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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June 10, 2009

Pros:

fewer cysts, shorter duration of break outs, smoother skin, mild weight loss, less mood irritability, increased sex drive

Cons:

occasional light-headedness

If you are in your late 30's and suffering form hormonal fluctuations, then this medication is for you. Not only has it helped me with the acne, but I also experience less premenstrual irritability. My sex drive has increased since I started this med. Perhaps this is due to increased self-esteem now that my skin is clearer and I've lost a few pounds. I love this medication!
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June 10, 2009

Pros:

clearer skin, less cysts (normally 8-12 each month)-this month only 2! Skin feels smoother, less facial hair growth

Cons:

Feel some weakness, heart palpitations. Swelling in lower arms, hands?

Started taking this "wonder" drug about two months ago. I've had acne since I was 10 years old. Have taken Accutane 3x but each time after taking the cysts, oil, etc. came back with a vengeance. First time IN MY LIFE (I'm 48) that I've had skin that's not loaded with breakouts. I do have a question, though for others that are taking this drug- my lower arms/wrists/hands have been swelling and are painful since I started taking this med. Today the skin is even painful to touch and it feels like my arms are going to 'bust.' Has anybody else had any symptoms of swelling, etc. like this?? I am currently taking 100mg daily.
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June 6, 2009

Pros:

Hang in there--everyone's hormones are different. I havent had a cyst since the 3rd week, and my blackheads are gradually disappearing (I am in my 8th week). I also feel like I need to shave my legs and pluck my eyebrows a lot less.

Cons:

One big breakout a week in. For the first 2 weeks, it was hard to sleep and I had to go to the bathroom a lot. Now, I get pretty tired about 2 hours after a pill. I also have noticed I feel like my body temperature is much warmer.

I don't have insurance but the Spiro is worth the $60/mo. I pay (I take 50 mg in the morning and another 50 at night). This works by reducing the aldosterone and testosterone in your body, so its usually prescribed for women only--but less testosterone means less oil, bigger breasts, mild weight loss--all were big plusses for me. It does take time to see results, but I've been struggling with acne so long (since I was 12 and I'm 30 now) and tried so many treatments (incl. Accutane), I was willing to wait. After a breakout one week in, my skin has improved a little bit each day; I'm getting lots of compliments now, and feel like I can just shower and go without having to take a lot of time to put on makeup. One caveat for me was that after 2 weeks, your doctor will want to check your potassium levels with a blood test (since Spiro is also used to lower blood pressure, potassium becomes really important)--I'm scared of needles, but it was worth it! Try it for at least a few months!
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June 5, 2009

Pros:

My skin is perfectly clear, skin & hair is less oily then it's ever been, less body & facial hair, weight loss (no belly bloat), hair & nails growing faster, breasts are larger & firmer!

Cons:

Urinating more often, leg cramps from dehydration (went away when I started drinking more water), shorter time between periods & fatigue (also went away when I started drinking more water).

This is the best thing I have ever used for acne. I am 40 years old with cystic acne and extremely oily skin & hair & I have tried EVERYTHING! I started taking Spirnolactone over a year ago. I noticed a difference within 2 months & I have been acne free every since - with the occasional (1) I might get the week before my period which now I take Bactrim the week before and that keeps me from getting any. I drink a lot of water and it keeps me from being fatigued & I don't get leg cramps. As for urinating more - it isn't bad enough that I have to get up in the middle of the night but I can tell a difference. I can also tell a huge difference in the amount of water weight - I no longer have the the belly bloat & my breast are definitely more tender but this is a positive thing since they are also firmer and larger. I try to tell every woman I meet that has acne about this drug because it is the best thing out there! I wish I would have know about this 20 years ago!! :) Good Luck :)
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June 2, 2009

Pros:

Some weight loss, fewer breakouts, less oily skin.

Cons:

More restroom breaks the first week, and fatigue. However, it only lasted about a week.

