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My dermatologist gave me doxycycline, spironolactone and birth control to help with my moderate hormonal acne. Anyone have experience with this? Is this combination safe or too much?

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I’ve taken spironolactone and it definitely does help with hormonal/cystic acne. But it’s also a mild diuretic. Even with increased water intake, I kinda felt like I had a UTI for the first week or two I was on it until my body adjusted. After that, I didn’t really notice any side effects. Birth control will likely make a significant difference over time. My skin got really bad after I stopped taking hormonal birth control. Unfortunately, it had some negative side effects on my body that make it not worth going back on, but the impact on mood and (in my case) cholesterol levels are very individual. Doxycycline is a pretty standard antibiotic used for acne. I’m not personally a huge fan of taking antibiotics unless absolutely needed and I’m not sure it ever really made a difference for me, but you’re unlikely to have any side effects from it. I’m surprised you haven’t mentioned any topical treatments. I’ve found adapalene and aczone helpful in addition to everything else. But to answer your actual question, no, this doesn’t sound like too much. It seems perfectly normal for treating adult acne that hasn’t been responsive to other treatments.


You should also try Retin-A! It works wonders for my hormonal acne when used nightly

I’m not familiar with the first two, are they topical creams or pills? I would try to make sure you have a good skincare routine (good cleanser, a serum or two, chemical exfoliant, good moisturizer and possibly eye cream if you feel you need it) and good hydration + sleep before starting 3 things just to make sure you can isolate if it’s any of those things that are the problem. Unless you have another reason to be on the pill I’d probably save that for last because it can take your body time to adjust and you may have side affects (nausea, weight gain, spotting, and sometimes even acne 😕). I’ve been on the pill for years and haven’t found that it affected my acne much (it was bad when I was a teen/early 20s then my skin naturally got drier so I don’t have amazing skin now but I don’t have real acne like I used to). BC can absolutely help but if you don’t feel you need it for other reasons like regulating your period or avoiding getting pregnant then I would first try to clean up your skincare routine and work with the other medications first. Sorry, I know this isn’t what you asked. It is probably safe if your doctor prescribed it but only you know your body and you need to decide if you’re ready to deal with any side affects of birth control or other medications.

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I would say it is safe if both a doctor approved it and a pharmacist approved it to be filled...


It was neither snarky nor unhelpful. You asked if it was safe?


This is a common treatment for women with PCOS that aren’t successful fighting the symptoms of fluctuating hormones in other ways. I’m PCOS. I’m on all of these you mention + metformin and have been for 6m. For me along with a change in diet (goal of 30g protein each meal, goal of carbs only from fruit & veggies/limited processed & preservative type foods/lower dairy milk consumption) and exercise the combination has: reduced early onset hair loss, cleared acne issues on both my face and on my sides under my arms where my bra strap goes — my testosterone levels have bottomed though so I do have a couple days a month of low energy. I’m usually able to counter that with caffeine though. I’ve also lost some weight, but I expect that is more the healthier eating and exercise than the medication.


My friend actually went on spironolactone and it did wonders!! she was on Acutane twice and it did nothing for her, she did spiro for a year and now she doesn’t take it anymore and never has to wear makeup, her skin looks amazing


thanks all. I am feeling like a cocktail, I feel tired and nauseous. Threw up at 4am


update: doctor told me to stop taking doxy... still woke up at 330 this morning after taking birth control on empty stomach. this sucks lol

Check out Dr Jolene Brighten’s website. She has tons of good info on managing PCOS and hormone related issues naturally.


She is great.


I just turned 49 and have been on all 3 for 5 years. It has worked great for me and I have had no issues. Topicals didn’t work. Because Spiro is a diuretic, if you choose to use it make sure you follow directions when you choose to stop as it can have side effects if you immediately stop rather than ween off. Good luck! Adult acne was a surprise to me and not fun. I have been grateful that this blend worked well for me.


Yes! I was put on a combination of medications like this very young (have been on birth control since 6th grade due to severe acne) and was fine. I think it’s always important to track how you’re feeling over the first few weeks to see if you have any side effects that might need to discussed with your doctor.

My daughter was on this combination and it worked. No topicals or homeopathic solutions worked for her.

Personally spiro never helped me that much. I did see benefits from birth control but still have some acne while on it. I’ve started the book woman code that does discuss how to balance hormones and supposedly get rid of acne with lifestyle changes. I can’t say if it works or not yet, but I’ll be trying it. Birth control can have an impact on mood and other functions of the body, so if you’re taking it only for acne, I would suggest a different approach first. I also know how much acne, esp as an adult, sucks so much, so this is just my input. Do what you think is best.

Foods not goods*

Spiro is great for me—no side effects at all. Recommend getting a strong probiotic to have in conjunction with the cocktail. BioK and Goodbelly are good ones

I've never been on spiro, but I was put on on doxy/birth control, and then after a while just birth control, and it did wonders for my acne.

I started the regimen when I was 16 so I cant recall exactly. I remember it working really quick though (maybe one to two months).

My dermatologist suggested the same for me for my “mild” acne a few years back. I didn’t want to be on so many pills so she suggested starting off spiro (in low dose) plus topical cream, Ziana (which is clindamycin and tretinoin). It worked really well. Took about 3 months to see the effects of the spiro. I stopped taking it after a year and would occasionally use Ziana. I’ve since stopped Ziana and my hormonal acne hasn’t been back.

I took doxycycline at the same as birth control, didn't have too much in terms of side effects. It did actually clear up my acne long term, I stopped taking it after a year or so and I really havent had any since aside from the occasional pimple. Antibiotics will make your skin photosensitive so make sure to where sunscreen or hats when you're outside.

I’ve been on the combo of spironolactone and birth control since I was 15 and it works great for me!!

Try tretinoin! I have hormonal acne and was also prescribed spironolactone but stopped taking it because of side effects. tretinoin is a topical retinoid and one of the best out there for acne

Hey there. I have been dealing with PCOS and hormonal cystic acne all my life. I even did a course of accurate when I was 21 that did nothing for me....and then I found a doctor that actually diagnosed the PCOS and related hormonal issues and spiro is the only thing that has EVER cleared my cystic acne. If your acne isn’t cystic, then maybe you don’t need to take it. The one thing you need to understand is that the effect does not happen overnight. The drug needs about 4-8 weeks to build up in your blood to be effective...so don’t lose hope if you don’t see dramatic results in week 1. I’ll also say this - Doxy always made me sick (like vomiting) if I took it without food. Also I never thought doxy helped all that much, even when I could stomach it. Then last year I had very unusual acne patterns for the first time ever - large red patches of smaller bumps. Again my amazing dr realized this wasn’t my typical hormonal type of acne and he gave me a course of minocycline which cleared it up right away —- so turns out that breakout really was more of a bacterial infection, whereas the cystic acne is clearly hormonal. I have been taking spiro for about 10 years with birth control for most of those years and (at least for me), it’s the most effective approach with absolutely no side effects. The only thing I’d be cautious of is taking antibiotics for a prolonged period. I am generally of the mindset that they should only be used for shorter periods to treat the more acute inflammations that are suspected to be bacterial in nature. Feel free to message me directly if you have any other specific questions for me!

I had horrible hormonal acne. Bc was the only thing that really helped. My skin erupted when I went off of it. I ended up taking accutane in my 30s and it was a godsend.

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