u/Unhappy-Orange647

Hi! I have been on spiro for 1.5 years and on accutane for just under 2 months (40mg/115lbs/53g) and my dermatologist said I should look into upping my dose and stopping spiro.

I let him know about my concerns upping my dose (re-purge (skin still purging the tiniest bit rn as well but it was very bad the first 2-3 weeks), extra dryness (my nose has been scabby with nose bleeds, cuts on my mouth, dry lips, hair, etc), and drowsiness/fatigue). He said ultimately it is up to me and wrote me a new script and another script with my old dosage. He said the main reason for upping the dose is that I see faster results and am on the medication for a shorter amount of time. I am around 54 days into my course and already I see results, despite the purge. I do have redness and PIE scarring, and of course, I would love to have clear skin very fast but I don't think I have it in me (mentally) to go through another really bad purge.

I asked about tapering off spiro (around my 10 month mark of being on it, it just stopped working for me for some reason - I was on it with epiduo as well and had a bit of topical reactions too near the end- but my acne on my chin/jaw/cheeks returned quite worse (still moderate though)). Ultimately, I started accutane while continuing spiro, as per my derm's suggestion. He said it may lessen the side effects (which, unfortunately, was not the case for me). I am scared because I am not sure if I HAVE had other positive outcomes from spiro like weightloss or mood changes. Lots of thing happened when I started it (going to the gym, hanging out with people I like/who like me, starting uni and being focused/selective), so I am not sure if it is those things that made me feel better or if it was the spiro.

Anyways, he said that I can just stop spiro without any tapering. My dad who is a medical practioner/GP for skin/skin cancer patients (BUT not a dermatologist) also told me to just listen to the dermatologist and stop spiro, but as for the accutane part he said: if I already have this many side effects while also seeing improvement and the only issue is me being on it longer than I should stay on 40mg.

I am wondering if anyone else has been in this situation? Has anyone stopped spiro while on accutane and saw no side effects? What are your thoughts?

i am officially 2 weeks into accutane. i have been on 40mg daily of accutane (i weigh around 52kg/112lbs/5'4) and i take it with alot of fat (i.e. bowl of full fat greek yoghurt, peanut butter handful of peanuts, pepita seeds, sunflower seeds and almonds) - twice a day (20mg morning and night). i take antihistamines with my pill (zyrtec at night and one claratyn in the morning). is it bad to take both?

context: i have been on epiduo or adaplene for 1.5 years before starting so i figured i wouldnt purge crazy. however i knew i had some closed comedones and was thus expecting something but later on in my course not this early and not this 'bad'? i am also on spiro 100mg and have been on it for 1.5 years too so i guess it may be because i am extra dehydrated? (i put quotations around bad because ik it could always be worse)

i am "purging" in new places. i can tell its "purge acne" bc it was the same as when i started epiduo last year (i hope i am assuming correctly), they are whiteheads, red and inflamed and hurt + are itchy. i think the antihistamine is helping a little (but not that much) and that it could be worse without it (idk if im right or wrong here) but its not THAT bad when i compare it to other peoples' that i have seen in this reddit but its bad enough for me to be like ??? could it be bc i stopped epiduo and topicals idk?

they are small painful whiteheads and some inflamed red spots as well. i am. nearing my period (one week away) so perhaps it may be a little flare up. just feeling very flop lol. my skin is a little dry lately but my face/lips are just tight not flaky thus far. my skin was just VERY burnt and red the first 2-4 days but now is just purging. i dont have body aches either just an itchy scalp :/ idk if its bc i started to eat more fat with my pill that its absorbing better and making the purge come quicker? bc before i used to only take a spoonful of peanut butter, but now i add what i mentioned in the first para.

additionally, i live a relatively happy and healthy life so ik its not really anything abt my lifestyle: i eat a balanced diet, i workout (pilates, cardio, light weights - nothing too crazy), i get around 7/8hrs of sleep, i drink lots of water but im trying to drink more (around 3L) but idk if its something else too im really spiralling i just feel so demotivated man!!!! i use qv gentle cermaides face wash, qv ceramides lotion and LRP 50+ anthelios sunscreen everyday as well as the LRP cicaplast spray sometimes if my skin hurts.

