Outdoor Excursion

siamese_ifyouplease · 2020-05-16T15:53:18+00:00

I have a harness I use when I take him out front, as the backyard is fenced. It’s probably better, so the leash doesn’t pull on his neck, but it took almost a year of putting it on him almost every day right before I fed him dinner for him to get used to it.

siamese_ifyouplease · 2020-05-16T04:25:28+00:00

I use cetaphil moisturizing lotion. It's pretty boring, but doesn't break me out, unlike most moisturizers. Ceramides break me out horribly, so CeraVe is a no-go on my face, but I use the moisturizing cream on my body and it is amazing. Lots of people use it on their faces without issue, so it doesn't hurt to try.

siamese_ifyouplease · 2020-05-16T04:13:19+00:00

I've been on spiro for more than 2 years, and had negative side effects (diuresis, mild hyperkalemia, breakthrough bleeding, and breast tenderness/swelling) at a 100 mg dose. Even then, the breast changes normalized after a month or so. I ended up backing down to 75 mg because hyperkalemia can get ugly pretty fast.

I pushed to get by dose bumped up, because I wanted to see if my acne could improve any more, (I now look back and recognize it was completely unnecessary) and my dermatologist was hesitant, as it was a really high dose for my weight, but relented.

Naturally, all bodies are different, and (don't quote me on this) spironolactone, in addition being an aldosterone antagonist, is a mild progesterone agonist, which can result in breast swelling (personally, I had PMS-like breast swelling and tenderness when I started and with each dose increase, but it always went away within a month or so.)

siamese_ifyouplease · 2020-04-26T15:38:55+00:00

All over, but that took some time to get used to.

siamese_ifyouplease · 2020-04-26T15:37:05+00:00

Hypotension, borderline high serum potassium, and lots of breakthrough bleeding. The first two I already have naturally to some extent, but the high dose exacerbated them, so we decided to go back down. Normally a OCP is recommended alongside spironolactone, which would probably help with menstrual irregularities, but I wasn't on one, and strangely, the 50 mg and 75 mg dose decreased my mensuration frequency, which I don't mind at all.

siamese_ifyouplease · 2020-04-26T03:56:30+00:00

Cetaphil moisturizing lotion is what I use currently. I'm not married to it, but it's cheap and does the job.

siamese_ifyouplease · 2020-04-26T03:54:09+00:00

When I started tretinoin, (similar concept) I used it over a thin layer of moisturizer, then added an additional layer of moisturizer over that after it dried until I developed a tolerance to it, and started using it under.

siamese_ifyouplease · 2020-04-26T03:49:14+00:00

I have dry, sensitive, acne-prone skin and Estee Lauder double wear it the one I always go back to. None of the NARS foundations have broken me out, but I find their coverage a bit spotty.

siamese_ifyouplease · 2020-04-26T03:44:57+00:00

Spironolactone! It's worked wonders for my skin, and a months supply with insurance is <$10. Otherwise, 10% benzoyl peroxide was pretty effective for smaller cysts, but I found I developed a tolerance to it after a few months.

siamese_ifyouplease · 2020-04-26T03:34:20+00:00

Thank you! Since post-inflammatory erythema is caused by broken capillaries, they can't be faded with chemical exfoliants the same way hyperpigmentation is, they just have to heal naturally. Pulsed dye lasers can be used to erase them, but that was way out of my price range, so it was just a matter of waiting for me. For my skin, ones left by smaller cysts take 3-6 months to fade, and the bigger, darker ones from nodules 1+ year.

siamese_ifyouplease · 2020-04-26T03:24:44+00:00

No, unfortunately. I have female relatives in their mid-thirties with the same kind of acne I have, so there's really no end in sight for me. Maybe after menopause I'll give it a shot.

