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Any suggestions on what might work for me?

My history: I'll be 27 in a few days, and have had acne since I was 12. I started getting occasional cysts when I was probably 13 or 14. My acne has always been moderate in amount, probably an average of 1-5 active large zits at any given time and countless other tiny whiteheads and bumps. The larger, more inflamed ones have never covered my whole face or anything, but they've been persistent. With my current regimen, I'd say that regular little whiteheads and whatnot are about 98% gone. But I still get cysts. I usually have one bad breakout when I'm PMSing, and then I get cysts here and there which seem to be random. This morning, I woke up with a monster one on my nose and I'm not near PMS or ovulation.

I feel like I've done as much as I can OTC, and though I generally try to avoid jumping to medical intervention too quickly, I feel it's time for me to move on to prescription options. I would like to start as mild as possible and progress if needed, though, and plan to start with topicals. I've done a fair amount of research and am aware of what the various meds do and how they work, but I was just curious if anyone has any personal experience with acne similar to mine being effectively treated by topicals alone, and if so which ones.

Obviously I'll be going to a derm, but I would prefer to have a pretty good idea ahead of time of what I'd like to try.

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The absolute best advice I can give any woman is Spironolactone. It takes a long time to work, some see results quickly, others 4-6 months and beyond, but it's SO worth it. Do some research on it.. read other reviews. Good luck :D

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Thanks! I've been really curious about Spiro from what I've read about it. I would prefer to try topicals first before making the jump to something that seems like a fairly serious drug, but it's definitely an option I'm considering. Is it something you have to continue to take, or is it like accutane where you do a course of it and then have (hopefully) lasting results?

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