32/f. First post.

I've had acne since my teens, but the older I get, the more frustrated I am that I can't seem to get rid of it. I just want clear skin, and preferably before I get wrinkles.

Background: I feel like I've tried every variety of OTC topical medication , and a ton of different prescriptions (both topical and oral). Most recently I was on retin-a 0.1% along with trimethtoprim 100mg/2x day and clindamycin 1%. It felt like absolutely no changes. I could see that the retin-a was possibly reducing previous scarring, but I was still breaking out just as much. I was on that combination for about a year (most of 2016)

I have PCOS, so I know there's hormonal issues involved with my ance. I've read a ton about how there's not really any medication (save for accutane) that can really get rid of hormonal acne. Someone randomly mentioned spironolactone as an acne medication, and I did quite a bit of research, and then basically begged my dr. to put me on it. He was concerned because I had previously said I didn't want to do accutane (children are not forthcoming this second, but potentially soon, and the side effects of accutane are enough to scare anyone regardless.) He made me promise not to get pregnant, and said we'd have to check my potassium levels to make sure it wasn't elevating them too much.

I'm now on spiro, in addition to doxycycline (new), and I'm still doing the topicals retin-a 0.1% and the clindamycin 1%.

For the first month, I did 50mg 1x/day, and now I'm in the middle of the second month, 50mg 2x/day.

And -- I think I see a difference! I know I feel like there's one, at least. I'm not breaking out as much (though possibly getting slightly more blackheads, but not at any level of concern). Nothing cystic! What's interesting is that before spiro, most of my blemishes were around my chin /mouth / lower cheeks (as is consistentt with hormonal acne), and since being on it, I've had pimples appear on upper cheek, forehead, hairline. Not incredibly troublesome, just not really expected. I may have had a small amount of "extra" breakout from starting spiro, but not anything crazy.

Doctor tested my creatinine and my potassium, results came back today. They were both also tested in June of last year, which I'm using as a "control" of sorts for myself. Creatinine stayed the exact same, 0.7 (normal is .4 - 1.0). Potassium did increase, from 4.0 to 4.7 (normal is 3.6 - 5.0). Worried that my doctor won't keep me on the higher dosage if my potassium is too high. How high is too high?

Questions for spiro people:
How long until you saw a significant difference in your skin?
I was also excited to see potential decrease of body hair / facial hair, but no difference so far. How long until you saw a difference there?

And, for me, spiro is not going to be a long-term thing, because I plan to get pregnant in a year or so. Were the effects lasting at all? How long should I plan to be off before trying to get pregnant? if anyone stopped then started back again, did it work just as easily? I'll also need to get off of retin-a and doxycycline before pregnancy, though from what I can tell, there's no reason to get off clindamycin. Thoughts?