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Mirena and acne treatments

I posted a while back about the acne that I am having. After about three months of trying non-chemical, natural and gentler methods of treating it, I don't think it's getting much better and have decided to go to a dermotologist.

I'm pissed, so please excuse the rant.

I've been using LUSH soaps: Coal Face and Dark Angels. Phresh Pharm doesn't clean the make-up off my face, and I don't like it. Thayer's lavender witch hazel, which is alcohol-free. And tea tree oil, either straight or in a 20% or less solution with the witch hazel. Thank god my BF likes the smell of it. Benzoyl peroxide makes my face break out into dry scales that bleed if they get peeled off, and makes the skin underneath bright pink and crackly dry.

It's impossible to search for Mirena and acne online because everyone who mentions them together is complaining, saying Mirena causes acne and it's eeeeevil, when more than likely, they were on the pill for years and don't have that positive side effect anymore.


I think I'm just bacteria-friendly. I had raging yeastie beasties on the pill every other month, and at my first annual since getting the Mirena I ended up having mild BV. The NP gave me an oral antibiotic for the BV and within a week my face was nearly clear (but my tongue got fuzzy and I got a YI). Two weeks after stopping them, my face is breaking out again. I hate antibiotics but at this point I'm not beyond asking for them as treatment.

I do NOT want to get the Mirena removed, and if acne is the side effect, I'll take it over the migraines, moodiness, forced periods, daily maintenance, yeast infections, vag dryness, and cost of the pill.

So, I've never had the luxury of a dermatologist before. I have good insurance, so cost really isn't a factor. What should I tell them? Has anyone here had any experiences with Mirena and Accutane? Other retinoids or so on? Any products in particular I should be aware of?
edit:  I have been moisturizing like crazy.  Sometimes I use Vaseline Intensive Care around my mouth and on my cheeks, because those are the worst places.  It helps the dryness and doesn't seem to make the acne worse, so no harm done there. 


( 19 comments — Leave a comment )
Feb. 13th, 2010 03:47 pm (UTC)
I have nothing to offer by way of solution or what to expect with the dermatologist.
I will say that I was off all birth control for a year prior to Mirena. I got mine placed in December. Since then, I have had a daily fight with acne. So no, the pill wasn't keeping my face clear, b/c I wasn't on it. I have also tried numerous things with very little by way of result.. except my pocketbook being considerably lighter.
Feb. 13th, 2010 04:31 pm (UTC)
I also don't have anything to offer about the dermatologist, I just thought I'd give my take on what has helped my acne. I have gotten flare ups with my paragard due to, as you say, not being on the pill anymore, which I know is a diff. situation from what you have, but still, I thought I'd share what I do. It is still due to hormones, after all.

What has helped me is eliminating all fragrances, all essential oils (inluding tea tree, which while it is anti-bacterial, is also irritating for the skin. so it works for some but not for others) So yeah, eliminating all possible irritants. Then including a BHA (the one I use is from Paula's choice) and a benzyol peroxide (also from PC) They have different strengths of BP so you may want to find the one that is the weakest and also make sure it has no fragrance or other irritants in it, if you wanted to try it again. This is why Paula's choice has helped me. In most brands, even something that is "for sensitive skin" will still have small amounts of fragrance in it.

As a cleanser I use garbanzo bean flour. I use about a teaspoon with a bit of water to make a paste and scrub my face. This is very gentle and yet very effective. It's a great exfoliant and has no irritating ingredients at all, and it's very cheap. I keep it in a flip-top water bottle and dump a little into my hand for each washing.

I used to put essential oils like tea tree and others with anti-bac properties directly on my face, or on a cotton ball with witch hazel and now that I've stopped I firmly believe that was making my breakouts worse. Essential oils are irritants for the skin and I know they work for some people, but not for me! My two cents.

