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Should I start Spironolactone?

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Hello, I'm looking for some advice due to a 13 year struggle with acne that is still yet to be resolved. I've read these forums for a while but not had the courage to post before. I'm female and have what is defined by dermatologists as 'moderate' acne on my face, back and chest and a face that gets very oily. I get most kinds of acne (blackheads, whiteheads, papules, pustules). It has never been described as cystic although I do get some really big red spots. Throughout this time I've tried various types of treatment, including various types of topicals (adapalene, benzoyl peroxide, duac, isotrex etc), antibiotics, birth control and isotretinoin. I have always been very diligent and disciplined following instructions and length of time to use treatments for. I've never particularly had any kind of success with antibiotics, and after having an allergic reaction to Trimethoprim (which I was prescribed last year) I am fairly certain that continuing to try antibiotics to resolve my acne is not going to be successful and is potentially dangerous to my health. I've tried various alternative methods, including diet changes and vitamins, but again have not had success, and am generally in very good health and physically active. I really wanted diet to be my answer but I've never had a bad diet (always get fresh vegetables and fruit, green smoothies and cook most food myself - I like eating healthily). Unfortunately after various incarnations and elimination diets my skin did not look improved. The most successful treatment I have used is isotretinoin, but I had to stop after a couple of months due to aphthous stomatitis which meant that I couldn't eat properly for a good week. I've never experienced any kind of ulcer before taking it so I'm fairly certain it was the cause, although it did baffle the doctors I saw. Nevertheless this treatment produced the best clearing of my skin. But my acne returned after stopping it. I've had various blood tests done and the only thing that I potentially think could be related to my ongoing acne is low oestrogen levels. However, my GP was fairly dismissive and said that my blood test results were normal and said there wasn't anything to be concerned about. In fact, I was told at my last appointment with one GP that I've pretty much exhausted all treatment options. Birth control only mildly improved my acne but I still had it, and if anything, I've noticed that my acne is better around my period rather than worse (which is frustratingly contrary to most people's experience and most medical literature). I'm concerned that without some kind of intervention my acne will not resolve itself because my mother is in her 50s and still gets bad skin. After speaking with various Dermatologists I think I have two options: spironolactone or a low dose course of isotretinoin. I am apprehensive regarding isotretinoin because of my previous experience, yet this is the only treatment that has really helped. I've not tried spironolactone yet which is why I'm leaning more towards that - and I'm also hoping it will help with my extremely oily skin - but wanted to know if anyone who has had a similar experience to me can offer any advice? Thank you. 

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Hi @CuriousPhoenix I'm sorry that you've been going through the acne struggle for so long, I understand how frustrating it is when you feel you've exhausted all options and nothing is helping, I went through the same thing, Saw the dermatologists and they all wanted to do the same thing, Give me harsh prescriptions or epiduo and send me on my way didn't listen to my concerns or what I felt my body was telling me. I also saw my general practitioner and got my blood drawn for them to say my levels were normal. So dead end there. No help. My acne started after I got off birth control and my hormones went crazy pretty much. After countless times of research I figured out I had cystic acne huge bumps under the skin that no matter how hard you tried to pop or what not they never came to surface. My cysts were always on my chin, they say that acne on your chin has a lot to do with your hormones so to me it makes perfect since why I got acne there after I got off the birth control. Anyways fast forward to now. Ive reduced my intake of dairy; they say the hormones in the dairy produce more Sebrium and your body try's to expel it from your skin which makes acne. I still eat milk and cookies and icecream but try not to over indulge. I think that's been a minor help but what I think majorly helped my skin was witch hazel. I bought it at target for like 3.00$ in the first aid isle near the peroxide. I put it on in the morning and at night after washing and exfoliating my face. Witch hazel helps reducing inflammation and minimizing pores which is so important with acne! I highly suggest trying the witch hazel. On top of that I do ice my chin just because I'm so scared to get a new cyst so I call it preventative measures. Rather be safe then sorry and have to back track. I know everyone's skin is so different but i just know how bad it sucks to have severe acne I mean i wouldn't go to restaurants because I just felt everyone was staring at my pimples. It got to the point I was having anxiety attacks and I've never been a person to have those until my acne was at its worse. I'm sorry this is so long and if you've made it this far into my novel and decide to try the witch hazel and icing I hope it works for you like it did for me. 

nightly routine:
1.dermalogica acne foaming cleanser with the Clairisonic mia2 ( for a really deep clean)
2.dermalogica daily rice exfoliant (exfoliating helps turn over those dead skin cells way faster than your body alone)
3. Pat dry
4. Witch hazel!!
5. Moisturizer 
6. Lay in bed and ice my face. 
Dermalogica is kinda pricy but it works well. But I'm sure just washing your face and exfoliating with any product that's not to harsh would be good! Anything is better than nothing!  Make sure to stay away from over the counter "pads" like stridex because they're to strong and drying so then your skin starts over producing oil because the pads are stripping all your natural oils.

Good luck!

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Thanks so much Haileym, it means a lot that you took the time to reply. Mine got worse after stopping birth control too. I've tried Witch Hazel in the past, but maybe I'll try it again. I'm trying the spironolactone and I'll update if it helps. 

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