Accutane or Aldactone?

[hammonks]

Okay.... accutane or aldactone? Which would you choose and why? Went to the derm earlier today and these are my main two options, or continue to juggle oral antibiotics and hope we find something that works... current oral antibiotics are no longer cutting it, topicals never touched acne. My acne is on my face, neck and back (the worse area is my back). I'm 31 and just soooo tired of acne!! He's open to letting me try whatever treatment I would like. Accutane is appealing to me now because he said 80% of those who do it never get acne again after 1 course. Otherwise he said I'd have to be on the aldactone long term. On my way to the Endo in a week and a half, so I'll definitely talk to her as well about the options before choosing.

[thewhitedaisy]

Hi, I took Accutane before I was diagnosed with PCOS. I didn't know my face was so bad BECAUSE of PCOS. I just thought it was a really bad case of acne. It was absolutely horrible. Dents everywhere. My cheeks would be full of acne. I took Accutane for a few months, and my skin completely cleared out. It was almost clear. However I stopped taking it because I assumed that the Accutane made me gain weight. This is not true because I just didnt realize that it was the same period where my PCOS symptoms were appearing too! (I know this for sure because shortly after, I got the facial hair!). I'd recommend Accutane. Don't use it for very very long periods because I've heard cases of hair loss, but maybe serve one complete course. I have little acne on my face now (AFTER YEARS) and am considering Accutane again too. So yes, I'd recommend it. Oh yeah, the only con of it might be your lips DRYING out. Hope I helped you!

[Shantess]

I never used Spiro (aldactone) so can't comment on it. I took Accutane 3 times nearly 15 years ago before I knew I had PCOS. The first time cleared my chest, back, and shoulders but not my face (hence the other two rounds). The only thing that ever cleared my face was the bcp Diane-35, which has an androgen blocker much like Spiro. However, when I stopped taking Diane, my facial and backne came back...I think Accutane has a high rebound acne rate after several years of it being clear. Would I do Accutane again? Honestly, I don't know. Taking something that is the equivalent of chemotherapy for acne (Accutane is used to treat prostate cancer) seems like overkill but if my acne got that bad again I might be desperate. It also messed up my digestive system (chronic constipation for life....), which is a very common side effect with Accutane.

[etuc]

My derm tried all kinds of stuff for my cystic acne the only thing that worked was accutane, that would have been about 31 years ago or so. I think it took two rounds to be clear and I haven't had any big breakouts since, I will occasionally get a zit but nothing bad like I used to get, I was pleased with the results. Not sure if aldactone was used for acne back then, if it was my derm probably would have tried that too, at one point he even had me on something used for leprosy that almost killed me... oh and of course we tried BCP too but they gave me a blood clot.

I think if I was going through that now (and knew I had PCOS, we didn't know it back then even though all my symptoms pointed right to it sigh) I would try aldactone since it also helps many cysters with excess hair and that is one of my biggest problems atm.

Hope that helps

[hammonks]

Wow.. didn't know that it was used for prostate cancer!! That is something to think about. I get cystic acne on my back, my face also has acne, but mostly inflammatory and black heads. I can usually cover the acne on my face well with make up, it's my back acne that's driving me crazy! I always have to plan my outfit selections around my acne in the summer. I'm also constantly embarassed to wear a bathing suit because of it. I'd just like to have a clear back for once and wear a tank top in public or a dress with an open back!

Went to the endo today for the first time and it was a GREAT appt. I felt like she really listened to me & wanted to help me get down to the bottom of what's going on with my hormones. She's ordering more tests to confirm if I actually have PCOS or some other type of endocrine disorder like LOCAH, other adrenal gland disorders or a pituitary disorder. She was okay with the accutane option, but told me she would probably recommend the spiro (aldactone) as it would also help with any excess hair growth I have (argh.. chin hair!) depending on what all my labs come back as. So glad I decided to push my doc for a referral to a medical endo to deal with all these issues ... excess hair, hair loss, fatigue, acne, irregular cycles, cysts... she actually acted like she cared and would help me look for answers. We'll see what these lab results say, but I think I am leaning towards aldactone to help with the hair growth as well. Also getting more nervous about long term effects of accutane, especially ulcerative colitis since I already have issues with IBS. Makes me a little nervous.

[ljean]

I would go for spiro over accutane. I was on accutane twice and each time my skin looked great for a little bit after being off of it, but the acne came back. When I took spiro it cleared up my face.

[JulieofDenial]

Spiro does definitely help with hair growth (and hair loss too I have heard) as well as some other PCOS symptoms. I attribute a lot of the PCOS improvements I've had do to diet and weight loss, but spiro's a good way to start out your treatment IMO. Only side effect I had is that it makes you pee a -lot-.

I can't say that it will make your hair grow back, or your extra hair go away, bit it will stop things from getting worse. On the other hand... I do have facial hair, and it seems to be going away however it wasn't extensive.

[hammonks]

Thanks girls. I also am leaning towards the spiro. I already exercise every day for at least 30 minutes, have a healthy BMI and eat mostly low GI foods. While eating low GI and exercising have made me lose an extra 7-8 lbs I had on me, I have had no improvement in cycles, acne, hair growth, nothing! I had an endo appt 2 weeks ago and they ran a bunch of blood work. She thinks I maybe have LOCAH and not PCOS. But she was leaning also towards spiro and thought it would help more of my symptoms over all regardless of if I have LOCAH or PCOS. I just am not crazy about going on spiro and yet again birth control, although I know it's probably the best option for me as I also have endometriosis that has been bothering me as of late.

[MaggieMae]

Hi. Just checking in on you to see how the spiro is working for you. For me, it took 2-3 months to fully work, but i felt like I started seeing some improvement in the oiliness of my skin within the first month. I tried Accutane and the side effects were terrible. Spiro has been an easy drug for me to take with very few side effects and has kept me 100% clear for the last 3 years. Honestly, while relieved to finally find a treatment that worked, I also felt let down by my doctors. Having spent thousands upon thousands on dr visits and accutane, topical treatments and antibiotics it made me mad that such an easy and simple drug could have saved me such heartache. Not to mention it is super cheap....and could have saved me so much money over the years! I hope you are starting to see some results. I can empathize how cystic acne impacts self esteem and I wish you the best of luck with your treatment.

[pinksunset]

i use a facial sauna for spot outbreaks then splash cold water on my face to close up all the pores!

[ljean]

I totally agree. I had acne for a long time, was on Accutane twice, all the antibiotics, and everything. I wish I would have found out about spiro 20 years ago, my bad skin was so hard to deal with!