The drug spironolactone is actually one of the huge drivers in why I decided to start keeping this blog. It was a really long journey to get to the point of taking it — mostly, dealing with the neverending cycle of terrible skin and terrible, misleading skincare products. While spironolactone ended up being my acne’s endgame (for now), I realize that this isn’t necessarily possible for all people suffering the same issues I did.

My skin was NEVER great, and I’ve struggled with cystic acne off and on since I was 13. I had a friend throughout school who had crystal clear skin — I was jealous of her, and confused how she had gotten to that point. She told me she ONLY used some cleanser from Clean and Clear, so I tried it, too. It did nothing. If anything, I found more new spots.

In college, my acne cleared up a tiny bit. I’d still get the occasional cyst, but nothing damning, or nothing that makeup couldn’t fix. It went on like this until I hit 27. All the sudden, my face was disgusting. Painful, inflamed, HUGE spots, that were crazy deep into my skin. I was new to my current company at this time, and this condition was absolutely mortifying. No matter how good a foundation was, it would never fully cover the issue I was experiencing.

I subscribed to r/skincareaddiction on reddit. I read every skincare blog (especially Simple Skincare Science — while I don’t agree with 100% of the product reviews on his page, this is one of the greatest, most extensive info-dumps of all things skincare, and I still read it religiously). Still, NOTHING helped (except maybe Cerave PM… even though I had a ton of zits, the “good” skin was super glowy, woohoo!). After many nights of crying about my busted self-esteem, I realized that maybe it was time to go see a dermatologist.

So I did. I slapped down $200 for my first time appointment, at a dermatologist’s office (and that was after insurance! It’s not a cheap venture). Within five minutes of examining me, the dermatologist recommended Epiduo and Spironolactone. She told me she had seen a lot of success with Spironolactone — and, if that didn’t work, I would begin the dreaded Accutane.  I zipped over to another office to get my blood work done, and once it was decided that all was well, my pharmacy filled the order of Spironolactone. I was overjoyed to get started.

After four days, I looked in the mirror and was foolishly disappointed that nothing had changed (guess I was hoping for the whole “wake up and it’s fixed” effect). When I wasn’t looking in the mirror, I was hunched down over the toilet wondering if I was going to throw up — the first couple of weeks of Spironolactone bring a few gnarly side effects, one being nausea.

The second week was misleadingly good — I thought I was beginning to see progress! Then came the third and the fourth week, and my acne was worse than it ever had been before. I suspect this is what they call the purging period, and it may have been exacerbated by the Epiduo. I still wanted to puke during all hours of the day. I wanted badly to throw in the towel, but I decided I would give it more time.

Around month two, I could start seeing the spironolactone work. I still had a few cysts that were new, but I wasn’t seeing the same “volume” of new acne that I had been before. Unfortunately, month two brought about a new, less pleasant surprise: I was getting my period every 14-15 days, instead of my normal 24-25. My derm expressed some concern about this, and suggested I ought to go from 50mg to 25mg if this persisted. I decided to keep going with the 50mg/daily and see if anything changed.

Month three and month four were my biggest breakthrough of clear skin. The new spots were small, and certainly not cystic by any means. I had a ton of scarring to deal with, so it was difficult to tell that my skin had actually cleared up, but I wasn’t in pain like I had been before with the cysts. And my nausea was finally starting to diminish! (although the five lbs of weight loss was technically not the worst thing that’s ever happened to me).

So here I am now on month nine. Here’s how my life looks now:

  • My skin is virtually acne-free
  • …minus the “that-time-of-the-month” blemishes, but even those disappear on their own in under three days.
  • I still take my spironolactone religiously without missing a day, at 50 mg, and use Epiduo every other night, or as spot treatment.
  • I’ve made huge strides with scarring, but I have a ton of work to do. Some of the ice pick scarring will likely never go away, and everything else will take years to turn over, but I’m okay with that.
  • I try to stick to oil-free moisturizers and makeups, nothing “too heavy”. But, my skin can pretty much tolerate anything I throw at it now, unlike before where it would break out just on contact with a product.
  • My period cycles are still way shorter than they were before I started all of this, but are starting to creep back to 19, 20 days in between.
  • No more terrible nausea  🙂

Just the first line alone — the fact that I do not have pervasive, cystic acne, that is LIFE-CHANGING. I can go out into the world without makeup. I’m not in pain anymore. I don’t have to find ways to hide my face from people.

I suffered with acne for half a lifetime before I summoned both the financial means, decent enough insurance, and emotional courage to go to a dermatologist. So for all of you in that place right now — I completely understand and empathize with you. It’s really, really tough. That’s why I wrote this blog — so when you’re in that “in between space” of buying products and seeing a derm, hopefully one of these blog entries will resonate with you, to help steer you toward, or away, a drugstore product. We live in a world where people are monetized to go online and say good things about a company, even if that company’s product totally sucks. I myself fell for planted reviews, on several occasions. I would never wish that on anyone else, because it’s just an honest to goodness waste of time and money.

But when, or if, you can get to a dermatologist — it is absolutely worth the high upfront cost. It saved my face, my skin, and my self-esteem! ~A

Perceived efficacy: 5/5

Longevity: 5/5 (as long as I’m on it anyway… hopefully!)

How much I actually like this product: 5/5