Has anyone ever tried really small doses of Spironolactone and build up to a larger dose to avoid an initial breakout? I know some people start at 25mg and go from there, but I'm talking about maybe even cutting the pill in half or in quarters and starting even smaller, say 12.5mg or 6.25mg? I'm wondering if the microdoses wouldn't shock the body's hormones as much and then slowly go up in mgs. Please let me know your opinions! 
i started at 25mg, 50mg, 75mg and 100mg when i first went on it years ago and found that each time i upped the dosage it would totally throw off my cycle so i would get 2 periods a month. for me the worst breakouts i would get is before my period so that made it much worse then if i would have just jumped in and taken the 100mg a day instead. once i started on keflex then my acne cleared up and over time i was able to wean off the keflex and stay totally clear on the spiro. its been almost 6 1/2 years for me now so best decision i ever made. good luck to you!