I'm 5 yrs old and started getting acne at age 16. After I had my son, I went on Ortho-tricylin and it did improve. (about half of what I was getting) However I started to get some cystic ones,but mostly med. sized ones. Of course I'm a picker so that only made it WAY bigger and spread...it was horrible. I am currently taking 50 mg. daily, seems ok. I would say on average you would see 3-6 pimples (one of which was usually a cystic on a day that would just NEVER go away!) I've tried the usual ortho-tricyclin, Proactiv, Yaz, doxy, Murad...everything OTC. NOTHING helped. I got by with TONS of benzoyl peroxide, good covering makeup and tanning. ( I know...a no no. But it helped dry it up! And I still do it!) After 3 weeks..it has almost cleared the acne on my neck, back and chest. I'm going to the beach right after my period..so I am thinking about taking 75 mg the week before my period so i can actually swim when I'm there and not worry about not having make up on! Good luck to all!
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May 31, 2009

Pros:

I started taking spiro in Jan, but unfortunately stopped in Mar because I wasn't sure if it was working. Ironically, looking at pictures now I realized my break-out were mainly on the surface and all the under the skin stuff was really clearing up!

Cons:

I've noticed some muscle aches due to dehydration, so I've started drinking more water. I also know it's going to get worse before it gets better.

I've had acne since I was 12 but it's gotten far worse since college, nothing over-the-counter was working, and I realized it wasn't just going to go away. According to blood work, my doctor discovered that my DHEA (hormone) levels were twice that of an average female. Basically my hormone levels were all out of balance and that's what was causing my acne... and probably also my excess hair growth (thankfully I'm blonde), my muscular build, and small chest size. I'm hoping I can stick with it this time, because I know I will see results eventually. I'm also trying to decide if I should combine this medication with the pill, has anyone seen a more positive outcome by combining the two?
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May 31, 2009

Pros:

works great skin is less oily less breakout no cyst hair is less oily as well

Cons:

the only side effect for me has been decreased libido (yikes!) i hope that will go away

i love this med i have also tried everything from Rx to Otc. oral and topical this is the first thing to give me this much hope in a long time. The thought of having bigger boobs is a nice plus i just hope that im one of the ones that this happens for. if you think your acne is hormonal you should definitely give this a try its very affordable as well just be sure to drink plently of water.
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May 29, 2009

Pros:

It started working fast - I had one more breakout but everything is clearing up great! Back and face!

Cons:

A LOT of fatigue. I am an avid runner - and there is an extremely visible decline in my stamina and endurance. Overall though, lacks the cons of other treatments. I've had no mood swings or weight gain and haven't even noticed breast tenderness.

This is definitely worth a try if you're at your wits end trying to get your acne to stop appearing.
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May 29, 2009

Pros:

cheap, easy to take

Cons:

made me feel dizzy and very sick most of the time, didn't notice any improvement in my skin

This medication apparently lowers your blood pressure so if you have normally lower blood pressure like I do, may not be worth it. I stuck with it for a month but with no results I couldn't handle the side effects.
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May 27, 2009

Pros:

The only thing that has worked. It feels like a miracle that I rub my face with my unwashed hand while I'm at work and not freak out about giving myself a breakout. Instead I think about how soft and smooth my face feels. + My hair is no longer oily.

Cons:

4 months to really start working. My skin went from kind of bad to beyond horrible. Like taking Accutane, but the break outs were all cystic, itchy and on my jawline and neck only. I also experienced a few of heart palps. My boobs are too big now.

If you can stick with it, you will finally be happy with your skin. My skin started breaking out when I was 15 or 16 and I'm now 38. I took Accutane, birth control pills, IPL (which worked for 1 year, but it cost $1200), but my skin always eventually broke out again. Interestingly, it was a Physicians Assist at my derm's office that suggested I take it. I started out with 25mg and worked up to 100mg. I read this blog back in Dec and it gave me hope to stick it out. Believe me, I wanted to quit because I started dating a new guy that month and was literally crying on New Year's Eve because my face was a mess. The guy is still around and told me last week how great my skin looks. If you decide to take this medication, I suggest you find a great facialist to get a series 6 peels and monthly facials while you're waiting for the magic to start happening. The PA agreed this would be helpful. My facialist told me that she hadn't seen such dramatic improvement in her 20+ years working. :)
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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.
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