I have been on spiro a little over 4 months now and wish I had known about this medication back in my 20s! It would have probably saved me a lot of grief. I've never had serious acne, but mild to moderate breakouts, mild rosacea and clogged pores persisted into my mid-30s. This site was the first place I'd heard about spiro (thanks to everyone on here for the advice!) and once I researched it, I went straight to a nurse practitioner and asked for it. I started very slowly, just 25mg for 2 months, then upped it to 50 for a month, then 75 and now I'm at 100mg. Yes, each time I upped the dose I noticed gunk surfacing from my pores. Not regular pimples, but the blackheads were purging. The initial breakout probably peaked at about 2 weeks in and then started to improve. The first month was definitely the worst. On the first increase, I noticed that -- like others on here have noted -- I was breaking out where I normally would be clear. At 100 mg, I am (aside from just a few spots of PIH) clearer than I can remember ever having been. I'm almost afraid to write about it for fear of jinxing myself!

I did not gain weight. In fact, I lost weight. I'm sure it was also partly due to anxiety over my skin, loss of appetite and other related causes. I have a hard time maintaining a weight over 100 lbs.

No other side effects. Nothing. I was hoping to get some of the cup size back that I lost after breastfeeding 4 kids and struggling with anxiety, but so far, not much has happened. My hair is fine and I shed considerably after each child was born; again I was hoping spiro might improve thickness but it's tough to tell. At least I don't appear to be shedding currently.

I I declined birth control because 1) the family is complete, 2) my husband is vasectomized, 3) I was afraid of further messing with my hormones.

If you suspect your breakouts are hormonal, go for it! I am very glad I did. I hope spiro truly is the solution I've been waiting for. Just the reduction in oil production alone has been a big relief (I suspect this, along with poor facial products, was the source of most of my skin issues). Good luck to you!

On 2/20/2016 at 8:15 PM, destinyreanne said:

How many of you have tried spiro? I have a dermatology appointment in five days and I want to ask about spiro. I have taken doxycycline, Oracea, and minocycline. I also use retin-a cream and clindamycin solution but nothing seems to be keeping my hormonal acne at bay. I have a few questions for the current and past users:

1. Did you have an initial breakout? If so, how long did it last?
2. Did you gain weight?
3. Did you experience any other considerable side effects?
4. Did you take birth control with it?

Thank you all for all of the help.

Hi there! Welcome to sharing your journey with us Spiro ladies. You can look up my profile and my story, I've been on Spiro for over 2 years now. My experience was pretty typical, things got worse before they got better. It was about 3-4 months of purging, breaking out and clearing. At the time I started I was on Yaz and also started Doxy to help with inflammation I was experiencing with breakouts. I would probably rethink that, as it really destroyed all of the good gut bacteria which can lead to issues with acne in the future. I got clear on 75 mg and Yaz, but when I stopped BCP I had to up my dose. I've recently had to up my dose again and am breaking out from this, about 1 1/2 into the increase. Unfortunately hormones are not an easy fix, but when they are the cause (PCOS) in my case, then you have to attack the cause. Please feel free to reach out with any questions and wishing you the best and that they prescribe the Spiro to you. It's been a lifesaver, even though the process isn't fun at all!

Thank you for the response!Have you ever taken DIM (diindolymethane) it's a supplement that's supposed to help hormone imbalance that I am also looking into.

Hello! 

I was on Spiro for about 2 1/2 years. I initially had a breakout due to starting the medication but it was not anything drastically different than the bad breakouts that I would get. At first I did not gain any weight with the spiro. I was started on a very low dose 50mg/day. I loved it I was definitely noticing a change in my skin but my dermatologist thought that I needed a bit of a higher dose in order to get rid of the rest of the acne that was left (I had moderate cystic acne) so I was raised to 100mg/day. At first I was doing great with the higher dose. No more breakouts, no more new pimples popping up everything seemed great! But, a few weeks after upping the dose the side effects began to kick in. First my periods were shortened from around 30-40 days to every 17-20 days which is crazy for anyone but especially crazy and annoying for a 16 year old! I was able to deal with the periods coming freqeuntly because they were shorter and much lighter than before I started the Spiro so I was to deal with it. Then another big side effect for me was a huge weight gain while taking the Spiro. Before starting I weighed around 113lbs and recently have weighed around 135lbs. With the weight gain and frequent periods I have talked to my dermatologist of switching off of spiro and onto bcp. I personally have not had a mix of spiro and birth control pills but I have heard wonders from many who have taken the combination! I would not be opposed to starting so myself! Spironalactone is a miracle worker and is great to combat acne but just be cautious of the side effects and don't be afraid to talk to you dermatologist about your side effects. Good Luck!!  

