, but naturally deal with red marks that linger for a long time. I have found a *wonderful* laser doc in town that has been able to blast the marks away (not to mention the permanent red capillaries that I had on my cheeks from rosacea) but the laser therapy is very expensive and I don't want to have to go running to him every time I get so much as a red spot on my face.

I know 50 mg is a low dose of spiro, but both the NP and I want to start slow. As I mentioned, I don't really have much active acne or cysts on my face. I am praying that the medication does not all of a sudden give me a load of both and am taking an antibiotic along with the spiro. I don't want to bump the dosage until after a few big events going on in the later part of the year. I have read many horror stories of IBs, but it always seemed to me that the user was already broken out to begin with. I'm wondering if the medication caused someone nearly completely clear to break out and if so, at what dosage? I also supplement with Vitamin D (my levels were low), biotin, Vitamin A (to try to lower oil production), take a probiotic, and a combination of zyrtec and zantac to ward off hives. As a topical, I've been trying Paula's Choice 2% BHA treatment at night, moisturizing when needed with her toner, and spot treating with PC's BHA 9 (which has proven to be pretty great). I have prescriptions for Differin and Retin-A but am afraid to use them on my face for fear they'll make me purge.

Thanks for any help with this.

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Good luck.  I don't think spiro is a good first line of defense if clogged pores is your main issue.  But here's to hoping you have positive results.

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Hey! It's Amelia! We talked a lot about a year ago during my Accutane treatment! I did spiro for 6 months before accutane and it made my skin much worse when I increased doses. At 25 mg I was perfectly fine my skin was glowing but going to 50mg ruined my skin .  

It has been 8 months since accutsne and I'm still breaking out , not as bad and for the most part clogged pores are gone. I am going on mino hopefully in the next few weeks to control hormonal breakout and only take intermittently. I have completely clearer my diet as well.

acne is an on going fight. 

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Good luck.  I don't think spiro is a good first line of defense if clogged pores is your main issue.  But here's to hoping you have positive results.

leelowe1, thank you for your response! Yes, clogged pores are my main issue but I was hoping that if the spiro lowered my oil production, I would be less likely to clog. I use a 2% BHA treatment daily, occasionally an AHA peel, and I spot treat with a 9% BHA product. I've seen improvement, but still clog. I have prescriptions for retinoids but am afraid to use them all over my face. Would you suggest anything else for a first-line treatment?

Hey! It's Amelia! We talked a lot about a year ago during my Accutane treatment! I did spiro for 6 months before accutane and it made my skin much worse when I increased doses. At 25 mg I was perfectly fine my skin was glowing but going to 50mg ruined my skin .  

It has been 8 months since accutsne and I'm still breaking out , not as bad and for the most part clogged pores are gone. I am going on mino hopefully in the next few weeks to control hormonal breakout and only take intermittently. I have completely clearer my diet as well.

acne is an on going fight. 

Melie87, did you decide to go off spiro because of the bad effect on your skin? You mentioned that things were good at 25mg. Most people on here say they had to take 100-200 mg of spiro to get good results.
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Spiro was wonderful for my active acne but it obviously can't force clogs out of your pores or even prevent blackheads.

For existing clogged pores I do some pretty aggressive at-home exfoliation and dissolving. Gentler methods have not helped.

Daily, at night
1. A full 2 minute manual exfoliation with tree hut shea sugar scrub.
2. 2 minute oil cleansing with botanical beauty grapeseed oil (need that linoleic acid!). For me this means massaging in for 2 minutes, rinsing all the way off with hot water. 
3. Spritz face with water, than moisturize with juice beauty stem cellular moisturizer (expensive, but with aggressive exfoliation you need this step)

3x a week only on areas with clogged pores
1. 30 minutes leave-on elemis pumpkin enzyme peel.
2. For as long as you can stand (you have to work up to max time), dr. song 50% lactic acid gel peel.
3. Cold water rinse, wait 5 minutes.
3. For as long as you can stand, planet eden 30% salicyic acid peel.
4. Cold water rinse, leave it for an hour, then moisturize with the juice beauty.

