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Hi Shadows 
I'm curious-- have you ever tried to see an endocrinologist? While you may not think you have a hormonal problem, you never know. Endos seem to have the most experience with Spiro and possible hormonal issues, so if being referred to one is an option for you, I'd definitely look into it.
As far as your concerns about your skin looking worse (red & oily), I think it could be due to starting the Differin cream. I've never used it before, but I'm a long-time Retin-A user, and they are both topical retinoids. With what I've learned about topical retinoids, your skin pretty much always gets worse before it gets better. The cream makes it so that your skin cells slough off faster, and it purges the underlying acne out. This means things are probably going to look bad for at least 6 weeks (I didn't notice things improving until about 2 months). Are you using a moisturizer with SPF during the day? This is pretty much a necessity while using Differin. Also, what kind of cleanser are you using? You should probably be using a gentle, non-medicated cleanser (I like Cetaphil), and definitely not something with benzoyl peroxide or salicylic acid in it.
Spiro--- I think you're on the right track here! It seems to really help adult acne. And you're right-- most will say that you need at least 100 mg to fight acne, and it can often take months to really start working. I experienced side effects similar to yours at first (fatigue, lack of appetite, nausea, super dry skin), and they lasted about 4-6 weeks. Now that I'm 3 months in, I have no side effects at all.
I'm really not sure about the alcohol + spiro....I would assume it's not a great thing to do on a regular basis, but I must admit, I tend to get a little tipsy on the weekends to unwind. If anyone knows about alcohol effects I'd love to hear. I have heard that ibuprofen isn't good, so I'd try to stick with Tylenol or Excedrin instead.
Are you currently taking a bcp? I'm on Desogen, but I hear that a lot of people like Yasmin, and that it has DSRP which is equivalent to 25 mg of Spiro.
I hope some of this helped! Please keep us posted on your progress Good luck!!
Hi Shadows
As far as your concerns about your skin looking worse (red & oily), I think it could be due to starting the Differin cream. I've never used it before, but I'm a long-time Retin-A user, and they are both topical retinoids. With what I've learned about topical retinoids, your skin pretty much always gets worse before it gets better. The cream makes it so that your skin cells slough off faster, and it purges the underlying acne out. This means things are probably going to look bad for at least 6 weeks (I didn't notice things improving until about 2 months). Are you using a moisturizer with SPF during the day? This is pretty much a necessity while using Differin. Also, what kind of cleanser are you using? You should probably be using a gentle, non-medicated cleanser (I like Cetaphil), and definitely not something with benzoyl peroxide or salicylic acid in it.
Spiro--- I think you're on the right track here! It seems to really help adult acne. And you're right-- most will say that you need at least 100 mg to fight acne, and it can often take months to really start working. I experienced side effects similar to yours at first (fatigue, lack of appetite, nausea, super dry skin), and they lasted about 4-6 weeks. Now that I'm 3 months in, I have no side effects at all.
I'm really not sure about the alcohol + spiro....I would assume it's not a great thing to do on a regular basis, but I must admit, I tend to get a little tipsy on the weekends to unwind. If anyone knows about alcohol effects I'd love to hear. I have heard that ibuprofen isn't good, so I'd try to stick with Tylenol or Excedrin instead.
Are you currently taking a bcp? I'm on Desogen, but I hear that a lot of people like Yasmin, and that it has DSRP which is equivalent to 25 mg of Spiro.
I hope some of this helped! Please keep us posted on your progress
I wanted to update on my last post (20th Jan)
I went to see the dermatologist - and he was about as useful as a chocolate fireguard! Said he woudn't prescribe Spiro - as it was too dangerous!? I tried my hardest but he wasn't gonna budge on it. He said just to wait and see - and .. wait for it..... when I am about 40 my skin may change ?!? Huh??! I felt llike banging my head on the wall!!
So until I can think of anything better have decided to self-medicate with Dianette although I shouldn't really take it at all. I started taking it again just two weeks ago and hey presto - the oiliness has just vanished! It proves that it works for me - and with immediate effect.
So doctors... waste of time - well in UK it appears so! Grrrr!!!!!
Right - that's all but I will keep reading these posts as it's interesting and there is no such thing as too much information.
