I've been on the full 100 mg dose of spironolactone now for 5 months. My acne has significantly lessened! I no longer get deep cystic acne. I used to have a lot of painful cysts along my jawline and cheeks and I no longer have that. The only significant acne I have now is on my neck area, but I expect that will go away in time. I also get a few smaller whitehead type pimples on my chin and sometimes my forehead, but this is the type of acne I've had for pretty much my whole life before it got to be really bad, so I think I'm okay with it!
The first few months taking spironolactone were pretty awful (at least skin wise). I got huge cysts all over my face. It was probably the worst my acne has been in my life. It was kind of weird because it seemed like my acne traveled around my face. For instance, at one point my cheeks broke out really badly, and then my chin did, and then my forehead. Consequently, I now have a lot of red scarring all over my face which is pretty annoying. I just purchased a PMD which is coming in the mail and I've been using a retinol cream so hopefully those two things will help the red marks. My skin looks pretty much clear with makeup on!
I was worried about the side effects of spironolactone before taking it but I honestly haven't really had many side effects. I've noticed I am slightly more thirsty. I also didn't have a normal period for about 4 months and instead had light spotting for that length of time. My periods have regulated themselves though and I'm back to normal now. I was mostly worried the medicine would worsen my anxiety because I heard that happen to some people on the forums but I've had no problems with that whatsoever.
I didn't see much improvement at all the first four months and I only recently started seeing a huge improvement in my skin (yayy!) Hopefully it will continue to get better and better.
I attached some recent pics of my skin, the redness in my face is mostly from scarring, not active acne. I don't have many pictures from when my skin was really bad while on the medicine but I'll try to find some…The last pic is what my skin looks like with makeup on.
I'll update you on how the PMD in combination with retinol works out!