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Spironolactone not working 4 months in??? Advice please!!

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Hey all. So devastated to be on this site again :(((

After 6 years of smooth, 100% acne-free skin I dropped my daily dose of Spiro from 100mg to 50mg around Nov-Dec last year.  For about a half year, nothing happened apart from a couple spots (1-3 a month). Then suddenly in June acne came back with a vengeance - one on top of the other.

Ever since then, I raised my dose to 100 then 150 and evenualy 200mg-s. Acne decreased, and could go 3+ weeks without red spots, but was never free of whiteheads - the kind that could flare up any day. The first time Spiro got me clear after 3 months, now it's been 4 and I'm still breaking out with new whiteheads and the occassional red spot/cyst, and the old ones left marks so my skin looks awful overall. Now I got a couple of cysts/whiteheads out of nowhere, just when I thought I was out of the woods!

I'm beyond devastated and about to start accutane for a 3rd round (previous ones were low dose and short). I hate the idea of going to the 'tan (especially that my eyes are bone dry as they are and wouldn't fancy permanent conjunctivitis).

Should I stick with Spiro???

ANY INPUT AT ALL would help me.

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I have hormonal acne and dapsone 5% gel helps to stop early bumps from turning into whiteheads/clearing up a lot quicker. Zinc picolonate also helps. My hormonal acne also has to do with insulin resistance and flares when I eat high GI foods so bc, Spiro, berberine, and metformin helps with that.   

Edited by hlp334
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Hey. Last year I was in your shoes. I too suffered from cystic acne before that accutane took care of. Imagine how devastated I was to turn 32 and get hit with the worst cystic acne/hormonal breakout ever :( I felt hopeless and suicidal and couldn’t believe I was dealing with it again. So I was put on Spironolactone. I thought it was helping but then I couldn’t tell, 5 months had passed and I was still breaking out! My dermatologist told me to stay with it. Which was hard because I was collecting more scars. After about 7 months I noticed a big difference. Just a few but significantly better. It’s been a year now and I am 100% acne free and the scars have improved although they’re still there sadly. 

I got frustrated about 5 months in and told my dermatologist I wanted accutane again because I was so depressed to be in five months of treatment and still my face was a mess. They refused because of my depression from acne, glad I stuck it out though because Spironolactone has cleared me up. It takes a long time, longer than I’d like... I wish it was faster acting, but my point is that it does work! You’re on a good dose. Try to remain patient. Stick it out longer. I know it’s hard. Remember you’re not alone. Acne is a hellish nightmare. It WILL get better, I am glad you’ve got 4 months down. 

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