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MH14

My spironolactone/antibiotic/klonopin log

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I decided to keep a log of my progress with these various new medications I'm taking - if only to track my (hopefully) progress, but if it can help someone else out, well, then that would be a bonus. I'm really at a terrible low right now having just backed out of a trip to Europe due to the ever-present anxiety over my skin and, because my husband is now gone for two weeks, I had to ask my parents to take my kids for a couple of days to get past this rough patch. I know I am not alone on these boards in that my skin essentially controls my mood; I hate to say my entire life, but often it feels that way. I have struggled with body dysmorphic disorder for about 16 years and as each year goes by I fear I may live with it for the rest of my days.
There have been many issues that have plagued my skin over the years, several of which I have managed to either solve or get very much under control. Currently, my problems involve mild hormonal acne and the absolute bane of my existence, extremely stubborn clogged pores that harden into deep plugs below the surface - almost always on my cheeks - that refuse to resolve on their own and must be manually extracted. Almost always by myself, because I cannot resist the urge to squeeze them out, and naturally this leaves varying degrees of trauma to the skin.
I'm fairly certain hormones play a big role in both the mild acne I get before my period, and if hormones are responsible for stimulating sebaceous glands, then my oily skin leads me to believe that it is partly responsible for plugging my pores. My hope is that spironolactone can help lower oil production and keep the acne at bay and clogged pores to a minimum. I'm also taking an antibiotic (doxycycline) as prescribed by the GP who recommended the spiro (to help in the case of an initial breakout, perhaps?) and I was prescribed klonopin just yesterday to help take the edge off my extreme anxiety over all these skin issues until a better medication can be determined to help treat BDD.
Other products and supplements I use: Paula's Choice 2% BHA treatment nightly, Paula's Choice toner for moisture (with oily skin, I don't need much), and PC's BHA 9% salicylic acid to spot treat. Every month I do a mild at-home AHA peel, mostly because I am afraid of damaging my skin with anything stronger. These manage to do a fairly good job keeping my skin clear. I also supplement with Vitamin D, biotin and iron (for thin hair, another issue I am hoping spiro can help with), about 32,000 IU daily of Vitamin A, a probiotic to go along with the antibiotic, and a zyrtec/zantac combo to ward off hives. I am not currently using any prescription topicals, mostly because I am wary of them breaking me out.
So I am currently close to finishing my second week on spiro & doxy. My GP said I could start at 50 mg if I wanted, but I'm a nervous nellie and usually just take 25 mg/day because I'm terrified of an initial breakout. The stories I read on here are awful. I haven't broken out in cysts in I don't know how long - my acne has never been what you would call severe - and to break out like that would push me over the edge. I'm hoping that if I start very low and work my way up I might avoid breakout out badly. So far, after two weeks, I have noticed I will get teeny tiny pimples popping up near the sides of my chin that resolve quickly, and I got a bunch at my hairline near my temples (unusual for me). Don't know if I can attribute them to the spiro or not. My period is due probably next week. I have also noticed, as many have stated, my lips are dried out and cracking (even at 25 mg). The good side effects I've noticed are that my skin seems drier (could also be the cooler weather) and my hair, which is usually oily after one day, seems a little less so.
As for the klonopin, it's pretty powerful stuff and definitely takes the edge off  my anxiety. Again, it's not supposed to be long term, but I appreciate the effect it's having while I'm dealing with a low period.
I'll update again at the end of next week, hope to be in a better place by then but, as many of us know, it's hard to know what to expect when dealing with our skin.

 

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Good luck!  I'm on 100 mg of spiro and a month in and my acne is worse than when I started.  Keep in mind it was pretty rough to begin with.  Definitely recognize that spiro is a marathon and it can take months at the right dosage to get results.  Look up green gables on this website as she is a Spiro guru.  Are you going to post pictures?  In regards to your state of mind, definitely seek counseling for those self esteem issues.  I am in therapy and it has helped tremendously.  keep us posted.

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Good luck!  I'm on 100 mg of spiro and a month in and my acne is worse than when I started.  Keep in mind it was pretty rough to begin with.  Definitely recognize that spiro is a marathon and it can take months at the right dosage to get results.  Look up green gables on this website as she is a Spiro guru.  Are you going to post pictures?  In regards to your state of mind, definitely seek counseling for those self esteem issues.  I am in therapy and it has helped tremendously.  keep us posted.

