Unless you have experienced Acne, it is impossible to understand the physical and mental toll that it takes. My Acne did not appear as a teenager, but as an adult in college. Brought about by face masks, and made worse by hormonal fluctuations, my Acne revealed itself when I was 20. As a now twenty-three year old, the only thing that was truly able to help my skin was medication, though I was viscerally against it for a long time. If you, too, are wondering if it is time to try your last resort, here’s how I decided it was right for me.
Dermatologist trips, thousands of dollars worth of product, obsessing over skin; if you have had Acne, these are just a small portion of the experience. The first time I saw a dermatologist for my Acne, I was prescribed the antibiotic Clindamycin and the extremely popular retinoid Tretinoin. For the most part, it worked. I believed that I was in the clear until the next year, when my body went through a hormonal change that led to a severe imbalance. My acne had returned. This time, when my doctor put me back on the two prescriptions, they did nothing to clear my skin.
This marked the beginning of a long, painful journey of trying everything I possibly could to clear my acne. Except medication. The side effects that Accutane often presents frightened me enough that I decided I would rather go down the natural route. I stayed on Tretinoin, though it was destroying my skin barrier, especially since I was trying other active ingredients. Sulfur, Niacinamide, Salicylic Acid, Glycolic Acid; you name it, I probably tried it. Nothing worked.
After almost three years of this ongoing losing battle with my skin, my dermatologist suggested it may be time to start Acne medication. I was still viscerally against Accutane, knowing the side effects and my own limitations. This is when my dermatologist not only made the decision to take me off of Tretinoin, but start me on another type of medication specific to hormonal Acne: Spironolactone.
While Spironolactone was made to be a blood pressure medication, it was discovered that this medication actually blocks acne-causing hormones while helping to balance hormone levels. While starting this medication, I also started the popular over-the-counter Retinoid, Adapalene 0.1% gel. They didn’t work either, at least not right away. Retinoids have a tendency to cause a purge in the skin as they speed up cell turnover and push out any breakouts that were hiding under the skin.
The purge I experienced was less than enjoyable, and about 3 weeks in my skin was the worst it had ever been. Red, irritated, with white heads peppered across my cheeks, chin, and even stretching all the way to my forehead. I wanted to give up, to stop the medications and with them, this horrible purge. Yet I didn’t. I kept going, until at about 3 months in, I started noticing major changes.
My Acne was slowly but surely starting to dissipate, only flaring up around my cycle. My PIE (Post-inflammatory Erythema) was beginning to fade, my skin texture had melted away and left behind smoother, more vibrant skin. For the first time in 3 years, it was no longer painful to wash my face, I no longer had to do my skincare in the dark due to insecurity. I could look in a mirror and see me again.
I was against taking medication, but after trying almost everything, I felt that it was the best and only decision for me. It is definitely, however, important to recognize the symptoms that Sprinolactone can be paired with. This medication is a diuretic, meaning you might need to pee more than usual. Due to its original use as a blood pressure medication, it does lower blood pressure so you might feel dizzy or lightheaded. This may not be the best medication for those who already experience low blood pressure, which is why it is vital to ensure your dermatologist is aware of this.
Muscle cramps, low energy, and fluctuating potassium levels are also something to keep in check. Regular blood tests might be required of you upon starting this medication, and some doctors require you to be on birth control as it can cause major birth defects.
Acne is an extremely difficult skin disease to deal with, and there is no one right solution. Consult your dermatologist and create a plan of action that works for you. After exhausting all of my options, Spironolactone and Adapalene 0.1% Gel have worked in tandem to not only clear my skin, but give me my confidence back.