Managing Acne with Diane-35: Efficacy, Side Effects, and Duration

Using Diane-35

Hello, Doctor: I have been experiencing acne on my face for the past four years.
The condition fluctuates, and during severe episodes, my face becomes covered in acne.
From March to August of last year, I continuously visited a dermatologist, but the improvement was slow.
In July of last year, I consulted a gynecologist at your hospital, who performed an ultrasound and observed cysts near my ovaries.
He indicated that this could lead to hormonal imbalances, resulting in excessive acne.
Consequently, he prescribed the oral contraceptive pill, Plan B3, which I found to be very effective for my skin.
However, due to side effects such as weight gain (which felt like water retention) and breast tenderness, I stopped taking the pill after four months.
Unfortunately, two months after discontinuation, my acne flared up again, and my face became severely inflamed.
When I consulted the gynecologist again, he mentioned that it was a constitutional issue causing my acne, and while the contraceptive pill could help, stopping it might lead to a recurrence.
Feeling disheartened, I have now chosen to take Diane-35.
I would like to know if the lower dosage of Ethinylestradiol (0.035 mg) in this pill compared to the previous one (0.05 mg) might result in fewer side effects.
Additionally, if Diane is effective (I understand it usually requires at least three cycles), how long should I continue taking it to fully resolve my severe acne? Should I wait until I am no longer experiencing breakouts? If I stop taking it, will it lead to a recurrence? I have only been on Diane for half a month, and since I still have some inflamed and slightly swollen acne, I am also taking Cleocin 450 mg daily (three times a day) and IRZAIM.
I am concerned about potential adverse interactions between these medications.
I appreciate your time and look forward to your response!

Bu xiang zai wei dou dou fan nao le!, 20~29 year old female. Ask Date: 2003/04/28

Dr. Liao Wenyu reply Dermatology

1.
A lower dosage results in relatively fewer side effects.
2.
Monitor the condition of the face (wait until there are no more acne lesions).
3.
It is possible.
4.
Long-term use of Cleocin is not recommended; generally, these medications do not produce adverse interactions!

Reply Date: 2003/04/28

More Info

Diane-35 is a combination oral contraceptive that contains cyproterone acetate and ethinylestradiol. It is often prescribed not only for contraception but also for the treatment of acne, particularly in women who have hormonal imbalances contributing to their skin issues. Your experience with Diane-35 and the concerns regarding its side effects, especially weight gain and breast tenderness, are valid and common among users of hormonal contraceptives.

Efficacy of Diane-35 in Treating Acne
Diane-35 can be effective in managing acne due to its ability to reduce androgen levels in the body. Androgens are hormones that can increase sebum production, leading to clogged pores and acne. By lowering these hormone levels, Diane-35 can help decrease the severity and frequency of acne breakouts. Many patients notice improvements after a few months of consistent use, typically around three to six months. However, individual responses can vary significantly, and some may require longer durations to see optimal results.

Side Effects and Weight Gain Concerns
Regarding side effects, common ones include breast tenderness, nausea, headaches, and mood changes. Weight gain is a concern for many users, but studies have shown that significant weight gain is not a universal side effect. For instance, a study from Canada indicated that while some patients might experience minor weight fluctuations, the average change was not statistically significant. The perception of weight gain may also be influenced by water retention, which can occur with hormonal changes.

In your case, the previous contraceptive you were on had a higher dose of ethinylestradiol (0.05 mg) compared to Diane-35 (0.035 mg). This lower dosage may indeed result in fewer side effects, including less water retention and weight gain. However, individual responses can vary, and some may still experience side effects regardless of the dosage.

Duration of Treatment and Recurrence of Acne
As for how long you should continue taking Diane-35, it is generally recommended to stay on the medication for at least three cycles to assess its effectiveness fully. Your dermatologist will likely monitor your skin condition and may suggest continuing the medication until your acne is well-controlled. If you stop taking the medication, there is a possibility that your acne may return, especially if the underlying hormonal imbalance is not addressed.

Combination with Other Medications
You mentioned that you are also taking Cleocin (clindamycin) and IRZAIM (which I assume refers to a topical treatment). Clindamycin is an antibiotic that can help reduce inflammation and bacterial growth associated with acne. Using it in conjunction with Diane-35 can be beneficial, as it targets different aspects of acne development. However, it is essential to monitor for any potential interactions or side effects. Generally, there are no significant interactions reported between Diane-35 and clindamycin, but always consult your healthcare provider regarding any concerns about combining medications.

Conclusion
In summary, Diane-35 can be an effective treatment for acne, particularly when hormonal imbalances are a contributing factor. While side effects such as weight gain and breast tenderness are possible, they are not guaranteed and may be less pronounced with the lower dosage of ethinylestradiol in Diane-35. It is crucial to maintain open communication with your healthcare provider about your treatment plan, any side effects you experience, and the duration of therapy needed to manage your acne effectively. Regular follow-ups will help ensure that your treatment remains appropriate for your needs and that any concerns are addressed promptly.

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