Even since last Thursday, things appear to have improved a little (*knocks on wood*). I quit using my Retina-A gel because all the dead skin sloughing off my face induced probably way too much scrubbing with a wash cloth to remove it. It also made my skin dry enough to require a moisturizer and, for the life of me, I have yet to find a moisturizer that I trust to not make me break out. I've tried everything from Burt's Bees Acne Lotion (which, in addition to seemingly make my acne worse, also makes my face smell remarkably like fruit loops) and even Pro-Activ's green tea moisturizer. Maybe I'm just paranoid about putting things on my face (I'm sure you can relate), but I'd be interested to hear what tried and true lotions you guys have used with no negative consequences. Anyway, so no more Retin-A which means no more scrubbing and no more lotion.

The other thing that I did was quit (for the second time) using whey protein powder. The first time I had stopped using it was before I had started spironolactone. I thought maybe the whey was the cause of the cystic acne, but it didn't seem to improve when I switched to a plant-based protein powder. So I started on the Spironolactone and began with the whey protein powder again. Now I'll try to go without it once more and see what happens. [So a side note to all my fellow fitness junkies, if you haven't come across it before, there is some evidence/speculation across the internet that whey protein powder is not-so-great for your acne. Not sure if it's the problem for me, but might be worth investigating if it's the problem for you.]

Updating, mostly because I feel like the first photo I posted doesn't really capture the extent/severity. Coming up on 2 months of Spironolactone now. The initial progress that I thought I was making has now pretty much been annihilated, and I'm back to nearly the same level of severity as when I began 8 weeks ago. Summoning every ounce of patience I have; feels like I haven't got much else to do. Wait, wait, wait. . . 

Had a dermatologist appointment today. She still firmly believes that I will start seeing results from the Spironolactone "soon." But I expressed that I had some anxiety while waiting for this to happen, and she agreed to prescribe me two months of Doxycycline. Even though it had seemingly quit working earlier this year, I have now been off of it for several months and have some hope that a new round will work to provide a temporary fix until the Spironolactone has time to reach full efficacy. She also prescribed Differin as topical solution since the Tretinoin creme was a bit too intense. Of course the Differin bottle says that an initial break-out is to be expected. So that's cool.

How long is Spiro supposed to take to see improvement? Let us know how the Doxy works.

She couldn't really tell me. I told her that I'd read online that it usually took about 3 months, but also that it could take anywhere from 6 months to a year as well (hence my anxiety about waiting). She had only responded by assuring me that in all her years of dermatology, it has "never taken anyone a year to see results." It's been a little over a week on the Doxycycline now. No noticeable changes or improvements yet, but that would have been extraordinary. Hopefully I'll be back soon with some good news!

Hi Rachelle. It took over a year for me to see some consistent results and even now, i still breakout. 6 months is just a guideline but many don't fall into that category. Keep your head held high friend.

Well, it's been about two weeks on the doxycycline now (plus the Spironolactone-2.5 months; plus the Differin creme-2 weeks). It's hard to tell (while comparing photos) if there's been much improvement, but I feel like maybe there has been. . . I still have a lot of hyper-pigmentation, which I think is masking the fact that there might be fewer active pimples (at least that's what I'm telling myself). There definitely seem to be fewer cysts though and that is certainly cause for celebration. At this point, there are really only two, and they're both quite. . . deflated. Seems like pimples are appearing less frequently.

On a personal note, I'm going home for the Christmas holidays in a couple weeks and I'd really love if the Doxy kicked it into high gear before then ("Dear Santa. . ."). Nothing like running into exes when your self esteem is suffering.  Am I right? 

Hi Rachelle, I'm in a similar situation as yourself with the Spiro. I've been on it for about 7 weeks (started at 12.5 mg for a week, then moved up to 25 mg for a few weeks, and now i'm on 50 mg for 3 weeks) and it's not seeming to be doing anything yet except make my acne worse. I am breaking out in places I've never broken out before. I was put on Cephadroxyl (antibiotic) to help with this initial break out and have been on it for almost 2 weeks and it doesn't seem to be making a difference as of yet. How are things for you now? I have read so many reviews on this website and like you am holding onto the hope that everyone seems to write about that it just takes time to work. It's definitely hard with the holidays coming up too! Seeing friends and family and facing everyone with this condition is so hard... praying we both see results soon!

3 months on Spironolactone, 3 weeks on Doxycycline, 3 weeks on Differin

While it probably doesn't look like things have improved, I am convinced now that they have, at least a bit. Most of the redness I have is residual from previous acne. My skin feels almost smooth now, even if it doesn't quite look it just yet. At least the hyper-pigmentation is relatively easy to hide with make-up. The problems that I'm dealing with now are smaller and quickly come to a head. No more cysts! At least for the moment; there might be one that appears on the other side of my face soon. 

I feel like the Doxycycline is doing most of the work. Unfortunately, I won't know if the Spiro has stepped up until after I stop taking Doxy in 5 weeks. My dermatologist also pushed my Spiro prescription up to 150 mg per day. 

Weid(wo)man, thanks for your comment. I hope you start getting relief from the antibiotic soon. I feel like those generally work much faster than the Spiro. It took me 3 weeks to start seeing improvement with Doxy, so hopefully that means it will be soon for you too. I don't have much hope to offer on the Spiro front just yet. It's so hard to have the patience that it feels like the Spiro requires of its users! Good luck, my friend! 

Quick update. My face had been improving, but as that damned time of the month drew nearer, it became worse once again. Seems to be that about the week before I actually start my period is the worst, and it improves afterwards. Which is a step up from when it was bad all the time andreallybad around my cycle. This round did seem a little bit less severe, thankfully. Only a few cysts. Again, pretty sure this is Doxycycline doing all the work, but who knows for sure? Side effect note: just these last 10 days my boobs have been killing me! Somehow hadn't seen that one on the side effects list before, but the breast tenderness is real.

