The New Acne Solution You Haven’t Heard of Yet

My skin struggles started one December morning about two years ago. I woke up with my arm swollen, purple and numb. The pain became so intolerable I couldn’t lift my arm, much less type. I lost ability to control and move my arm and eventually ended up in the ER hoping the feeling would return to my fingers soon. I finally received a diagnosis of a blood clot. I was one of the 3,000 women who develop a clot when taking the birth control pill. And I had to stop taking them immediately to avoid potential complications including blindness or even death.

A couple of weeks later, I regained all of the feeling in my limb, but I developed a new problem: My skin was breaking out on a scale that I hadn’t seen since my early teen years. The worst of it was my back. I kept hoping the red bumps would disappear as quickly as they surfaced.

When New York City summer arrived in full steamy, sticky effect and required a wardrobe of tanks and sleeveless dresses, I stayed covered up. I opted out of weekend beach trips and was relieved for rainy days. When I realized how much these breakouts were affecting my quality of life, I asked for help.

My dermatologist prescribed oral antibiotics as a way to control the acne bacteria that cause breakouts. Within the month, I was back in swimwear and sundresses. A few months later, I was off the antibiotics and my skin clear though the spring. But when summer returned, so did my acne. This time the antibiotics were less effective. Long-term antibiotic use isn’t an ideal solution, regardless—resistance is a potential side effect. I spent another summer in hiding.

I kept asking my doctor: isn’t there anything else that will work? The topical options irritated my sensitive skin. But the next possibility was one I hadn’t heard of before: spironolactone.

Originally used as a blood pressure treatment, spiro can also reduce acne in many patients. The drug has anti-androgen effects and has a similar effect on your skin as combined oral contraceptives (which kept my skin clear for so long).

Spironolactone binds to oil glands to reduce sebum production and provide “less food for acne-causing bacteria,” says Joshua Zeichner, director of cosmetic and clinical research at the Mount Sinai School of Medicine in New York City. “In my experience I find that it actually works better” [than oral contraceptives].

Spiro’s impact on hormones makes the drug useful on many types of acne. “Hormones stimulate oil production,” Zeichner says. “Your hormone levels could be normal, but your body could be more sensitive to them.” In other words, all acne, whether it’s spattered across one’s back or nose, has a tie to hormones and could potentially benefit from this medication.

The reason you’ve probably not heard of it: “Spironolactone isn’t FDA-approved to treat acne, even though it’s been used for decades to treat skin,” Dr. Zeichner says. Usually only dermatologists who specialize in acne write prescriptions for the drug.

Needless to say, I started taking the medication as soon as I could. Within a few weeks, I noticed an incredible difference in my skin. While it wasn’t completely clear, its worst days were far better than the pre-spiro norm. Now, I’m at my three-month mark, the standard amount of time needed to spironolactone to work its magic. And guess what?! I’m totally clear—just in time for summer.

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