apologies for the essay and i hope u all enjoy ur day 🚀

is this normal? i have only been on it for 5 days (20mg twice a day that i take morning and night with peanut butter)

i take antihistamines with my pill (claratyn 10mg) and i have been on epiduo or adaplene for 1.5 years before starting so i figured i wouldnt purge crazy. however i knew i had some closed comedones and was thus expecting something but later on in my course not this early? i am only "purging" in places i had acne and i can tell its "purge acne" bc it was the same as when i started epiduo last year (i hope i am assuming correctly), they are whiteheads, red and inflamed and hurt + are itchy. i think the antihistamine is helping a little and that it could be worse without it (idk if im right or wrong here) but its not THAT bad when i compare it to other peoples' that i have seen in this reddit but its bad enough for me to be like ??? could it be bc i stopped epiduo and topicals? i used epiduo a few days ago too because it was getting bad already so not sure. im def spiralling so sorry for the rant 🔥

i am also on spiro 100mg and have been on it for 1.5 years too so i guess it may be because i am extra dehydrated? im trying to drink more water but idk if its something else too. i use qv gentle face wash, qv ceramides lotion and LRP 50+ anthelios sunscreen everyday as well as the LRP cicaplast spray.

but is it normal for it to happen this fast? im very confused and my chin hurts :( i still have no face/lip dryness but my face is feeling a little tight and i think tanner? idk how to explain it even tho its the middle of winter for me. my nose has been very dry also and hurts on the sides. is that a side effect too or am i looking into things too much?

my situation is annoying. ive been dealing with stubborn breakouts for years but my acne is just mild, like i know i should be grateful for this. last year april my GP prescribed me spiro 100mg and epiduo 0.1%. and for a few months i purged like crazy but then i had really nice skin (either way tho i would still get pimples here and there, and have crazy blackheads + sebacious filaments) so it wasnt like my skin was that clear. i still got regular breakouts but nothing as bad as before - which after what i had been through i would have settled for.

come like january this year, i started breaking out again on my chin and some on my cheek area. very mild. my skin was dry and pasty as well so i thought i had too much BP on my face from epido. so i switched to just adaplene/differin ( i know i should have consulted my Dr when I did this) but at the time i was desparate. and my skin continued to get worse so ia dded benzac (2.5%) and was like "mimicking" epiduo on my skin and putting BP only in the mornings sometimes. 2 months of this and my skin kept getting worse so i went to my GP again and explained to him the situation. he said to go back on epiduo and continue spiro if it worked before. im still on the same dosage. he said 6-8 weeks to see improvement again.

it has been 7ish weeks and there has been like zero improvement in my eyes, even though i have handled epiduo before + i never stopped a retinoid i was still on adapalen. to be fair it could be even worse now. im so tired and sick of dealing with this and my mental health has truly been at an all time low. i know i may have effed up my skin barrier but my skin was already getting bad beforehand. i dont know if its spiro thats not working anymore. i dont know. like im really stumped here.

but im exhausted, and i think i just want to go on accutane. i might stay on spiro since i hear Drs say especially when starting new medication. i know the risks of accutane, my siblings have been on it. i dont drink, etc. my parents are both doctors and say that i should do this as well, especially considering that its coming to winter here so the sun won't be too strong on my skin.

but what are you guys' thoughts? has anyone experienced something similiar? im desparate for help.

i was on epiduo for around 8 months and it worked great but then i think i was getting too irritated from the benyzol peroxide so i swithced to adaplene and i stopped my sandwich method. so for a few months i was only on adaplene but my skin kept getting worse and then for a bit i added benzac (BP) back into my routine in the mornings sometimes but my skin got worse.
i got prescribed epiduo again. is it normal to purge after going bakc on epiduo?