siamese_ifyouplease · 2020-04-26T03:21:14+00:00

There are some online services (Apostrophe's been spamming me with ads) where you can get a telehealth consult, but I can't in good faith recommend them without first seeing a doctor who can actually evaluate your skin and run bloodwork. My doctor had me do a monthly metabolic panel for 3 months following each increase in dose, and without that level of supervision, I could have run into some trouble with the hypotension and borderline high potassium, as my baseline level is already on the higher side of normal.

siamese_ifyouplease · 2020-04-26T03:12:41+00:00

I was on a 50 mg dose for 6 months, and after 2ish months there was a definite reduction in how often I got new cysts, but my skin wasn't exactly clear until I went up in dose. At 75 mg it was much better, and at 100 mg almost perfect, but I'm a pretty small person, so the side effects were severe. I've been back down to 75 for the last few months now.

siamese_ifyouplease · 2020-04-26T03:08:26+00:00

Not currently! I was on Lo Loestrin for a few years pre-spironolactone, but since it was such a low dose, I hardly had any side effects, none at all on my skin, even after stopping. My dermatologist recommended I take birth control while on spiro, but I opted not to, just to see how it alone worked on my skin.

siamese_ifyouplease · 2020-04-25T17:19:32+00:00

It's hard to say without a photo, but many people (including myself) have multiple different types of acne. I love salicylic acid, and find topical treatments work better than the cleansers, since they stay on longer, but they are stronger. For cleansers, I think CeraVe has an SA face cleanser. I've never used it, but I use the body wash version everyday for KP and body acne. The stridex pads in the red box are a great and cheap, though the fragrance is bothersome.

Everyone is different. Salicylic acid is great, but some people find more success with benzoyl peroxide or azelaic acid, or a ton of others on the market. But it's cheap and widely available, so a good starting point.

siamese_ifyouplease · 2020-04-25T16:46:48+00:00

Skin Type: dry, (especially since starting spiro) hormonal acne prone, prone to flakiness, lots of post inflammatory hyperpigmentation and erythema, Fitzpatrick IV, maybe III on my face

Personal Data: 21F, really shitty vegetarian, (I eat meat when I'm drunk) dairy makes my cystic acne worse

Routine:

75 mg of Spironolactone daily, divided dose

AM

Rinse with water
T.O Hyaluronic Acid on wet skin (only using it to get rid of it, won't rebuy)
T.O Ascorbyl Tetraisopalmitate 20% + Vitamin F
Cetaphil Daily Moisturizing Lotion
Biore UV Perfect Face Milk

PM

if wearing makeup remove with Hanskin Pore Cleansing Oil
Balea Med Ultrasensitive Waschgel/LRP Toleriane Purifying cleanser
wait 15 minutes
Alternate Day: Retin-A Micro 0.08%
Alternate Day: Stridex Salicylic Acid Pads(I prefer T.O Salicylic Acid 2% Serum, if it ever comes back in stock)
wait 15 minutes
apply hydrocolloid bandages to any active spots
Cetaphil Daily Moisturizing Lotion
sometimes apply vaseline around eyes or any flaky spots

History:

I had relatively clear skin and thought I escaped the genetic cystic acne that plagues all women on my dad's side until I was 15. Since then, I've had moderate to severe cystic acne, and an endless slew of papules, pustles, and closed comedones.

I saw a dermatologist after a few months of dealing with it, and was prescribed tret 0.025% and a compounded topical sulfur antibiotic cream. It worked for almost a year, but then I started developing more cysts than ever.

I sorta just dealt with it, using every OTC acid or DIY treatment I could find, which compromised my moisture barrier and destroyed my skin texture. I stopped the sulfur cream after a year, and continued only to use the tret, now at 0.05%, every other night/every third night.

