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Hmm, were you taking any antibiotics long term? I know that when my BC (tri-levlen) and Spiro (200mg) stopped working after 3 years of use, it was because I had used Minocycline for 3 months. It was so sad and frustrating because those two meds had helped 50-75% of my problem (depends on the season) and after mino, it was like 25-50%. I got more cystic acne, small little tiny bumps near my mouth and on NEW areas of my body. I got nose, ear, lower arm, lower leg acne among my usual facial, scalp, and body acne.

So I cried depression (blaming the BC) and my gynecologist sent me to my current endocrinologist. Since I was on BC to control my hormones, I had to see a specialist before I could be taken off. Of course I had to go off of both meds in order for him to get a baseline of my normal hormone levels (takes 2-3months). Luckily it was nearing summer (when My skin is at it's best) and I didn't start to breakout from lack of medication unitl mid-july, but by then I had a dx of PCOS or Insulin Resistant and I began treatment.

It's been almost 2 years later, and the only drug I now take is a lower dose of spiro (150mg), could probably go lower, and follow my low carb diet (Gluten free, etc). I've been on this regimen for 9 months now, and I've noticed improvements in other areas (not thrilled about the weightloss) and my skin is 99% clear!!! That's a success rate better than any other combination of treatments (natural, topical, and prescrpition) that I've tried. I know that spiro helps with my oilies and the acne a bit, but I mainly take this to help with my mild hirsuitism. Maybe one day I can find an alternative to this as well.

Have you gone to an endocrinologist? If you find a good one, took me several tries, it could change your life. =)

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