Never had acne a day in my life until I became pregnant at 24 and it triggered relentless cystic acne. My breakouts completely ceased within 3 months of the spiro (100 mg), and it looked like entirely different skin completely within 6. I basically consider it a cure. I see people concerned with weight gain, but that's not something you should anticipate with a potassium sparing diuretic like spironolactone. It will make you thirsty, so stay hydrated, but also mind your electrolytes.