Hey,
Id like to thank everyone who had contributed to this informative discussion! I've read every single post in this thread! I've had hormonal acne for years... I've just started taking the Australian version of Yasmin and yesterday started myself on 100mg of spiro... prior to this I tried every method except for accutane, acupuncture, diet, oral and topical antibiotics, creams, holistic health, apple cider vinegar. I only get acne on my chin, a few odd zits and some charming cysts.....I'm going to give myself a topical break and just use a mild herbal cleanser, continue taking my multi vitamin, and zinc and avoiding dairy.
Your advice has been so valuable!
I just hope I can have the success many of you have experienced!
Thanks!!!!!
Hey,
Id like to thank everyone who had contributed to this informative discussion! I've read every single post in this thread! I've had hormonal acne for years... I've just started taking the Australian version of Yasmin and yesterday started myself on 100mg of spiro... prior to this I tried every method except for accutane, acupuncture, diet, oral and topical antibiotics, creams, holistic health, apple cider vinegar. I only get acne on my chin, a few odd zits and some charming cysts.....I'm going to give myself a topical break and just use a mild herbal cleanser, continue taking my multi vitamin, and zinc and avoiding dairy.
Your advice has been so valuable!
I just hope I can have the success many of you have experienced!
Thanks!!!!!
WOW! Great info! I just read nearly the whole post as well! I just started my spiro today. I realized after doing months of research and cleaning my closet that I started my cysts back in college AFTER I stopped my orthro tri cyclen that I had been on for 6 years! I had mild acne in highschool and freshman in college. But cysts exploded about 6 months-1 year after stopping the BCP.
Honestly, I haven't done much about it besides pick and try retin-a and differin which burns the hells outta my face. In January I started ACV internally and Milk Thistle and cleared up in a week. I was estatic!!! Then slouched a bit and everything came back! So I came back as well guns blazing. I now take a million pills from fish oil to EPO to Vitamin E to Veggie pill to Zinc to Beta Carotene and my multi....hmmm....thats all crazy but I wanted to experience those 3 weeks of heaven again. Now I just started Spiro today and will continue the ACV and vitamins as well but hope that I can drop most of that.
Cysts beware! I am after you!! Read my log for daily updates and good luck my friends!! 
I really don't want to jinx myself but....... it seemed that every single blocked up pore, deeply hidden zit, lump or bump on my face quickly became massive, quickly developed a white head and then quickly disappeared, all stages happening in less then 24 hours, the process lasted about 10 days and I was devastaged while it was occuring.... now when I really look at my chin, you know really look at it, I can't see any lumps developing, no blocked pores, no redness, no pus developing deep down....could this have worked, does it sound like your experiences, and does it sound like my BCP or Spiro????
Wow I hope I haven't finxed myself, but I feel like something has been won!!!!
Hi all,
I am still taking spironolactone (100 mg daily for about 1.5 years now, prescribed by my dermatologist). I am 39 y/o, so am starting to go through the dreaded change of life and yet my skin was relatively acne/oil free until about 2 weeks ago, when I developed half a dozen massive cysts on one side of my face seemingly overnight and out of nowhere. I think the culprit was dairy products as I was drinking 3-4 milkshakes a day for about a week or so before the cysts appeared as my IBS was flaring badly due to my period making an appearance after being MIA for 3 months; (my IBS always flares badly at that time of the month, and usually I am stuck on liquids for the week or so til my period is done and I can pass semi-normal stools once again).
Needless to say, I am not happy at all to have this stuff back on my face, but I killed it relatively quickly with massive doses of BP, (within a week), now just the scabs and indented red marks remain. I am hoping against hope that this doesn't scar, (I have that redheaded super sensitive ultra white freckled skin that scars if you even look at it funny, so I suspect I will have more pitted scars to add to my collection when all is said and done, but as I will be going for laser scar treatment soon, I hope this is the end of the cyst problem).
No more dairy for me EVER. I will stick to soups and sorbet if I need a liquid diet from here on out. I never realized I was so sensitive to dairy products as I don't have any true food allergies (or so I'd thought) but apparently I was sadly mistaken. This is definitely something to watch out for...
Best wishes from bookyone
Hey guys, I'm new here and I just started taking 50mg daily of spiro. I just have to ask you guys one thing. What are you doing about the potassium issue? For some reason I am really worried that I will eat too much potassium and die lol. I looked online and nearly EVERY food has potassium in it! And the foods that don't are just really unhealthy, and I don't want to start eating an unhealthy diet. I was just wondering what your doctors said about the issue and how your tests have turned out.
Thanks so much!! 