On 2/22/2016 at 2:04 PM, destinyreanne said:

Thank you for the response! Have you ever taken DIM (diindolymethane) it's a supplement that's supposed to help hormone imbalance that I am also looking into.

I've tried Estroblock and even natural progesterone supplement from a naturopath that I was seeing before Spiro worked.  Unfortunately neither did anything for me.  I even tried Saw Palmetto for several months and really could not tackle my PCOS/Testosterone issues.  I do take Berberine which is an herb, similar treatment/effects as Metformin for those of us with PCOS.  I've been doing that for a few weeks.  

On 2/23/2016 at 8:26 PM, Kseiders33 said:

Hello! 

I was on Spiro for about 2 1/2 years. I initially had a breakout due to starting the medication but it was not anything drastically different than the bad breakouts that I would get. At first I did not gain any weight with the spiro. I was started on a very low dose 50mg/day. I loved it I was definitely noticing a change in my skin but my dermatologist thought that I needed a bit of a higher dose in order to get rid of the rest of the acne that was left (I had moderate cystic acne) so I was raised to 100mg/day. At first I was doing great with the higher dose. No more breakouts, no more new pimples popping up everything seemed great! But, a few weeks after upping the dose the side effects began to kick in. First my periods were shortened from around 30-40 days to every 17-20 days which is crazy for anyone but especially crazy and annoying for a 16 year old! I was able to deal with the periods coming freqeuntly because they were shorter and much lighter than before I started the Spiro so I was to deal with it. Then another big side effect for me was a huge weight gain while taking the Spiro. Before starting I weighed around 113lbs and recently have weighed around 135lbs. With the weight gain and frequent periods I have talked to my dermatologist of switching off of spiro and onto bcp. I personally have not had a mix of spiro and birth control pills but I have heard wonders from many who have taken the combination! I would not be opposed to starting so myself! Spironalactone is a miracle worker and is great to combat acne but just be cautious of the side effects and don't be afraid to talk to you dermatologist about your side effects. Good Luck!!  

Hi doll! So sorry to hear about your issues with Spiro causing weight gain and increased periods.  Yaz or Yasmin have similar affects as Spiro, I was on a lower dose of Spiro paired with Yaz and that helped balance estrogen and testosterone.  Perhaps you stay at the 50 or 75 mg and add BCP.  Take note that BCP can also cause weight gain as well.  It's really unfortunate, but the 16+ years I was on BCP, losing weight was never easy.  I am off BCP and only on Spiro and prob about 115 lbs. 

I just posted on another thread about my Spiro experience. I started taking it in my late 30's and loved it. Started with 50mg and it worked perfectly. My skin was clear, gorgeous. I stayed on it for 7 years. I've had a tubal ligation so b/c wasn't needed.

In the last two years around age 44, I started gaining weight. Nothing worked to lose it. I have been fighting like hell for two years now to lose a measly 10lbs! I'm now 15lbs heavier than when I started Spiro. I decided to see a Dr and get a full hormone panel done along with tons of other blood work and boy, are things a mess in my body now. I have estrogen dominance and virtually zero testosterone. This is why I could build no muscle, despite lifting heavy 5x a week in addition to HIIT training and low carb dieting. My cortisol levels were also off the charts. So I am now off the Spiro for good. I did additional research and found that Spiro can really jack your cortisol levels and suppress your testosterone. Add in a dose of Perimenopause and then you're really a hot mess like I am now.

So my advice would be to just keep an eye on the weight gain. I didn't have it happen for many years. Now it seems to have really hit with full force so it will be a long road to losing it. So far, I've had one large zit since stopping three weeks ago, so I'm doing well so far. Fingers crossed. My suspicion is that many of us actually have estrogen dominance in our 30's and 40's but most derms aren't aware of it and just give us Spiro instead. Best of luck on whatever you decide, I've been there!