Mirena and acne... is it forever?

October 17, 2012 11:58 AM

IUDs and acne. How long should I wait before seeking serious acne treatment? Will the hormone acne subside?

My Mirena was inserted on July 1st. Since then, my acne has gotten progressively worse and is now on par to what it was in high school, which is about the severity of considering antibiotics or accutane. Normally my acne is mild and maybe I'll get one or two blemishes along with blackheads in the usual areas.

Obviously, as a 28 year old woman, I am not pleased.

Has anyone had a similar experience? Did it subside after while? I think I could wait a bit longer, but unfortunately it's taking a toll on my self esteem big time. I'm definitely not going to remove the device, but just get the acne treated. Can you even use accutane on this type of hormonal acne?

Can anyone offer advice or anecdotes here? Thanks in advance!

posted by two lights above the sea to health & fitness (16 answers total)

Anecdote: I have had an extremely similar experience. My acne did not seem to appear immediately, maybe within six months or so of insertion. And it's not off-the-charts bad, but considering I had one two two blemishes every once in a while and now I have a permanent patch on one cheek, it's less than ideal. I am currently on antibiotics and a topical cream (treninoin?) and it doesn't seem much better.

From what my dermatologist told me in the initial appointment, accutane is an option but she wanted to try other stuff with me first before we threw the big guns at it. There is apparently also a hormonal option, but it takes 2-3 months to start working and can cause birth defects if you get pregnant (and takes several months to get out of your system after you stop taking it), so we opted to start with the antibiotics.

I don't have advice to offer so much as solidarity, since I'm sort of in the middle of this process (going to my follow up with the dermatologist in a couple of weeks). I, too, will await the responses of other individuals with more information.
posted by pitrified at 12:06 PM on October 17, 2012 [1 favorite]

I had two of the worst episodes of acne in the first six months after the Mirena was put in. It really sucked. I also spotted for those six months. I'm one of those lucky people who hasn't had too much skin trouble in my life. However, things have really settled after six months. Stopped spotting, have light periods and have just some minor acne around my cycle. I'd talk to your doctor about it but it may get better. Just be very gentle on your skin right now!
posted by amanda at 12:06 PM on October 17, 2012

Thanks so far! I should mention that I was previously on no BC before (condoms) and then nuvaring after that until immediately before the Mirena. Acne was mild during both those times. However, I was battling what mild acne I had and nothing really worked for that, so I'm thinking I would just skip right to accutane if it doesn't get better in the next month or so.

Also, I have no other symptoms what. so. ever. Not even spotting. Haven't had a drop since the beginning of August, hence my complete and utterly refusal to remove the device. So, it's not all bad.
posted by two lights above the sea at 12:16 PM on October 17, 2012

There are other options besides accutane- I am currently on Ziana (a topical antibiotic and pore-shrinking gel) and it seems to be helping. I'd just go ahead and ask a dermitologist- worst case scenario, they tell you to wait a few months and then come back. (This is why I went for the copper IUD- I'd rather have a heavier period than even worse acne!)
posted by showbiz_liz at 12:20 PM on October 17, 2012

This happened to me. I definitely got way oilier and broke out all the time. My doctor told me to wait six months to one year - she said that I should acclimatize to the side effects, and they shouldn't be as pronounced, then.

It did get way better, but not like before. I now use a topical antibiotic gel, which is pretty golden, and does the trick.

So...things may get better in a few months, or may not. Or, it might be worse, but not so bad to require accutane, at all. My only regret is that I didn't get the gel at six months. I waited the year, but in retrospect, everything had stabilized at about 6-7 months, so there was no need to wait any longer.
posted by sock puppet of mystery! at 12:41 PM on October 17, 2012

Try spironolactone before jumping into the accutane.
posted by elsietheeel at 1:07 PM on October 17, 2012 [1 favorite]

I would wait much longer before considering Accutane, but I don't think antibiotics or topical treatment (retinoids or similar) is an extreme step. With Accutane, you have to worry about increased blemishes and/or cysts, but if you start around of antibiotics, your skin is unlikely to get much worse before it gets better and you have fewer side effects. I think post-Accutane scarring can be pretty bad, too.

