Let me preface by noting that I have had cystic acne all of my adult life. I am middle aged and have tried everything from Accutane (ugh) to topical prescriptions. Because I am also hypersensitive to most oral and topical medications, typically I have unusual and/or severe reactions. With that being said, I feel like I am the poster child for what symptoms an individual could possibly experience on the "negative side effects" end of the spectrum. It should also be noted that about two months prior to beginning treatment with Spironolactone, I began using a topical solution of vitamin B3 (niacinamide 5%) by Gia Naturals in place of my very expensive Dr. Dennis Gross moisturizer. The results were noticeably positive but not spectacular. Additionally, I use Bare Minerals liquid foundation, GloMinerals compressed powder, and Lancôme blush to avoid makeup based flare ups. Regardless, I was still having trouble with slow healing and (mostly) hormone related cysts. At my wit's end, I went back to my dermatologist. He prescribed an initial dose of 50mg of Spironolactone to start my treatment. I took the first pill around 7pm and within hours developed a severe dehydration-type headache that lasted all night and part of the next day. I called my dermatologist and after explaining my symptoms, he instructed me to cut the 50mg pill in half and try the lower dose before deciding to give up on the Spironolactone. I did and, thankfully, had no more headaches. I continued to take the reduced 25mg dosage for a couple of weeks (along with the above-mentioned products) and was seeing signs of improvement! About five days ago, with my menstrual cycle looming, I got brave and began taking the entire 50mg Spironolactone pill. I am happy to report that the headaches did not reappear and I made it through the worst of my period with no new cysts. The only side effect I have experienced over the past five days on the increased dosage is a notable tiredness. Bear in mind though, I am a 7th grade English teacher and my tiredness could be symptomatic of dealing with 85 twelve to thirteen year olds with spring fever while I am on my period!! Overall, I am cautiously optimistic about Spironolactone. My side effects have been manageable, the results thus far have been notable, and most importantly, the long term use of Spironolactone poses no significant physiological or psychological threat to users according to long term research findings. If you are considering Spironolactone, it is probably a safe bet to at least give it a try. As the poster child for side effects, however, I suggest starting with a low dosage and working up to higher dosages as your body becomes accustomed to the drug. WISHING YOU THE BEST! Sharron Z-W Post Script: I failed to mention that during this time I also began taking 500mg of vitamin B3 (niacinamide) orally every day along with my Spironolactone. My dermatologist said there are no contraindications and the vitamin is better absorbed when taken orally. (Please see research on vitamin B3 use for problem and/or aging skin)
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