Please note this is VERY aggressive. Layering the peels helps clear the inter-pore debris I seem to accumulate, so the salicylic acid can actually get into the pore. I listen to my skin and back off if it starts drying out too much or getting too irritated. 

To prevent future clogged pores I find that high doses of Vitamin A and fish oil help a lot. This cod liver oil has both. 

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On 10/11/2015 at 10:34 AM, Green Gables said:

Spiro was wonderful for my active acne but it obviously can't force clogs out of your pores or even prevent blackheads.

For existing clogged pores I do some pretty aggressive at-home exfoliation and dissolving. Gentler methods have not helped.

Daily, at night
1. A full 2 minute manual exfoliation with tree hut shea sugar scrub.
2. 2 minute oil cleansing with botanical beauty grapeseed oil (need that linoleic acid!). For me this means massaging in for 2 minutes, rinsing all the way off with hot water. 
3. Spritz face with water, than moisturize with juice beauty stem cellular moisturizer (expensive, but with aggressive exfoliation you need this step)

3x a week only on areas with clogged pores
1. 30 minutes leave-on elemis pumpkin enzyme peel.
2. For as long as you can stand (you have to work up to max time), dr. song 50% lactic acid gel peel.
3. Cold water rinse, wait 5 minutes.
3. For as long as you can stand, planet eden 30% salicyic acid peel.
4. Cold water rinse, leave it for an hour, then moisturize with the juice beauty.

Please note this is VERY aggressive. Layering the peels helps clear the inter-pore debris I seem to accumulate, so the salicylic acid can actually get into the pore. I listen to my skin and back off if it starts drying out too much or getting too irritated. 

To prevent future clogged pores I find that high doses of Vitamin A and fish oil help a lot. This cod liver oil has both. 

Thank you so much, Green Gables! I appreciate your reply. I thoroughly read your posts about spironolactone before deciding to try it. I'm glad to know that peels are the right direction to take (retinoids scare me, should they?) and I have been taking a vitamin A supplement for the past month or so to try and help with oil. What dosage do you recommend?

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On 10/12/2015 at 12:43 AM, MH14 said:
On 10/11/2015 at 10:34 AM, Green Gables said:

Spiro was wonderful for my active acne but it obviously can't force clogs out of your pores or even prevent blackheads.

For existing clogged pores I do some pretty aggressive at-home exfoliation and dissolving. Gentler methods have not helped.

Daily, at night
1. A full 2 minute manual exfoliation with tree hut shea sugar scrub.
2. 2 minute oil cleansing with botanical beauty grapeseed oil (need that linoleic acid!). For me this means massaging in for 2 minutes, rinsing all the way off with hot water. 
3. Spritz face with water, than moisturize with juice beauty stem cellular moisturizer (expensive, but with aggressive exfoliation you need this step)

3x a week only on areas with clogged pores
1. 30 minutes leave-on elemis pumpkin enzyme peel.
2. For as long as you can stand (you have to work up to max time), dr. song 50% lactic acid gel peel.
3. Cold water rinse, wait 5 minutes.
3. For as long as you can stand, planet eden 30% salicyic acid peel.
4. Cold water rinse, leave it for an hour, then moisturize with the juice beauty.

Please note this is VERY aggressive. Layering the peels helps clear the inter-pore debris I seem to accumulate, so the salicylic acid can actually get into the pore. I listen to my skin and back off if it starts drying out too much or getting too irritated. 

To prevent future clogged pores I find that high doses of Vitamin A and fish oil help a lot. This cod liver oil has both. 

Thank you so much, Green Gables! I appreciate your reply. I thoroughly read your posts about spironolactone before deciding to try it. I'm glad to know that peels are the right direction to take (retinoids scare me, should they?) and I have been taking a vitamin A supplement for the past month or so to try and help with oil. What dosage do you recommend?

Retinoids never worked for me. They increase the rate of cellular turnover in the deeper layers of the skin, but since I get debris clogs in the deeper layers (cysts), well, retinoids are a recipe for disaster. Peels literally peel away from the top and don't add to the mess.

I currently take 25,000 to 50,000 IU of Vitamin A. It seems to help lessen my oily areas (nose and chin).

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