Thanks for your support, leelowe1. It will probably take me a long time to reach 100 mg because I am so nervous about breaking out. I don't mind being on it and waiting to see results for months because, with the exception of these stubbornly impacted comedones, any mild hormonal pimples seem to be kept at bay with my topicals. In fact, if I posted pictures, people would probably laugh me right off the forum because it doesn't look like I have acne at all minus some minor PIH from impacted comedones I have messed with. I have had a lot of success removing red marks with a series of vbeam & KTP laser treatments. It's expensive, but I have loved what my laser doc has been able to do for me. I had mild/moderate rosacea for many years and he's been able to all but erase most of the little red capillaries and flushing from my face. It's been wonderful. I credit him with my skin looking so much more even and clear.
I have heard some information from green gables and liked hearing what she said about retinoids (she avoids them) and supplementing with high doses of vitamin A to help clogged pores.
Right now I am even lower than yesterday because I compulsively picked at one last minor whitehead smack in the middle of my cheek. It's been torturing me for months (since July) because nothing I applied to it would do anything except turn it red. So, I finally attacked it and unfortunately it made a mess, swelled up, I have no idea if I extracted all the gunk out (it *had* been months on my face - was it accumulating junk the whole time?), and the skin around the site is red and irritated, though not broken. If the swelling hasn't gone down by tomorrow I'm going to have a cortisone injection. I dread them because I am prone to atrophy. Takes about 5-6 weeks for my dents to fill in. Does anyone know what happens to any pus left in a cysts after an injection? Does it dissolve?
As for therapy, my husband is begging me to have CBT done but after 16 years of being like this, it is impossible for me to imagine changing my thought patterns. Impossible. Someone is going to help teach me not to care about my skin?! Plus, I am scared that any SSRI med I might take to help with the OCD thought patterns might worsen my skin. I am currently prescribed klonopin to deal with extreme anxiety over all this.
Thanks again for your support. I don't have anyone to help me deal with this except for my husband and he currently travels abroad every month for a week or two at a time.

Edited by MH14

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Good luck!  I'm on 100 mg of spiro and a month in and my acne is worse than when I started.  Keep in mind it was pretty rough to begin with.  Definitely recognize that spiro is a marathon and it can take months at the right dosage to get results.  Look up green gables on this website as she is a Spiro guru.  Are you going to post pictures?  In regards to your state of mind, definitely seek counseling for those self esteem issues.  I am in therapy and it has helped tremendously.  keep us posted.

Thanks for your support, leelowe1. It will probably take me a long time to reach 100 mg because I am so nervous about breaking out. I don't mind being on it and waiting to see results for months because, with the exception of these stubbornly impacted comedones, any mild hormonal pimples seem to be kept at bay with my topicals. In fact, if I posted pictures, people would probably laugh me right off the forum because it doesn't look like I have acne at all minus some minor PIH from impacted comedones I have messed with. I have had a lot of success removing red marks with a series of vbeam & KTP laser treatments. It's expensive, but I have loved what my laser doc has been able to do for me. I had mild/moderate rosacea for many years and he's been able to all but erase most of the little red capillaries and flushing from my face. It's been wonderful. I credit him with my skin looking so much more even and clear.
I have heard some information from green gables and liked hearing what she said about retinoids (she avoids them) and supplementing with high doses of vitamin A to help clogged pores.
Right now I am even lower than yesterday because I compulsively picked at one last minor whitehead smack in the middle of my cheek. It's been torturing me for months (since July) because nothing I applied to it would do anything except turn it red. So, I finally attacked it and unfortunately it made a mess, swelled up, I have no idea if I extracted all the gunk out (it *had* been months on my face - was it accumulating junk the whole time?), and the skin around the site is red and irritated, though not broken. If the swelling hasn't gone down by tomorrow I'm going to have a cortisone injection. I dread them because I am prone to atrophy. Takes about 5-6 weeks for my dents to fill in. Does anyone know what happens to any pus left in a cysts after an injection? Does it dissolve?
As for therapy, my husband is begging me to have CBT done but after 16 years of being like this, it is impossible for me to imagine changing my thought patterns. Impossible. Someone is going to help teach me not to care about my skin?! Plus, I am scared that any SSRI med I might take to help with the OCD thought patterns might worsen my skin. I am currently prescribed klonopin to deal with extreme anxiety over all this.
Thanks again for your support. I don't have anyone to help me deal with this except for my husband and he currently travels abroad every month for a week or two at a time.

