Clear skin post-spironolactone?

I've just been prescribed spiro (I have PCOS and therefore hormonal acne), but I really don't want to use this type of systemic treatment long-term. So, I'm wondering if anyone has been able to reduce their acne to a manageable level with spiro, and then maintain clear skin with just topicals after that.

My acne is usually mild, but I'm taking the spiro to control these gross under the skin lumps (they're like conglomerates of inflamed whiteheads or something) and cysts I keep getting on my chin after starting tretinoin (which I've been using for almost a month now). Nothing else seems to vanquish these gross jerks... I've taken several antibiotics in the past while on topicals to no effect, which always resulted in me just giving up on the topical due to redness, flaking, and IB... this time I want to stick it out, though. This is partly why my doc prescribed spiro rather than oral antibiotics (she said spiro would be more effective with my PCOS).

So anyway, is anyone clear post-spiro (with the aide of topicals)? Or is this just wishful thinking?

Now a RAM 0.1% Log

I've had mild/moderate acne since I was a teen (I'm 24 now), and in the past I've tried Retin-A, Tazorac, Differin, BP, and antibiotics. None of those really worked for me before, however I was never very good about using the topicals since they made my skin so flaky. For the past two years I've not been using anything at all, and I usually only suffer from comedones around my nose and chin, and occasional inflammatory acne or cysts, also around my nose and chin, ESPECIALLY before my period.

I had a particularly bad breakout before my last period that had me desperate for a solution; I'm really sick of looking in the mirror and seeing huge red spots (I'm one that doesn't want to go outside if I'm breaking out). So recently I went to a new doctor and esthetician to once again battle my acne.

I've never posted on this board before, however I have lurked around for quite a while, especially after being prescribed new medications, to see what others' experiences were like. I decided keeping a log might help me stick with my regimen this time.

OK my regimen (which began 7/15):

AM
Benev Glycolic Face and Body Wash
IS Clinical Moisturizing Complex (+two drops Benev Pure Titanium Dioxide SPF 30)
Paula's Choice Skin Balancing Super Antioxidant Mattifying Concentrate (this helps my makeup go on smoothly, so I don't bother with this if I'm not wearing makeup)

PM
Benzoyl Peroxide 5% Wash
Tretinoid Cream 0.05% (my esthetician has me using a pea sized amount mixed with the moisturizer 3x per week)
IS Clinical Moisturizing Complex

I've also been diagnosed with PCOS (polycystic ovarian syndrome), which means that my acne is likely a result of that. So, in addition to the topicals, my doctor has me taking daily supplements:

Chiral Balance (aka d-chiro-inositol) (for PCOS)
Vitex 750 (for PCOS)
Zinc (specifically for my skin)
Vitamin B
Omega-3 Fish Oil
Vitamin D (to combat deficiency)
Multivitamin

Whew. The only other thing to mention is that I occasionally use the Paula's Choice carbon mask, which really keeps my oiliness in check and also (slightly) reduces redness. This is probably not something I would recommend for everyone though, especially those with sensitive skin, as it tingles a lot when I first put it on (and my skin really isn't very sensitive). However, it works really well for me.

The IS Clinical moisturizer is amazing. Really. My skin became flaky as soon as I began using the tretinoid, however the IS Clinical has been totally keeping it under control. I'm still able to use my Bare Minerals powder; in the past my flakiness prevented me from using any sort of makeup.

Also, I used to get small red bumps on my upper arms and thighs, as well as ingrown hairs on my legs from shaving. The glycolic wash (I've been using that for about a month and a half now) has really effectively gotten rid of these problems.

Anyway, I've been breaking out a lot over the past few days, but I'm not sure if it's because of IB or an upcoming period (mine are irregular, so they're hard to predict). I still have a stubborn spot healing on my forehead from a cyst about a month ago. There are also several healing spots around my chin, which are peeling/ flaking and looking much better already. I have an active (well, healing now after it popped in the shower) inflamed spot on the left side of my nose, and I can feel another one coming up on the right side (yippee). Inflamed spots keep popping up along my jaw line, and there's one on my upper lip that's healing.

I'm also attaching pictures to track my progress. Yuck.