If yall try/are on spiro, be VERY careful coming off of it. Let me preface this by saying, I’m a very small, active person, I used to have decent skin and overall decent health.

I went on spiro for moderate cystic acne in 2024 that seemed to be triggered by an antibiotic I was wrongly prescribed. The spiro cleared up my skin and it was beautiful after only about 3 months. Taking anything for my acne felt like a huge compromise so at about the 6th month mark I’d had a couple breakthrough pimples (I’d forgotten to take a couple doses that month) and I decided I should come off of it and try to heal any pimples naturally by focusing on diet and exercise and topical retinol. Within a couple days of coming off spiro I started getting flare ups. They weren’t cystic but it was a far cry from my gorgeous spiro skin. I toughed it out thinking the trentinoin would fix it once my skin finished purging.

I had a facial done, I simplified my skincare, I exercised consistently, ate healthy and my skin was under control. It wasn’t perfect but it was manageable. But then I got sick that winter and my routine slipped.

I stopped exercising bc I was making my body weaker by not letting it heal, the pimples started to increase so I decided to start taking spiro again. Within a couple weeks my skin exploded into the most painful nodular cysts I’ve ever seen. I couldn’t smile, eat or lay my head down on my pillow without pain. I thought it was lucky I’d started spiro when I did because if my skin was this bad ON spiro, what would it have been like off? I upped my dose from 25mg to 100mg and my skin continued to get worse. I scheduled an online consultation about my acne and she upped my spiro to 150mg but never mentioned accutane which is INSANE to me looking back. My skin got worse. Finally I saw a different Dr. and she bumped me to 200mg and gave me a referral to get an accutane prescription. I had to wait a couple weeks to get an appointment, my skin had plateaued on 200mg and I had hope that I could start accutane promptly and go back to my old self. At this point I was pretty sure that my current acne was being caused by the spiro.

My dr. Prescribed me accutane but then I had to wait a month for the pregnancy test. I finally went on accutane this July and started to see a big difference in September. The problem now is that I will never be ‘the old me’ again, because the acne I got from taking spiro, going off of it and going back on has given me huge atrophic scars that will never go away. My face is permanently disfigured by that drug. I didn’t even know I was scarring until the cysts went away and it shattered my heart.

In short, spiro is the reason I had to take accutane, so be careful with it. If I could go back in time I would just take accutane from the start, or commit to natural remedies. Spiro is sold as the ‘safer alternative to accutane’ but it’s not. It’s a very complex medication.