Hey there, I do think it is a very personal thing based on severity of acne, levels of hormones, metabolism, etc. I am about 125 lbs, 5'5 and tested with mildy high testosterone levels. I am on 50 mg of Spiro in addition to Yasmin which is about 25 mg and helps to balance out the other hormones. I do have baby blond hairs on my face as well, so not sure if taking a higher dose would help with that. Either way I don't have any side effects from the medication except for frequently having to use the restroom. I'd prefer to be on the lowest dose that my body can handle because the scare of sparing potassium and other side effects. Some women will work their way up to 100mg and then after they clear try to ween down to a more maintenance dose. It does take time to take affect, took me about 3 months to slow down breakouts and clear. I still have some clogged pores I am contending with but very different then breakouts before and during the initial breakouts month 1-2+. You are pretty tiny, so maybe starting with 50-75mg. After reading through all of the reviews on here of Spironolactone in the Reviews section, many women cleared on 50mg which gave me tons of hope. I am still fairly oily which is fine with me as long as the breakouts aren't happening. I am seeing an Endocrinologist this week so if I get any additional info on dosing I would be happy to share with you. Good luck on starting your Spiro journey, feel free to reach out anytime.