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Suggest Treatment For Bad Acne On Face And Back
Question: I just started taking 50 mg spironolactone 1x a day (I take with dinner) about 4 weeks ago.
This is for acne that developed on lower cheeks and jaw and around lips (and several months after that, on back) and worsened over past 2 years (I'm 43) and longer, fuller and more all over (but still 99% blond at least) facial hair that developed over the past year (used to be barely noticeable teeny hair on limited places).
Before this, We tried everything but accutane during those 2 years (and I'll be happy to try accutane but my dermatologist said this will be easier to try first and I am hoping maybe it will help with the facial hair too).
My hormones fall within normal levels but we had no baseline for me to compare them to and it does seem from symptoms that my body is not reacting right with testosterone. Trying to eat a very strict anti-inflammatory diet (although i already ate very healthily) has actually given me better results than other things we tried over past 5 months, another indication that hormones are the culprit.
Anyway, so far there has been some improvement already on the XXXXXXX (I'm also still watching diet).
I'm still breaking out nearly every day or twice a day and still feel like i am putting way too much time and work into achieving what i have. But most blemishes, if not all, dry up by the next day and start on the path of fading away (although I've gotten 4 big ones at different times on chin, which I havent really gotten during all this time, and they take 3-5 days to go away --but I seem to recall I'd get 1-2 like that once in awhile before this all started; I laugh to think I called that acne before ).
My breasts and butt seem fuller and that Is ok.
But I've gone from nearly nonexistent periods to a light-medium one that lasted a full week (if I got one before, it was light and showed up last 3 days before time to start next pill pack and it would disappear immediately after 2-3 days). And this week, I started a little flow/spotting a week early. I started the medicine about 5 days before my last period.
But my stomach also seems bit fuller....
My questions :
(1) staying on same dosage, will I continue to see improvement in acne and increased improvement at that (maybe finally be able to go 2 days or more with applying a topical or 2 days without a fe new blemishes?)?
(2) if not or if maybe, will increasing dosage (maybe 50 mg, 2x day?) possibly increase improvement?
I will be seeing my dermatologist on Friday but I want to go in fully informed.
(3) I suppose I need to remove (either wax or thread) all the current facial hair to judge if the XXXXXXX is helping reduce it?
(4) will this cause me to gain weight? Especially in belly? I'm active and eat very healthy and exercise regularly and have nice lean muscle tone but am also very thin by nature. I don't think I can handle one more negative body thing at this point.... A few pounds Is ok and I'll be happy with bit increase in chest even butt, but .... at least my weight and fitness level was one thing I could improve and feel good about....
(5) I have been on different birth control pills for over 20 years straight and never had long periods, early periods, or spotting. Will my periods likely 'right' themselves over time as my body adjusts to the spiro?
(6) will this possibly help my regular hair? Over past year or so, I also have noticed so much more hair coming out on comb and in hands when comb hair , dry or wet. With long tangly hair, I'm used to some coming out every time and having to clean out shower drains every several months, but it is a lot more lately and shower drains clog after 2-3 months now.
Thank you! I am hoping XXXXXXX helps --I just want to feel pretty again and also be able to get up and go all day without constant breakouts.
This is for acne that developed on lower cheeks and jaw and around lips (and several months after that, on back) and worsened over past 2 years (I'm 43) and longer, fuller and more all over (but still 99% blond at least) facial hair that developed over the past year (used to be barely noticeable teeny hair on limited places).
Before this, We tried everything but accutane during those 2 years (and I'll be happy to try accutane but my dermatologist said this will be easier to try first and I am hoping maybe it will help with the facial hair too).
My hormones fall within normal levels but we had no baseline for me to compare them to and it does seem from symptoms that my body is not reacting right with testosterone. Trying to eat a very strict anti-inflammatory diet (although i already ate very healthily) has actually given me better results than other things we tried over past 5 months, another indication that hormones are the culprit.
Anyway, so far there has been some improvement already on the XXXXXXX (I'm also still watching diet).
I'm still breaking out nearly every day or twice a day and still feel like i am putting way too much time and work into achieving what i have. But most blemishes, if not all, dry up by the next day and start on the path of fading away (although I've gotten 4 big ones at different times on chin, which I havent really gotten during all this time, and they take 3-5 days to go away --but I seem to recall I'd get 1-2 like that once in awhile before this all started; I laugh to think I called that acne before ).
My breasts and butt seem fuller and that Is ok.
But I've gone from nearly nonexistent periods to a light-medium one that lasted a full week (if I got one before, it was light and showed up last 3 days before time to start next pill pack and it would disappear immediately after 2-3 days). And this week, I started a little flow/spotting a week early. I started the medicine about 5 days before my last period.
But my stomach also seems bit fuller....
My questions :
(1) staying on same dosage, will I continue to see improvement in acne and increased improvement at that (maybe finally be able to go 2 days or more with applying a topical or 2 days without a fe new blemishes?)?
