Spironolactone
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Spironolactone is a type of oral medication called an anti-androgen that is sometimes prescribed to females. Androgens are male hormones that are present...

Spironolactone is a type of oral medication called an anti-androgen that is sometimes prescribed to females. Androgens are male hormones that are present in both males and females that lead to more acne, and spironolactone helps reduce androgens.

It is usually taken once or twice a day, around the same time(s), preferably with a meal.

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July 1, 2007

Pros:

Realizing that most medications need at LEAST 3 weeks to start working. Also, side effects are starting to subside at week 2 and drug is really cheap.

Cons:

GI side effects (upset stomach, pain), palpitations, dizziness, cystic zits!

I started this after being on Diane 35 for about 7 years. Diane 35 made my skin absolutely beautiful. I couldn't handle the side effects (headaches, chest pains, worsening eye sight, risk of DVT, etc.) anymore so I got off it thinking my "high school" acne would be gone by now. My face broke out again and I have been battling it for almost 2 years now. I have tried everything and when used "consistently" it works (especially benzoyl peroxide) but I hate putting "extra" things on my face and burn like crazy when I got out in the sun. I started with 25mg per day for one week and now use 50mg per day on week 2 which I am going to maintain for at least a month before bumping up the dose again because the side effects were horrible. Upset stomach, palpitations, chest pain, cystic acne on my jawline and cheeks (never had this before), etc. It took Diane 35, 3 months to "fully" kick in so I am giving this a "trial" for 3 months too. I will up my dose from 50 to 75mg in 3 weeks..
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July 1, 2007

Pros:

Great for adult acne. I started to breakout when I hit 45 (hormones?. Started taking it a week ago and I have had no new breakouts. Skin is looking back to normal!

Cons:

If you don't have health insurance, it's a bit pricey. Am I going to have to this forever now?

I'm 45 years old so I suspect my sudden "breakout" was due to hormones. Tried retin A, over-the-counter products and nothing worked. My dermatologist put me on Spiro and an antibiotic. Since I can't go on birth control pills, Spiro was the best choice. I am gaining my self-confidence back. Having acne made me late for work (having to cover them takes forever) and I was even afraid to even look at my face in the morning. Now the question, will I have to be on this forever, or will my hormones balance themselves out?
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July 1, 2007

Pros:

This is the only thing that has cleared my acne.

Cons:

My dermatologist never mentioned anything about potassium issues so I am a little concerned - but the effects are so incredible that I will do just about anything to keep taking these. Also, you need to keep taking it -once you go off it,acne returns

I have tried the following: *Almost everything/anything topical *Photodynamic therapy w/ Levulan (cost $1300) *Antibiotics *Doing everything "right" - washing w/ Ovace, all products noncomedagenic, etc Spironolactone is the only thing that works. Proves that acne in caused internally. I was warey of it at first but was ready to try anything to clear up my skin for my wedding - it made a remarkable difference. After the wedding I stopped taking it... skin went back to it's normal ways. A month ago my skin was so horrible that I decided to resume it -- and here I am again at almost 2 weeks into the treatment and pores are smaller, skin is clearer...no plans of getting off of it anytime soon.
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June 21, 2007

Pros:

Works better than anything I have tried for hormonal acne and oily skin which I have had since I was 12.

Cons:

Remembering to take it twice a day.

I am 43 years old and have suffered with oily skin and acne seems like most of my life. Nothing has worked this well. I take 25 mg twice daily. My skin is less oily w/no breakouts. What more could I ask for. A little oil is ok. I don't want to dry up and look older. I would recommend this med under doctors orders for anyone who has tried it all. You will be amazed.
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June 11, 2007

Pros:

spironolactone was the only thing that worked for me

Cons:

you gotta maintain taking it

i had been on every topical, antibiotic, and even accutane. in 2002, i convinced my derm to put me on spironolactone after doing research on the internet. back then, it was rarely prescribed for acne. i had been tested for out-of-whack hormones, but the lab results always came out okay. however, i only ever got pimples along my jawline, lower cheeks, and onto my neck right on the sides of the the windpipe. the derm put me on 25 mgs/day, and i had to push to get it up to 50mgs/day. it took a while, but my skin cleared up. i lost my health insurance and went off spironolactone and within 3-4 months, acne was back on. i've since ordered spironolactone off the internet and started 100mgs/day about a week ago. so far, oiliness is decreasing. i'm confident things will get a lot better within the next couple months. i STRONGLY recommended for women, probably even before any antibiotics.
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May 28, 2007

Pros:

Oil reduction

Cons:

Really really really bad breakouts in the first month or so.

