Bonsoir!
Just thought I'd share the interesting appointment I had with my (UK) derm today.
On acne in women:
Usually men suffer worse with acne, but it is short lived. Unfortunately for women, acne can go on through to mid-thirties.
On Dianette/Dian 35:
There is no good reason for GPs wanting to take you off Dianette after 12-18 months, the problems with the pill have nothing to do with length of time on it. If you are going to have a bad reaction you will have it within the first 2 weeks. We find it is usually a very effective drug.
On Spironolactone in the UK:
Actually there is nothing new about Sprio for acne, we used to prescribe it quite a lot it before Accutane came along. But quite simply, accutane is more effective and usually results are indefinate
On having no periods during Sprio (or any hormonal drug) use:
Excuse the sexist explanation, but periods all the time aren't necessarily the natural thing for a woman, years ago women were having a lot more children and so would not have periods much at all! After six months gynocolgists don't really like it as your uterus can start to get heavy, but there's really no medical cause for concern if you don't have a period every month..
On Accutane:
2 out of 3 people never have to be re-treated after one course of accutane, it really is the drug of choice because everything else merely 'blocks' skins receptors to acne, accutane stops the acne itself. Side effects can be painful, but if you're willing to go through 4 months of hell, and come out the otherside probably never having to suffer again, that could be the end of it. Breakouts are usually in the 2nd and (sometimes) 12th week.
Anyway, he said I can have accutane if I want... or stick with the spiro. Gosh I wish I'd had this appointment at 18 when I just could have taken the course of accutane in the summer holidays.. but there's no way it feels worth it now.
Basically I've never suffered terribly with acne, only ever had it on my chin since I was 18. Been on Dianette and topicals, taking 100mg pd of Sprio for 4-5 months now, I have cleared up a lot and now only really get one cyst per month (which still sucks) but I want to give Spiro a full 8 months before I give up.
As you can imagine, though I would love a long-term fix. The thought of accutane scares the hell out of me. Mainly the part about getting worse before it gets better, I take sick days at the moment just because of one cyst, there's no way I could cope with more. Also, my acne has never scarred, but I hear it can with accutane...
Any advice? 
Thanks,
Sara
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