Ive had it. My face is literally destroyed from breaking out in the past few months. Still have some cysts but not as many... still have some closed comedones but way less... scarred horrifically from the cystic acne. Indents and hyperpigmentation. I feel like under the light I look like a burn victim. Im just washing with a salicylic acid wash now. Had to stop the BP again because of the irritation and burned skin... peeling and flaking and it just wouldnt stop. My face wouldnt just get used to it this time. It made it worse too. Right now Im on 50mg of spironolactone from the dermatologist and while my face isnt worse, its not a lot better either. I have new cysts along my jaw and neck too. Bad ones. Can spiro cause initial outbreaks? Ive been on it for a little over a month. How long before you notice results? Is the 50mg dose too low you think? Tbh my face is causing me severe depression and I feel hopeless against my breakouts at this point. Ive been on accutane once in the past as a last resort. I never imagined Id get it back worse than ever less than 10 years later. I really dont want to go on it again but the spiro isnt doing a whole lot. Im 32. I already had scars that I tried to fade or years, only to be hit another round of cystic acne and worse scars.