When I started out taking Spiro I had one zit on my chin. Just one. During the course of taking it (it's been a little over 3 weeks) I have gotten *dozens* of zits. Now I have red scars all over my chin and forehead area. Seriously. I hardly ever leave the house and never ever look at myself in the mirror because I'm too afraid I'll start crying. When does this stuff start working? I am sick of looking awful. I'm just about at my wits end with this drug.
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May 26, 2007

Pros:

My skin is clear, not oily, my period is regular again, and I don't have leg/ankle edema at the end of the day anymore!!!

Cons:

If I drink alcohol, the combination makes me pee like crazy. Sometimes I have to go to the bathroom in the middle of the night.

I had moderate, non-cystic acne in high school. I went on accutane when I was 17 and it cleared my skin up great. No one in my family has had cystic acne. Then, all of a sudden, when i was 24 I started getting cystic acne. I would get 2 or 3 BIG nodulo-cysts a month. They would take 6 months to come to the surface and would scar. I went on accutane again for 8 months, which helped somewhat, but I was still breaking out while on the accutane up until the last month on it. I was really demoralized. I was also having a lot of problems with bleeding when I wasn't supposed to while on birth control pills. Then, 3 months ago my derm put me on 50mg twice a day of spironolactone. This stuff is great!!! My skin is PERFECT again, dry, and my periods are normal again. I've also stopped getting ankle edema by the end of the day. I wish I had tried this sooner. I would recommend this to any woman who has adult-onset cystic acne.
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May 17, 2007

Pros:

I'm 30.Started with 50mg for hormonal acne and hirsutism.After one month raised it to 100mg, which I take every other day. It cleared my skin like accutane without drying it and without the super nasty side effects. Use it without the BCP.

Cons:

the fact it messes with you potassium and sodium levels in the body can create letargy and lack of energy. You need to control your diet when on Spiro and never eat food rich in potassium (bananas, nuts etc) otherwise you might develop hyperkalemia

If you are over 25 and still with acne,, or you are younger but have other simptoms as well (alopecia, oily skin, hirsutism) chances are you have hormonal acne. That means that you can either have too much production of masculin hormones (androgens/testoterone) or your skin receptors are too sensitive to a NORMAL (within the range) level of hormones. So the skin converts the normal level of masculin hormones circulating in your body into a greater amount of acne, oil, body hair etc. Don't let the doctors convince you that if your hormones levels are within range that you do not have hormonal acne. There are lot of respectable reaserch atesting to that. Spiro is a great way to get rid of acne (hormonal or adult) acne, with almost no negative side effets and can be taken during a long period of time. Much better than pill. I take it without BCP, and i take 100mg 4 to 5 times per week. You don't need to take it every day mind you!Apart from a bit of lack of energy, no side effects for me!
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May 12, 2007

Pros:

Clears up, just slowly. The pills even have a little bit of a minty taste. They also make you go to the bathroom a lot, which made me lose weight, so I am not complaining.

Cons:

A little lethargic, especially in the morning for me.

Talk to your derm and see what he/she says. I have had very little side effects, and if I did have some, I didn't mind them. Yes, it did make me break out worse at first, but be patient. Just make sure and drink plenty of water. Basically, I have battled awful complexion for years now, done all of it (accutane, antibiotics, and everything else), I have only been on this for about 6 weeks, I am still not clear, but I am seeing a glimmer of hope that I will be (my face and scalp are so much less oily). I am sticking in there and seeing this pill through, I have seen improvments, patience is the key! I will post again in a few weeks.
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May 7, 2007

Pros:

I've tried everything - even accutane (which worked perfectly for about 2 years after stopping it) but then slowly but surely the acne came back. Spiro WORKS... I almost gave up on it when 2.5 weeks passed with no changes for the better or worse.

Cons:

Started working week 3 on 100mg

Be patient!!
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.
Find a Doctor Using The American Acacemy of Dermatology Website

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.
Find a Doctor Using the American Society of Plastic Surgeons Website