Retinoids are also great - or can be great - because they help with wrinkles. Just remember to wear sunblock like it's your job.
posted by ablazingsaddle at 1:38 PM on October 17, 2012 [1 favorite]

And by the way, don't feel bad about not "toughing it out" or something like that. Yes, this too shall pass, but acne is on your face! It's okay to feel self-conscious about something that's on your face, and it's good to be proactive in treating it to avoid further scarring.
posted by ablazingsaddle at 1:39 PM on October 17, 2012

If the acne is bothering you, you should definitely see a physician to discuss the best treatment option for your acne. Usually both patients and physicians want to try something else prior to Accutane because of the onerous requirements for women on Accutane and other possible side effects (i.e. mood issues, etc).
posted by treehorn+bunny at 2:18 PM on October 17, 2012

Like elsietheeel, I came here to recommend spironolactone (I think this may be the hormonal medication pitrified alluded to, also). Before getting my Mirena a month ago, I was using spironolactone in conjunction with hormonal birth control. Adding spironolactone made a huge difference for me initially, and hopefully it will keep being as effective with the IUD! [I was initially taking 50 mg of spironolactone, but when I told my derm that I was considering getting an IUD and stopping hormonal birth control, he bumped my prescription up to 75 mg to make up for it.] Good luck!
posted by hefeweizen at 3:47 PM on October 17, 2012 [1 favorite]

As you can see by the wide variety of answers here, see a dermatologist! There so many different types of acne, and causes of acne, and everyone's body is different so . . . see a dermatologist.

Your primary care doc will probably not be super helpful with this stuff.
posted by ablazingsaddle at 4:42 PM on October 17, 2012

Just chiming in to third spironolactone. I had some hormonal acne prior to my Mirena, but it got somewhat worse with Mirena, and my only regret is that I waited as long as I did to see my dermatologist. I've been on spirnolactone since January and it has made a huge difference in my skin. It is also reasonably priced compared to a lot of medications (I pay about $25/month) and I've experienced absolutely no side effects.
posted by Caz721 at 5:18 PM on October 17, 2012

Ack, that sucks! Sorry to hear about it.
I've had the Mirena for more than 4 years now (I'm 27) and can tell you that for me, it's been very much worth the troublesome first 6 months. Although I must say, I didn't have skin problems, but terrible cramping, spotting, etc.

I just wanted to share a skin-related anecdote (also for the poster Amanda) - about a year ago, I also got a bad patch of what I thought was acne on my right cheek, near my nose, and later on my left. I had been having more hormonal headaches/cysts and whatnot at the same time, so I thought it was possibly connected to that and the Mirena.

However, the acne patch didn't respond AT ALL to my usual, effective, at-home treatments. So I headed to the dermatologist, who diagnosed me with rosacea. To this day I'm not sure what triggers it, so I'm not sure if those "hormonal" symptoms were causal or coincidental.
Treatments for rosacea are quite different than those for acne, so perhaps that's worth checking out, if your acne doesn't respond.

I hope that you can find a solution! Good luck
posted by Pieprz at 11:41 PM on October 17, 2012

Yep, count me in as another wait out the six months vote. I was on Nuvaring before the Mirena was inserted, and had significant side effects, including oily skin and breakouts, for about six months after insertion. My doctor told me at the time that while there was no way to tell for sure, she suspected the experience might have amplified by going off Nuvaring, which carries side effects of its own (including skin crankiness.) Obviously, IANAD, but since you asked for anecdotes and mentioned you were on the ring I want to throw it out there.

It's now been 15 months and things are much more settled down. I get a couple of blemishes a month and I'm still slightly oilier than I was on the pill/Nuvaring, but it's TOTALLY, TOTALLY liveable. It was really hard to wait and trust people when they told me everything would settle down, but for what it's worth now I'm on the other side echoing that same advice.

My doctor was super reassuring during the adjustment period, so if you haven't already let him/her know, do so. If nothing else it can set your mind at ease.
posted by superfluousm at 6:18 AM on October 18, 2012

After going off the pill my skin was a mess for years. The thing that really worked for my hormonal acne was Spironolactone. I can't believe how much better it is. It took me years to get it sorted out, but going to a cosmetic dermatologist instead of the more medical-focused ones in the past meant that he was aggressive in his treatment. It's cheap/generic (one of the $4 for 25mg deals at many pharmacies, so if you're prescribed 75mg ask them to write the script as 3 x 25mg per day).
posted by Bunglegirl at 9:19 AM on October 18, 2012

Hi! Just to update:

Spoke to my GYN on the phone about my acne and that I've tried a ton of topical meds before. She said she would be totally willing to try spironolactone. Will update if anything changes.
posted by two lights above the sea at 2:43 PM on October 22, 2012