Good luck.
Feb. 13th, 2010 07:46 pm (UTC)
I second removing all irritants. A while before I swapped the pill for the Mirena I actually stopped using all products on my skin--no moisturizers, no astringents, no soaps. I rarely wear makeup or sunscreen (and probably I should do on the latter, but I spend very little time outside these days) so I was able to get away with it. I just use gentle rubbing with fingers and towels for exfoliation and only water for washing. My skin was 10x better after switching to this regimen than it ever was before. Being on the pill did help my acne some, but cutting out soaps and other cleansing products helped significantly more. I went from pretty much constant moderate breakouts to occasional moderate breakouts with constant mild acne on the pill to virtually nothing on the pill sans soap.

Now that I'm on the Mirena I was worried that the changing hormonal component might bring some of my acne back, and so far it has. As of right now it's about as bad as it was on the pill before I switched my cleaning regimen. It may even out in the coming months since I only had my Mirena inserted a couple of months ago, but in the meantime I'm supplementing my cleaning with Clindamycin phosphate, which is a prescription gel that is given as a topical anti-inflammatory and mild antibiotic. I was first prescribed it as a very acne-prone adolescent and it was the most effective product I've tried to date.

Though, I have to say, this garbanzo bean flour thing sounds really neat! I may have to give it a try. :D
Feb. 13th, 2010 09:06 pm (UTC)
I have never heard of using flour in that way. Does it remove make-up?

I must say I love make-up; it's one of my very favorite hobbies, as odd as that may seem.
Feb. 14th, 2010 12:10 am (UTC)
I wear make-up too (it's also a fun hobby for me!:)) and the garbanzo bean flour removes my foundation and blush. For eye make-up I use a separate remover. I don't think something that is harsh enough to remove mascara should be used on the whole face, even though it may save time.
Feb. 13th, 2010 05:02 pm (UTC)
While my acne was never really bad, I pick like crazy, so I saw a doctor to help stop the acne so that I could stop my picking.

I started out on Retnin A, which didn't do a lot for me. Then, I switched over to antibiotics. I think I was on amoxicillin and this could be what works best for you. It didn't work for me, but the acne healed quickly after I had it, so my picking decreased.

Finally, I went with Accutane. Ugh. It was horrid. But it worked like gangbusters. I was constantly thirsty, my lips were never not chapped, and I got a rare side effect of hip/lower back pain that took about six months to go away. But my skin cleared up amazingly. I don't think I would go through all of the hassle to do Accutane again. Really, you have to get a certified doctor and a certified pharmacologist to prescribe the pills after a full month of showing you're not pregnant. Then you have to go in every month for a pregnancy test and to take an Accutane quiz before they release another refill. You'll have to promise to start using a barrier method in addition to your IUD, too.

But like I said, it worked. Now that I'm off the HBC that I took as a part of being on Accutane, some of the acne has come back, but it's completely different (smaller and comes up maybe once every two months). Just be honest with your dermatologist. I'd go down the antibiotic path to try it out before getting into it with Accutane.

Good luck!
Feb. 13th, 2010 05:50 pm (UTC)
acne treatment
Hi there- I feel very strongly that people should not have to live with acne. I tried various things, short of acutane (that stuff freaks me out a little), all through my teenage years. Then, in college, I went to an awesome dermatologist who knew what was what. She prescribed Benzaclin (a topical oil-free antibiotic lotion with benzoyl peroxide) AND Tazorac gel (a retinod) AND some doxycycline. I used the Benzaclin in the morning, the Tazorac at night, and took two antibiotics daily. It was an insane regimen--and it worked like a charm. I only had a few weeks of dry, reddish skin and everything evened out. After a while I got nervous about being on antibiotics so much, so I dropped that and just use the Benzaclin in the morning and the Tazorac at night. It is just as effective! So you might suggest these two products to your dermatologist. I have long since moved on from the doctor, but nobody has ever had hesitations about writing me prescriptions for these two products. My advice to you, if you follow this. Find an oil-free face lotion and use it liberally (I like Neutrogena sensitive skin oil free moisture) and also an oil free sunscreen (I prefer the gel type. It smells weird and nobody else likes it, but damn if it isn't the only kind that won't make me break out.)

