Hey all. So devastated to be on this site again :(((
After 6 years of smooth, 100% acne-free skin I dropped my daily dose of Spiro from 100mg to 50mg around Nov-Dec last year. For about a half year, nothing happened apart from a couple spots (1-3 a month).Then suddenly in June acne came back with a vengeance - one on top of the other.
Ever since then, I raised my dose to 100 then 150 and evenualy 200mg-s. Acne decreased, and could go 3+ weeks without red spots, but was never free of whiteheads - the kind that could flare up any day. The first time Spiro got me clear after 3 months, now it's been 4 and I'm still breaking out with new whiteheads and the occassional red spot/cyst, and the old ones left marks so my skin looks awful overall.Now I got acouple of cysts/whiteheadsout of nowhere, just when I thought I was out of the woods!
I'm beyond devastated and about to start accutane for a 3rd round (previous ones were low dose and short).I hate the idea of going to the 'tan (especially that my eyes are bone dry as they are and wouldn't fancy permanent conjunctivitis).
Should I stick with Spiro???
ANY INPUT AT ALL would help me.
I have hormonal acne and dapsone 5% gel helps to stop early bumps from turning into whiteheads/clearing up a lot quicker. Zinc picolonate also helps. My hormonal acne also has to do with insulin resistance and flares when I eat high GI foods so bc, Spiro, berberine, and metformin helps with that.
Hey. Last year I was in your shoes. I too suffered from cystic acne before that accutane took care of. Imagine how devastated I was to turn 32 and get hit with the worst cystic acne/hormonal breakout ever 
I felt hopeless and suicidal and couldn™t believe I was dealing with it again. So I was put on Spironolactone. I thought it was helping but then I couldn™t tell, 5 months had passed and I was still breaking out! My dermatologist told me to stay with it. Which was hard because I was collecting more scars. After about 7 months I noticed a big difference. Just a few but significantly better. It™s been a year now and I am 100% acne free and the scars have improved although they™re still there sadly.
I got frustrated about 5 months in and told my dermatologist I wanted accutane again because I was so depressed to be in five months of treatment and still my face was a mess. They refused because of my depression from acne, glad I stuck it out though because Spironolactone has cleared me up. It takes a long time, longer than I™d like... I wish it was faster acting, but my point is that it does work! You™re on a good dose. Try to remain patient. Stick it out longer. I know it™s hard. Remember you™re not alone. Acne is a hellish nightmare. It WILL get better, I am glad you™ve got 4 months down.