Adult Cystic and Hormonal Acne - Roseville, CA

After a lifetime of perfect skin everything changed when I got pregnant.
For the last 5 years I have suffered non-stop from what seems to be hormonal acne. What makes my case significantly different from others who have been diagnosed with hormonal acne is that my acne has always been mainly on my forehead.

When I first started breaking out I used all the topical and acne cleansing systems out there. Dermalogica, proActiv, X-Out, Neutrogena acne line, etc. Would get cortisone shots directly into the acne and even used the Zeno Hot Spot (which I really liked and depending on what kind of acne you have, it can actually be really useful). When I miscarried I consulted my dermatologist and he wrote me a prescription for Doxy and other prescription grade topicals. Nothing was really working. I would think it was making things better but then the acne would return. The whole experience was traumatizing to me, I had a whole new respect for people with skin issues.

When I got pregnant again (a few months later) I had to stop the oral prescription meds.

My acne was a mess throughout the pregnancy and continued after. My breakouts were cystic and so my face hurt a lot of the time, I was feeling pretty bad about life. A new baby, things should have been exciting and beautiful but catching my reflection in a window just made my chest tight and gave me that sinking feeling of despair. I had to do more. Started eliminating things from my diet, but if things made a difference it wasn't enough to clear my skin.

Went back to the dermatologist and I started getting acne extraction facials. They were excruciatingly painful, my eyes would just stream tears non-stop as my aesthetician would twist, squeeze and lance the inflamed sites. There was still something about it that was satisfying, like we were clearing everything out. My face would look horrendous immediately after and for the following few days but I could tell it sped things along nicely.

In summary over the last 5+ years my face would act up then calm down a little, then act up again and again and again. When I felt like my skin had looked better than it had in years, I would break out soon after. Fast forward to this last fall, I was written a prescription for Spironolactone. I held onto it for a while before taking it and when I did I lowered the initial dose by 25mg in the evenings, mainly because I suffered some typical side effects (lightheaded and dizzy) and so I just wanted to ease into it.

After taking it for a few months I noticed that my breakouts were less "severe". They still happened but this stuff was actually working (for the most part). It seemed as though I would still break out a bit the week before my period (usually between 1-3 blemishes, pretty big, deep like before). I started freaking myself out about being on medication twice daily and for so many months so I called the Derm and asked what my options were. They said that everyone is different and that I could try coming off of it and taking it during that week before my period or if I start breaking out again. I tried the on and off technique but I feel like I might not have been on it for long enough to start, I read that spiro can take 3 months to really start working.

March (2016) was a REALLY stressful month and I've noticed that stress can be a trigger for my breakouts. I broke out really bad again. I then made the executive decision to be very disciplined and consistent about taking the Spiro, not skip doses, not lower the dosage and not go off and on. I've been on it consistently for almost 2 months now. Same scenario as before, still break out but not as severe. Last time I went to go and get an acne extraction facial about a month ago, I was talking to a different aesthetician and she asked me if I had tried Retin-A, I told her the Derm prescribed it for me but I just hadn't picked it up. When she broke down WHAT it did, I realized I was thinking it was something different entirely (thought it was like Accutane).

Retin-A is a really strong exfoliant and it processes the skin faster. With my pigment, acne scarring is pretty prominent and although I exfoliate daily using a wipe with a rough side (and exfoliating cleansers), it doesn't renew the skin efficiently like Retin-A does.

So in these last few weeks I've started using Retin-A, in addition to the Spiro. I did a lot of reading online about it and everyone has me terrified about the purging that the skin goes through so I've decided to take it easy and just apply twice a week.. Once on Monday night and once on Friday night. I've only seen very minor peeling so far. Fingers crossed. Stay tuned for more (as if I didn't totally just flood you with my acne tales).

*sigh* wish I had something better to report but I'm at that week before my period and I can always tell when my hormones are crazy because of the intensity of my PMS. Now over the last 5 years, my skin tends to break out during my "week before" and this cycle is proving to be no different.

I have been on Spiro consistently for the last few months now. I'm holding onto something I have read which stated that it can take 3 months before it is truly effective.

In addition to the Spiro, I added Retin-A (2x per week) about a month ago. I am still easing into it, after being totally freaked out by everyone's experience on here with the "purge" phase.

What I noticed with the Retin-A is that if I do get a blemish, it seems to process faster. I apply heat in the evening and by the next morning there would be a head on it which I could just pick right off and drain the contents (deelish, I know).

My acne before was DEEP and cystic, usually painful and would rarely move to the surface.

Here I am at my first "week before" after starting to Spiro and Retin-A combo. I'm definitely breaking out :( the actual blemishes themselves don't seem to be as bad as before but there are still plenty of them and enough to make me self conscious in public (WITH makeup on).

Stay tuned for more...

I can hardly believe how liberating it feels to have my skin clear again. Part of me is terrified to even express it because of how on-and-off my skin has been over the last five/six years but instead of worrying about jinxing myself, I am going to just be grateful for how it is all going in this moment.

My plan was to take both Spironolactone (50mg at 2x per day) along with Retin-A (1%) every other night, for three consistent months to give the meds time to really work. I read somewhere in a thread online that "sometimes Spiro can take upwards of three months to really have a full effect" and I took it to heart, so glad I did. Previous to April, I would take it for a solid month then try and see if I could go without it.. I tried taking it during that week before my menstrual cycle (when my skin would really break out).. I also tried lowering the dose a touch, out of random fears of consistently being on medication and none of that worked out for me.

For the first few cycles (I've had three since I decided on this game plan) I still broke out the week before my period. The first cycle of the three I broke out the worst. Hormones didn't seem to be in check quite yet and neither was my skin. The second cycle I noticed that I still generated a blemish or two but there was something different about them. They weren't as deep and they seemed to go away quicker, which I attribute to the Retin-A (powerful exfoliant).
Between the second and third cycle I had a major epiphany, I didn't feel as psychotic as I used to, just about things in general. Things that would normally send me flying off the handle, I would just take in stride or just deal with it the way I used to, like In the "long long ago" when I was seemingly more level headed (pre-1st-pregnancy days).

So now there is no doubt in my mind that hormones are the key player here and it explains why Spiro worked so well for me, it targets hormonal acne in women. If anything changes, I will post an update. Also I plan on trying to work my way off of these meds slowly and I will document that as well.

My advice to you? Stay optimistic. Hook up with a solid Dermatologist and come up with a game plan. If it doesn't work, try your best to maintain your optimism and just push on to the next treatment plan. It's all just a matter of finding out what works for your situation (I know, I'm being Captain Obvious right now). When my skin was at it's worst I got SO DEPRESSED, I felt SO HOPELESS and ANGRY. I wondered all the time WHY!? WHY on EARTH is this happening to me?? Is this karma? Was I that shitty of an individual to deserve this? The hopelessness would set in from different methods not working and the depression from having to restart something new. It was a horrible cycle. Stay lifted, hopeful and optimistic. If there is anyone who knows how brutal this scenario is, it is yours truly. Good luck to you.

Side note: I bought a Clarisonic a few months ago and I love it. I use it in conjunction with Cetaphil's Oil Control foaming Facewash.