No. 018: Spironolactone.

On coming home.

I tell my brain it needs to have something like this memorized, but my brain says, “Sorry—the best I can do is the first five letters.”

A couple weeks ago, when the X-Acto knife skipped on the straight edge and sailed a quarter-inch into my forefinger, and the next day it looked so black and swollen I wagered I’d better take it to urgent care, the intake nurse asked what medications I was taking, and I said, “Spiro… spirolu… um, the acne one?” Thankfully she knew what I was talking about. I guess I’m not the first to get my tongue twisted on this one.

I just started taking spironolactone a few months ago, but my hormonal acne has been bothering me for a couple years now. It has never grown truly severe, but my skin scars easily, so every month I gain a couple new dark spots marking where the zits have been. I can cover them easily enough with concealer, but the acne is uncomfortable, and the scars itch too, so if there was a simple solution, I figured I might as well try it.

Last summer I moved back to my hometown in Georgia after fourteen years in the Midwest. When I browsed my insurance portal in search of a dermatologist, I noticed that the one who treated me when I was in high school was still practicing. I had liked her back then, so I estimated I’d like her now too. When we met for my appointment, she got straight to the point: “This is what you’re going to do: spironolactone.”

During our conversation she asked me whether I had ever been on Accutane. “Yes,” I told her—although I felt too shy to tell her that she had actually been the one to prescribe it to me way back when. She told me mine was a common story: Women who used Accutane as teenagers to treat acne on their foreheads and noses enjoy some dermatologically pleasant years in their twenties, but when their thirties roll around and they’ve had a couple kids, hormonal acne shows up to wage war against their chins. And then they go on spironolactone.

Coming home to Georgia has been like that. Old sorrows, old pains—ones I thought I had outgrown—have crept in and surprised me. This landscape brings out a side of me that I thought I had left behind, and I find myself returning to the same questions that pestered my high school self. Now, however, the questions hit me in different places, and I’m working with a different set of answers.

The spironolactone, honestly, is just okay. Some months my skin remains clear, but others it breaks out just the same as it did without the medication. Acne isn’t easy, and life isn’t either. I’m still trying to figure things out—still trying to heal the hurt spots. It’s a process, and I’m doing my best to trust it.

But all in all, I’m glad to have come home. It’s a matter of redemption.