(2) if not or if maybe, will increasing dosage (maybe 50 mg, 2x day?) possibly increase improvement?
I will be seeing my dermatologist on Friday but I want to go in fully informed.
(3) I suppose I need to remove (either wax or thread) all the current facial hair to judge if the XXXXXXX is helping reduce it?
(4) will this cause me to gain weight? Especially in belly? I'm active and eat very healthy and exercise regularly and have nice lean muscle tone but am also very thin by nature. I don't think I can handle one more negative body thing at this point.... A few pounds Is ok and I'll be happy with bit increase in chest even butt, but .... at least my weight and fitness level was one thing I could improve and feel good about....
(5) I have been on different birth control pills for over 20 years straight and never had long periods, early periods, or spotting. Will my periods likely 'right' themselves over time as my body adjusts to the spiro?
(6) will this possibly help my regular hair? Over past year or so, I also have noticed so much more hair coming out on comb and in hands when comb hair , dry or wet. With long tangly hair, I'm used to some coming out every time and having to clean out shower drains every several months, but it is a lot more lately and shower drains clog after 2-3 months now.
Thank you! I am hoping XXXXXXX helps --I just want to feel pretty again and also be able to get up and go all day without constant breakouts.
Brief Answer:
Spironolactone for adult onset acne vulgaris
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query.
Late-onset Acne Vulgaris (AV) commonly presents with a distinctive clinical pattern, often referred to as a hormonal pattern of AV, characterized by a predominance of inflammatory papules concentrated along the lower half of the cheeks, jawline, chin, and lateral neck.
Spironolactone is a diuretic. It is also an antiandrogen (reduces free circulating testosterone and also inhibits with the binding of Dihydrotestosterone to its cutaneous androgen receptor)
It has been used frequently for women with hormonal-pattern acne vulgaris, defined clinically as primarily inflammatory papules, many deep-seated and tender, that are located predominantly on the lower half of the face and anterior-lateral neck region.
The rationale for using spironolactone in the treatment of AV is that is has been shown to inhibit sebaceous gland activity due to its antiandrogen activity.
The onset of therapeutic effect of spironolactone is often noted within 4 to 8 weeks of starting therapy.
Persistence of AV into adulthood or late onset of AV in women specially who also exhibit clinical features of hyperandrogenism (androgenic alopecia, seborrhea, hirsutism, increased libido, clitoromegaly, deepening of the voice, and acanthosis nigricans), may warrant further investigation for underlying hormonal abnormalities, such as a hormone secreting tumor.
Spironolactone is used in doses of 25 to 200mg/day for treatment of AV in women; however, it is important to start with a lower dose and escalate in a stepwise fashion, if needed, depending on the clinical situation.
Spironolactone not only improves facial AV, but is efficacious in improving truncal AV as well.
The most common side effects with spironolactone are diuretic effects, menstrual irregularities (rather than normalising menses!), and breast tenderness.
Higher doses can cause gynecomastia.
Spironolactone may also help with androgen dependant scalp hair loss (androgenetic alopecia in females) at doses normally used for acne.
Regards
Spironolactone for adult onset acne vulgaris
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query.
Late-onset Acne Vulgaris (AV) commonly presents with a distinctive clinical pattern, often referred to as a hormonal pattern of AV, characterized by a predominance of inflammatory papules concentrated along the lower half of the cheeks, jawline, chin, and lateral neck.
Spironolactone is a diuretic. It is also an antiandrogen (reduces free circulating testosterone and also inhibits with the binding of Dihydrotestosterone to its cutaneous androgen receptor)
It has been used frequently for women with hormonal-pattern acne vulgaris, defined clinically as primarily inflammatory papules, many deep-seated and tender, that are located predominantly on the lower half of the face and anterior-lateral neck region.
The rationale for using spironolactone in the treatment of AV is that is has been shown to inhibit sebaceous gland activity due to its antiandrogen activity.
The onset of therapeutic effect of spironolactone is often noted within 4 to 8 weeks of starting therapy.
Persistence of AV into adulthood or late onset of AV in women specially who also exhibit clinical features of hyperandrogenism (androgenic alopecia, seborrhea, hirsutism, increased libido, clitoromegaly, deepening of the voice, and acanthosis nigricans), may warrant further investigation for underlying hormonal abnormalities, such as a hormone secreting tumor.
Spironolactone is used in doses of 25 to 200mg/day for treatment of AV in women; however, it is important to start with a lower dose and escalate in a stepwise fashion, if needed, depending on the clinical situation.
Spironolactone not only improves facial AV, but is efficacious in improving truncal AV as well.
The most common side effects with spironolactone are diuretic effects, menstrual irregularities (rather than normalising menses!), and breast tenderness.
Higher doses can cause gynecomastia.
Spironolactone may also help with androgen dependant scalp hair loss (androgenetic alopecia in females) at doses normally used for acne.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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