Hey guys, I'm new here and I just started taking 50mg daily of spiro. I just have to ask you guys one thing. What are you doing about the potassium issue? For some reason I am really worried that I will eat too much potassium and die lol. I looked online and nearly EVERY food has potassium in it! And the foods that don't are just really unhealthy, and I don't want to start eating an unhealthy diet. I was just wondering what your doctors said about the issue and how your tests have turned out.
Thanks so much!!
I've been on spiro for about a year now- 150mg, some days 200 mg. It only works well for me at that dose. Any less and I start breaking out in cysts yet again. Whenever I got off of birth control, I would always start breaking out really bad. I was hoping that I could take spiro and wean off birth control, but it seems as if my breakouts are just as bad now as they were before. =(
Anyways, I'm glad that I found something that works- and it looks like it's working for al ot of people as well! Only, what to do when I have to go off of it to become pregnant??
I've been on spiro for about a year now- 150mg, some days 200 mg. It only works well for me at that dose. Any less and I start breaking out in cysts yet again. Whenever I got off of birth control, I would always start breaking out really bad. I was hoping that I could take spiro and wean off birth control, but it seems as if my breakouts are just as bad now as they were before. =(
Anyways, I'm glad that I found something that works- and it looks like it's working for al ot of people as well! Only, what to do when I have to go off of it to become pregnant??
Days on spiro: 12
Dosage: 50mg daily
Pros: So my far oil production has gone down SOO much, and I don't even need to wear powder during the day. Also, I have not had a new pimple in about a week (that would have NEVER happened before). It seems like my skin is clearing up, although I still have old pimples that have yet to go away.
Cons: I really have not had many side effects so far, except that I have to pee about 12 times a day. I don't really mind that though. Also, I am worried about the potassium issue even though I'm not sure if I even need to be worried at only 50mg per day. Hopefully my period will not be irregular when it comes.
Have any of you girls had irregular periods? (who are not on birth control as well)
What did your doctors tell you about the potassium issue?
Do you have to stop taking spiro if you are having a dental procedure? (I think I have to get my wisdom teeth out sometime 
)
Hey guys, I'm new here and I just started taking 50mg daily of spiro. I just have to ask you guys one thing. What are you doing about the potassium issue? For some reason I am really worried that I will eat too much potassium and die lol. I looked online and nearly EVERY food has potassium in it! And the foods that don't are just really unhealthy, and I don't want to start eating an unhealthy diet. I was just wondering what your doctors said about the issue and how your tests have turned out.
Thanks so much!!
Hi all, I must admit that I feel kind of weird posting here since I'm a guy but I'm almost at wits end. My wife was recently diagnosed with PCOS and she is terrified to take BCP because of the chance that it will make her acne worse.
She has been so depressed lately and feels that Spiro is her best chance. Only problem is that her OB keeps INSISTING to try Yasmine and giving her the run around about prescribing Spiro (I'm guessing because it would cost the hospital less). I've read that although Yasmine might help, it could potentially make her acne worse, as opposed to Spiro, where it either helps or doesnt. She swears that if she breaks out more, she "won't make it." 
How much would something like this cost if it were not covered by insurance? I love my wife dearly and I'm willing to do/pay anything at this point to help my wife. Any input would be greatly appreciated.
Concernedhubby
Hi all, I must admit that I feel kind of weird posting here since I'm a guy but I'm almost at wits end. My wife was recently diagnosed with PCOS and she is terrified to take BCP because of the chance that it will make her acne worse.
She has been so depressed lately and feels that Spiro is her best chance. Only problem is that her OB keeps INSISTING to try Yasmine and giving her the run around about prescribing Spiro (I'm guessing because it would cost the hospital less). I've read that although Yasmine might help, it could potentially make her acne worse, as opposed to Spiro, where it either helps or doesnt. She swears that if she breaks out more, she "won't make it."
How much would something like this cost if it were not covered by insurance? I love my wife dearly and I'm willing to do/pay anything at this point to help my wife. Any input would be greatly appreciated.
Concernedhubby
Thanks Peachy.
Well, my wife called the hospital but looks they are playing hardball or are just plain ignorant. They are saying that her problems are not "hormone" based and therefore only needs to see her OB, who won't prescribe her Spiro. They say that she needs to be referred by her Primary care physician to see a hormone specialist (Endocrinologist i believe). Only thing is that they are saying that she does not need to see her primary care physician because her problem has already been diagnosed as PCOS (which they say don't involve Endocrinologists) which they handle with OB's ! Can you believe that?