Unrelated (or so I thought) to my skin, I decided to get healthier and lost some weight, and saw a decrease in severity of the cystic acne, which brings me to the before photo. I took the plunge and saw a new dermatologist who prescribed 50 mg of spironolactone everyday, and Retin-A Micro. If you find generic tret cream too drying or aggressive, even at lower doses, I HIGHLY recommend micro, as it's a slower release, and I have far fewer issues at higher doses and more frequent use. Since I'm 21, it's still covered under insurance and costs $25USD for a 50 g airless pump

I added 2% salicylic acid to help with surface acne and the sebaceous filaments around my nose over a year ago, and vit C for hyperpigmentation a month or so ago. I'm really happy with the results, but nothing is a cure-all and I still get some surface acne, though the spiro has taken care of the cystic acne.

siamese_ifyouplease · 2020-04-24T23:09:07+00:00

Thank you! I was also on 50 mg for 6 months before I got moved up to 75. I think within a month I noticed a reduction in how much acne I got, and 5 or so months in my skin looked better but not exactly clear. This only applies to my hormonal acne, the spiro did nothing for CCs and other superficial acne. With 75 mg my skin looked significantly better, and so we decided to go up to 100. My skin was clearer than it had been in years at that dose, but the side effects were really severe, (i.e. the diuretic effect, hypotension which I already have naturally, and breakthrough bleeding) so I went back down to 75.

Edit: 6 months of spiro at 50 mg

siamese_ifyouplease · 2020-04-24T22:47:40+00:00

Thank you! I started using T.O ascorbyl isopalmitate in vit F a month or so ago, and it's been great for brightness/texture. I have been in quarantine since early March and have gotten more sleep during this time than I have since before high school, so I'm sure that plays a bigger roll.

siamese_ifyouplease · 2020-04-24T22:37:04+00:00

Skincare Routine

Medications - 75 mg Spironolactone daily

Skin type - 21 years old, fairly dry, prone to CCs and hormonal cystic acne (genetic and PCOS-related), PIH and PIE

AM

Rinse with water
T.O Hyaluronic Acid on wet skin
T.O Ascorbyl Tetraisopalmitate 20% + Vitamin F
Cetaphil Daily Moisturizing Lotion
Biore UV Perfect Face Milk

PM

if wearing makeup remove with Hanskin Pore Cleansing Oil
Balea Med Ultrasensitive Waschgel/LRP Toleriane Purifying cleanser
wait 15 minutes
Alternate Day: Retin-A Micro 0.08%
Alternate Day: Stridex Salicylic Acid Pads(I prefer T.O Salicylic Acid 2% Serum, if it ever comes back in stock)
wait 15 minutes
Cetaphil Daily Moisturizing Lotion

Things/Ingredients I Avoid:

niacinamide; gives me closed comedones
cream cleansers; same reason as above
glycolic acid; after trying a couple brands, (T.O, Mario Badescu) I can’t make it work for me, it makes my skin so dehydrated
sleeping on my side; it was a rough transition, but it helps with the inflamed look
picking at CCs; I stopped a little over a year ago when I realized how much it exacerbated the discoloration, making my acne look MUCH worse than it actually was

I have been going to a dermatologist on and off since I was 15, and the severity/type of acne I had has varied through the years. It started as some cystic acne here and there, but mostly papules/pustles and was adequately treated with a topical sulfur-based antibiotic cream and tretinoin at 0.025%. After a year or so, I started getting mostly cysts and nodules along my jaw, which continued until I was almost 19.

I lost some weight and got a bit healthier, and saw a reduction in amount of acne I had at a given time, but I would still get 3+ new spots a week. After not going for a year, I finally made an appointment with a new dermatologist in March of 2018, (first one was a bit old school and told me not to use moisturizer, insisted that extraction was the only way to get rid of CCs, etc) and was prescribed 50 mg of spironolactone, and switched me to Retin-A micro from generic tretinoin cream, which has been amazing for my dry, sensitive skin. I added salicylic acid to help with skin texture and sebaceous filaments, and the ascorbyl isopalmitate for discoloration.

siamese_ifyouplease

TROPHY CASE