I know the risk is slim if you follow directions, but I'm downright paranoid about getting pregnant! I won't even accept generic pills, though I know they're chemically the same. (I got pregnant and miscarried at 16, and since then I've always been deathly afraid of getting pregnant. And I don't like kids.)
I discussed doing Accutane again with my dermatologist (same one since 11, I won't let him retire), but it was such a pain in the a$$. Er, face. I did it during summer, and I cannot imagine it during winter. I'm normally very oily, but this stuff had me cracking and bleeding in August! It was awful. I was so desparate one night that I put Vaseline on my face. That is such a no-no for oily/acne-prone, but it *hurt*! And I was dry, um, everywhere. Yeah, there. I still have a flaky scalp almost 6 years later, and I never had that before. Plus I had to get blood work done every month while I was on it to ensure my liver didn't explode or something.
The spironolactone affects the way that testosterone affects your sebum glands. We determined that my breakouts were hormonal long ago, and we both did some research on androgens and their effects on oil production. It was originally a blood pressure med, but this is a secondary benefit. It's working so far, along with the Proactiv. Before, it was zits on every square inch of my face around the time of ovulation (10-14 days before period, when oil production increases). Now, it's 2-3 total. We plan to half my dosage, except for during that time of the month.
Wow. I just bored *myself* to tears. Sorry to ramble.