This is a very common disease affecting 1 in 10 women and is often left undiagnosed. It is an overprodution of male hormones due to insulin resistance which leads to acne, especially around your period, and other symtoms including but not limited to irregular periods, excess hair growth, weight gain (though I am actually underweight), anxiety, depression among other things.
I was diagnosed with PCOS a few months ago and since going on supplements and meds, I am now acne free Soon I will be managing by diet alone but I wanted to get 'fixed' quickly with the meds and supplements.
If you have any of these symptoms along with acne, I would recommend going to a naturopath to get prescribed the following:
PCO PX - a herbal supplement that is AMAZING
Inositol - made from yams and regulates body sugar
Spirinolactone - reduces male hormones and their effect on the skin
You can get tested to see if you have cysts on your ovaries but even without the cysts, you could still have PCOS so I would try treating it to see if there is an improvement as none of these are harsh on the system. This is what I did and I was cured of my acne in less than a month.
For anyone else reading this [and in case your doctor didn't tell you] it sounds like you have Lean PCOS. You being underweight is a huge flag for this. Typically this form of PCOS comes from stress and high levels of cortisol...this site is a good resource: http://www.thepcosnutritionist.com/resources/adrenal-pcos/ Chronic infections, like Epstein-Barr [AKA Mono] can also contribute to stress-induced PCOS.
Good luck and I hope that your regimen continues to help! Aim to improve your immune function, adrenal function, and reduce stress and you should be able to eventually stop the Spironolactone.