Based on your comment about antibiotics, I really think a topical antibiotic like the benzaclin might be just the thing for you. It is brand name, and so is the Tazorac, but since you say you have good insurance, I don't think the cost will be a problem.

In case you are wondering, I am 28, np, and have had a Paragard for 1.5 years. I have never been on hormonal bc, but I have had acne issues since age 13, and I have got to tell you: the over-the-counter stuff and the natural stuff just doesn't cut the mustard if you have more than occasional breakouts. Oh, and dermatologists are great. They don't act like you are vain or superficial for wanting to deal with the acne. Good luck!
Sep. 10th, 2010 09:45 pm (UTC)
Re: acne treatment
Hi There,

I was doing some research about the effects of the Paragard IUD on acne. After being so excited with my initial research, I was sorely disappointed when I read all the horror stories of how it affects acne. I came across your post because you use Tazorac (as I do) and have the Paragard.

I’m so excited about getting the Paragard because hormonal pills have KILLED me and my husband’s sex life. I wanted to know your experience with Paragard while being on Tazorac if you don’t mind sharing a little more.

I had acne when I was in high school and it didn't return until I was 27 around the time of my wedding. I went to the derm and he prescribed Taz based on my recommendation and research. I've been on it for a year now and it's great. I've gotten to the point of not using it everday anymore and my skin still looks great. But I wonder if the Paragard will force the acne bach to my skin's surface despite how good Taz is.

Also, have you heard about taking Zinc supplements to counteract the high level of copper in your system? I wonder should I start taking zinc NOW!!

Any insight will be much appreciated.
Sep. 12th, 2010 11:42 pm (UTC)
Re: acne treatment
Hi! If the Tazorac has worked for you in the past, I don't see why it won't work again if your acne flares up after going off hormonal birth control. Just to clarify: the Paragard won't cause acne. Hormonal birth control often helps acne clear up, so going off the hormones can result in more acne for some people. If this is true for you, it would happen when you went off bc pills even if you didn't get an IUD. But like I said, I have had good luck with topical treatments and if you had success with Tazorac before, I don't see why it wouldn't help if you need it again. Good luck with your decision!
Feb. 13th, 2010 10:22 pm (UTC)
When I quit HBC for Paragard, I got skin problems. Now experiencing it a little again after going from Paragard to Mirena. I find that exfoliating first, then applying an acne face wash each morning helps. I like Philosophy microdelivery wash and Biore ice face wash work great together. My skin is also dry, so Olay regenerist daily moisturizer with SPF 15 does not clog my pores (SPF 50 does!). At night, I don't wash my face. I just apply an acne spot treatment to my oily areas and cover with Roc night cream because it has a little retinol, which is good for acne and wrinkles, but does not overpower my sensitive skin like Retin-A. I've been winning the battle ever since. It's a pricy routine, but it's way cheaper than the dermatologist.
Feb. 13th, 2010 10:29 pm (UTC)
Unlike many people, I still have acne on the pill. At 30. What I've found helps the most is drastically changing how I think about my skin. I rarely wear makeup these days. Instead I simply rinse my face in the morning and apply a homemade moisturizer. If I shower at night, my face gets washed and then moisturized. Otherwise, I leave it alone. As a few others have mentioned, I've cut all fragrances out of my products. Since my moisturizer is homemade, I know exactly what is in it (jojoba oil, vitamin E oil, mango/cocoa/shea butters, and a bit of tea tree oil {which doesn't bother my skin}). My shampoo and conditioner are also fragrance free, and honestly I think this has had the biggest impact. I've been using Desert Essence organic fragrance free, and am in the midst of switching to JessiCurl, also fragrance free, if it works for me. I still get pimples, but not nearly as many as I used to and my skin is so much calmer (and I NEVER get dry skin any more).
Feb. 14th, 2010 12:17 am (UTC)
I think beyond the face washes and moisturizers you use, what goes in your mouth is the most important to your skin. The two best things I ever did for my skin: 1. Take a probiotic (pill form), and 2.) Cut out dairy and refined sugars as best you can. This should also help your yeast infections.

