I've been continuing the regimen described in my first post, applying Vitastem topical ointment twice daily after washing with Cerave. Had a setback on day 5, a new painful cyst on my neck and another on my cheek - they were previously microcomedones. This is pretty standard for me and how my skin usually looks, even with the Spironolactone and doxycycline.
I'm slightly encouraged by Day 7, as the they seem to be healing up faster than usual (my cysts often hang around for 2 weeks or more). There's a new pustule (not usually what I get) on my chin that you can't quite see in pics - but I'd prefer that over the cysts. Haven't noticed any new microcomedones/whiteheads, and my skin seems a bit less oily. I'm sticking with it, still hoping to see better results. Will continue to update!