Hey Rachelle-
Thanks for your reply a few weeks ago. Its so nice knowing were not alone facing this battle. Im 32 and I have 4 little boys so I sometimes jusf cant believe Im the only mom in my group of friends who has acne! Sigh. Anyway, how long have you been on the Spiro now? I had to stop taking the antibiotic I was on because it was making me so sick and I was losing so much weight. Ive been on 100 mg of the Spiro now for 3 weeks. Before that I was on 50 mg for almost a month. My skin is still the same. I cant seem to get rid of these freaking deep zits down by my chin. They just hang out there all the time. and my forehead continues to be covered in little flesh colored closes comedones. I squeeze them then they bleed and get awful scabs. Sorry if thats tmi. Im just starting to feel afraid this isnt going to work for me. I want to give it at least 4-6 months though so that means I have to wait till April. Ugh. Do you use a moisturizer? If so what kind? Ive not found one I feel safe using because Im so worried itll break me out. Also Are you on birth control? My doc says that is something we could consider adding in but Im not really wanting to until Ive given the Spiro 5 or 6 months. Thanks in advance!

Hey Weid(wo)man,
I'm at about 3.5 months now. I've been taking 150 mg/day for about two weeks. I'm not sure I'll know what's really going on until after I've finished the two months of the antibiotic. I'm sorry to hear the antibiotic didn't work out for you. I agree that's it's very hard to be patient and trust that the medication will work. Feels like I'm about out of other options though, unless I want to bite the bullet and take Accutane, and I'm just not sure I'm ready to take on that hell yet. So wait it is! I do use a moisturizer; my dermatologist assured me that Cera Ve shouldn't create any problems. It doesn't seem to have made it any worse at least and I've been using it for over a month now. I am on birth control, some off brand low-dose pill that shouldn't be affecting my acne one way or the other. Have you tried any birth controls that are prescribed for acne? They actually do work wonders; I feel like most women benefit from using those birth controls as far as acne goes whether they realize it's happening or not. I just can't tolerate high dose birth controls like Ortho Tri-Cyclen or Yaz, or that's what I would be doing!

Thanks so much for responding to me. I actually got some of the CeraVe AM and PM face lotion and so far it seems okay but it sorta burns my skin. Ill definitely keep Birth Control in mind in the next month or so if the Spiro doesnt kick in. I think Im just afraid because Ive read horror stories and reviews on how it made acne worse at times. Who knows. Sigh. Its so depressing not having an answer to why this is skin condition is happening. And I agree, I also do not want to have to consider Accutane but honestly at this point if the Spiro doesnt work in like 4-6 months its gonna be my only option left. Just out of curiosity, do you feel like youve seen any improvement with being on the Spiro? Or do you think that any clarity you have is because of the antibiotic your on...? Thanks again!
Praying we both see results soon!!

Updates: I've just wrapped up my course of antibiotics (Doxycycline, 100 mg, 2x daily, 2.5 months). The doxycycline definitely brought me some much needed relief. I haven't had a cyst in over a month. I'm still getting some smaller things, but not that frequently. Compared to the cysts, these almost don't even phase me. The hyper-pigmentation is starting to fade, and is really only persisting along the jaw-line where the cystic acne had been most persistent and severe. If I'm wearing make-up, you basically can't even tell. It is such a RELIEF to finally feel like myself again. Right now I have one pimple. ONE. The rest of my skin is actually almost completely smooth. I'm still using some Differin, which supposedly promotes skin turnover, and potentially will speed up the process of reducing the hyper-pigmentation. 

I met with my dermatologist on Thursday. We decided to up my dose of Spironolactone to 200 mg/day, the highest that they'll prescribe, but in compromise, she did not continue my doxy prescription. She told me that if, by my follow-up in 5 weeks, the cystic acne is returning, she'll issue another round of doxycycline. But we're really hoping that just the spironolactone will work. We're at 4.5 months now. I also switched birth controls. I just started Yaz yesterday. My stomach seemed to actually tolerate it okay, so I might stick with it for a little while. Supposedly, Yaz is the most effective birth control at controlling hormonal acne. But then it also comes with some side effects (like a higher risk of blood clotting). We shall see! 
 

Your skin looks fantastic! Im so happy for you! I am so hopeful the Spiro kicks in for me in another month or so. I hope it continues to work for you. Thanks for the update, it gives me hope to keep pressing on and stay positive.

Wow reading all your posts I feel like I can relate so much. I was on doxy years ago and it was a lifesaver I was clear for years until my BC randomly got switched to a generic version and my skin went to shit basically. Iv been on Spiro for 2.5 months and finally asked for doxy again to help cause I have gotten no relief so far. Your skin looks awesome in your newest pic compared to that first one you put up!! That's awesome and it's giving me a bit of hopefulness while I wait out the spiro. It's definitely not an overnight miracle drug. So frustrating!

I was really worried that after stopping the doxycycline everything would just come creeping back. . . but it hasn't! I guess it's only been a couple of weeks, but still. This feels promising. 

I appreciate your guys' support. I hope to hear that you get some relief soon too! Cyn2711, any chance of switching back to your other birth control? Or finding a new one? 

Just some other notes on side effects:
Since I started the 200 mg/day dosage, I have been experiencing some extreme fatigue. I'm a pretty fit person, and lately, even just long walks feel like significant trials. My body just feels. . . sluggish. I'm hoping that I'm just in an adjustment period right now, and that my body will learn to tolerate this dosage and will find a way to compensate? Other than that, I haven't noticed any other significant symptoms (other than peeing a lot, my gosh--I had to significantly increase my uptake of water to stay hydrated).