Good luck!
Feb. 14th, 2010 01:39 am (UTC)
You may have already thought of this, but how often do you clean your makeup brushes/sponges and replace your makeup? I know I'm really bad at throwing stuff out when it's not finished! This is an article on seven bad makeup practices you might want to consider, including timescales for replacing different products. Apparently, pure mineral makeup products are better for your skin, too.
Feb. 14th, 2010 06:31 pm (UTC)
Ooooooh I am nuts about cleaning my brushes and having clean hands. I wash my brushes weekly at least and always use the same brush for the same product to prevent any cross contamination and never share it. I had a food handler's lisense, so I think my habits came from that!

I do really like pure mineral makeup, but right now my face is so freaked out that it doesn't offer the coverage I need and it also causes the dry places around my mouth to get even dryer. :(
Feb. 14th, 2010 06:06 pm (UTC)
I noticed in your post you mentioned Accutane. You basically wouldn't be a candidate for it until you tried other more traditional and safer treatments for more than a year without any improvement. I go to a dermatologist for acne now, but I've had acne problems for years, and I have a Paragard, and I was never on any form of HBC. The first thing I did was ask about this magical Accutane I'd heard of and they just gave me the pamphlet, pointed out the part about "hey it's not exactly safe stuff (for anyone, not just women who might be baby incubators) so you have to jump through this long list of hoops (a few extra for potential baby incubators) to get it," and said we could discuss it in a year if the usual stuff didn't work. You might want to check out their website and all the stuff about the iPLEDGE program.

Anyway, they'll probably start you on some sort of benxoyl peroxide wash, so if you know that irritates you, make sure you tell them. The alternative is probably salicylic acid. Along with that they usually prescribe a topical antibiotic (sounds like just what you need) and a retinoid. They might also throw in an oral antibiotic (sounds like that might be a good one for you, too), but I had to discontinue mine because it wreaked havoc on my guts. In the meantime, I'd be quick to blame your makeup (and/or moisturizers). Look for products that are genuinely oil-free and non-comedogenic, as that could be exacerbating it, especially if you think your acne is strongly triggered by bacteria. Good luck!
Feb. 14th, 2010 09:36 pm (UTC)
retin a worked for me!

also accutane is for cystic acne. so you wouldn't be a good candidate for it.
Feb. 15th, 2010 04:42 am (UTC)
Clear skin
Three must have's:

Benzaclin (and don't go with the generic)
Jan Marini Oily Skin Glycolic Acid wash

I have tried 900 million other things from my derm and after 15 years of battling acne my skin is FINALLY clear. If they try to give you retin A ask specifically to use Differin instead. Duac also didn't work for me.

Routine: wash and benzaclin in the morning; wash and Differin at night (you can use Benzaclin to spot treat at night too because they work well together)
Feb. 15th, 2010 06:02 pm (UTC)
I think my skin sounds a lot like yours (whether on Mirena or anything else, for that matter). I have had a lot of luck with topical antibiotics, zinc, and retinoids.

I know it sounds crazy, but something else is maybe to stop washing so much. In fact, try stopping washing altogether, except perhaps splashing with warm water a few times a day if you are very oily. When things get bad for me, nightly hot compresses soothe a lot. No soap!
Nov. 2nd, 2010 02:29 am (UTC)
Try dandruff shampoo. If your skin is anything like mine, it's not bacteria but a yeast overgrowth. Washing my face with a gross-smelling, medicine-y dandruff shampoo has helped more than anything actually created for acne.

Worth a shot.
( 19 comments — Leave a comment )