She called again today and they kept asking why she needed to see her Primary Care Physician over and over, paranoid that she is going to try to be referred to an Endocrinologist. What's up with that? I thought PCOS was also a problem with hormones?? She was finally able to convince them that it was for a routine check up, so we have an appointment in a couple of weeks. Hopefully her Primary Care Physician will refer her to one.
Thanks Peachy.
Well, my wife called the hospital but looks they are playing hardball or are just plain ignorant. They are saying that her problems are not "hormone" based and therefore only needs to see her OB, who won't prescribe her Spiro. They say that she needs to be referred by her Primary care physician to see a hormone specialist (Endocrinologist i believe). Only thing is that they are saying that she does not need to see her primary care physician because her problem has already been diagnosed as PCOS (which they say don't involve Endocrinologists) which they handle with OB's ! Can you believe that?
She called again today and they kept asking why she needed to see her Primary Care Physician over and over, paranoid that she is going to try to be referred to an Endocrinologist. What's up with that? I thought PCOS was also a problem with hormones?? She was finally able to convince them that it was for a routine check up, so we have an appointment in a couple of weeks. Hopefully her Primary Care Physician will refer her to one.
Thanks Peachy.
Well, my wife called the hospital but looks they are playing hardball or are just plain ignorant. They are saying that her problems are not "hormone" based and therefore only needs to see her OB, who won't prescribe her Spiro. They say that she needs to be referred by her Primary care physician to see a hormone specialist (Endocrinologist i believe). Only thing is that they are saying that she does not need to see her primary care physician because her problem has already been diagnosed as PCOS (which they say don't involve Endocrinologists) which they handle with OB's ! Can you believe that?
She called again today and they kept asking why she needed to see her Primary Care Physician over and over, paranoid that she is going to try to be referred to an Endocrinologist. What's up with that? I thought PCOS was also a problem with hormones?? She was finally able to convince them that it was for a routine check up, so we have an appointment in a couple of weeks. Hopefully her Primary Care Physician will refer her to one.
It was originally used for high blood pressure, but my derm just prescribed it for me today as my chin and jawline acne is hormone related. I have tried all the products and even a strict diet change, but nothing. The derm said its my ovaries producing hormones. I cant go on the bc pill because I got a blood clot from it last year. Have any women tried Spiro (in Canada)? It's known as Aldactone in the USA. Men cannot use it because its a hormone treatment.
Hi All,
I've read this entire thread and thought I'd join in to discuss my experience with spiro, too! Today is Day 18 and so far I can say with certainty that oil production is definitely down and it seems like my skin texture is changing. I am on 50mg/day with plans to gradually increase to 100mg/day as tolerated over the next couple of months. I am definitely noticing the diuretic side effects but I am very good at drinking water (10-12 glasses a day) so I have not experienced the headaches and lethargy that many report. I am on a relatively low dose so that may be why I'm tolerating it so well. We'll see.
I did break out this week 
, 1 week post period, which is unexpected, but I'm nursing a cold and I always break out when I'm sick for some reason. Anyway, I am hopeful as I am already noticing that something is happening but I realize that it takes a while to see significant change. FYI, I am also on Ortho-Tri Cyclen (have been for many years, since age 19, am 32 now), and using azelaic acid 20% cream (Azelex) for its antibacterial properties and treatment of hyperpigmentation. I get facials once a month and alternate between salicylic acid peels and microderm more or less monthly as well to help improve skin texture. Will keep you posted along the way....
On a side note, I'm a pharmacist and I just wanted to make a comment about potassium. From reading these message boards I notice that many spiro users are avoiding foods that contain potassium. While it is true that spironolactone is a potassium-sparing diuretic, if you have healthy kidneys you shouldn't have a problem. While it is wise to to have a blood draw every few months to check potassium levels, for people with good kidney function, it should be perfectly ok to consume potassium containing foods in moderation. I put half a banana in my cereal every morning and don't have plans to stop. It's good to be aware and cautious but when kidneys work well, there is no need completely forego all potassium rich foods. Just don't overdo it. You would have to cut out ALOT of healthy foods to avoid potassium in your diet. The following link will take you to a webpage with information about potassium and if you scroll down to the very bottom there is long list of foods and their potassium content. Check it out, just FYI!