Ive been using one with 50 billion live cultures for about month. I have yet to see any negative effects. Although I am also on amoxicillin so it might counteract any effect it might have on acne. As far as I know probioitcs shouldnt give you spots, in some cases it might also prevent bad bacteria from colonising.SInce everyone is different , if you feel it gives you spots try reducing it?. To maybe a couple hundred thousand cultures? See if that helps.