How long has she been on the met/spiro? It takes some months for improvements to show. Three months is when I started to see improvement. I'd say I eight months, I was clear.

Just some advice from someone who has PCOS. It's hormonal, she'll have to cope with it for the rest of her life. In the end all you can do it try to manage the PCOS.

I took Accutane at 16 (I'm 35 now) and while I did receive relief from acne, it only lasted about two years, and then it was back to business as usual. Acne. (so it came back about 18/19 years old)

Also, do they still require you to be on birth control because of the chance of birth defects on Accutane? They did when I took it, but its been so long, I don't know if they chanced policy.

Are you will to put her on a very aggressive drug with the chance of relapse? Just something to think about.