I am getting CBT and it is absolutely possible for you to change the way you think.  I  am doing it without meds too.  It is hard and there will be set backs but you are not beyond help.   My skin may never get better ( and that itself is a depressing thought) but i can't allow that fact to rule my life.  This disease that is acne is not our fault and we shouldn't deprive our loved ones the opportunity to experience the real us because we feel insecure about our skin. 

Good Luck and i'm looking forward to hearing about your progress.

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Day 19 of spiro/doxycycline, woke up fearful as ever. Like, I'm sure many a person on these forums, I dream about waking up and feeling peaceful. I'm fairly certain 25mg/day of spiro doesn't have much of an effect on my skin, but that's OK by me because it's not really making anything worse as far as I can tell. I get little pimples that pop up under my jaw here and there but that's not unusual and my Paula's Choice BHA 9 has been awesome at keeping those under control. Most likely, if anything, the doxy or spiro pushed a few things to the surface that were already present but save one cyst, nothing has been inflamed. I don't have much redness in my complexion, probably because I've had a series of vbeam treatments over the past several months. I'm going back for another one next week to work on the marks left behind from some extractions, including the one I had injected a few days ago. I am compulsive about picking, struggle so much to leave stuff alone on my face and let nature take its course.
After a big event in November, I'm going to push the spiro to 50mg/day and see what happens. I realize that I will probably have to go to 75 or 100mg to get any real result but I am not mentally prepared for breakouts. Speaking of mentally prepared, my GP is urging me to take an SSRI and I am filled with anxiety over being on something that can mess with those hormone receptors. Not sure what to do about that. I hope by my next update I will be in a more peaceful state, even just slightly more so.

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Typical of dr's to push drugs.   Having been on psychiatric drugs in the past, i can tell you that its a lot of trial and error.  Sam-E is a natural supplement you can try.  I will reiterate this again for you.  Counseling will help with those deeper issues and frankly, the best psychiatric medication in the world will not help you to change your thinking.  I am curious to know what the resistance is to counseling?  Is it lack of time, cultural acceptance (as it was in my case)?

I hear you about the breakouts.  5 weeks on spiro and my acne is worse.....sigh.  Dealing with it as best as i can.

Stay encouraged.

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Ive been on 75 mg of spiro for a little over a month, and im on month 4 of yaz and my acne is worse than its ever been. But it takes time, dont we all just hate waiting :/

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I am now on day #30 of spiro at the very minimal 25mg/day dosage. I'm reluctant to push it to 50mg until another month goes by because (knocking on a thousand doors of wood) I haven't experienced any devastating initial breakouts. I don't mind going at a snail's pace if it works eventually. As with the spiro, it's difficult to tell if the antibiotics are having much of an effect, either - mainly I just get a few pimples popping up under my jawline and near my temples. Those I can deal with; it's the deep, impacted pores that are my worst nightmare. I've been doing some light AHA at-home peels and, as I believe Green Gables suggested, take about 32,000 IU of Vitamin A daily to aid in slowing oil production.
Leelow1, you asked me about my reluctance to try CBT and the answer is so complicated. In short, it is so very hard for me to believe I can change my patterns of thinking. I know it's not impossible, but it would be a massive amount of work. I'm not sure a once-a-week or even a couple times a week with a therapist would be enough to have much of an impact. On my good days, I believe it might have a positive effect, but on my tough days, I figure you might as well ship me off to one of those fancy inpatient treatment facilities. There's the expense to consider, of course, but even more importantly that I'm a mom to four young children and don't have a lot of extra time to care for myself. And so I press on trying to solve my skincare woes...BUT...it's been a better week so I'm grateful for a somewhat more peaceful state of mind as I update this tonight. Good luck to you!!

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