It cured me COMPLETELY after 5 or 6 months (cleared 90% my skin after 4 months; 50% after 3 months, I think...). My acne was no joke, I had a lot of internal pimples, clogged pores, the whole combo, and as everyone here, I tried everything under the sun, except to Isotretinoin. It TAKES at least 3 months to have effect, no matter the case, no less than that, I saw that information once in a medical presentation. BUT after 2 months I was seeing VERY good and solid results. Your acne will, at first, slowly decrease, and then QUICKLY decrease, and one day you will wake up with no new acne, and cured of the past one and be amazed with your new skin. My skin is SO smooth right now, I can't believe it's my real skin, no more clogged stuff under it. I used Epiduo also as a treatment (and of course sunscreen). In the end of this review I will list everything I use now, and explain why I think I found the best minimal skincare regimen to support that pill treatment. 

That thing is so magical that I don't even use Epiduo anymore! I finally have a skincare routine of a normal person.

I never had any side-effects by the way. See a doctor to keep track of your health ok? There ARE side effects that can happen, so you have to keep an eye on that...

And you H.A.V.E. TO DRINK AT LEAST 2 LITERS OF WATER, ok? Break it into 500ml turns, or you will lost count...

 I use Pfizer's 100mg (my dermatologist said it was the minimum amount to have effect... after a while she said I can slow the dose). And yeah, she said I would have to use it for a long time. I asked "forever?" and she said that acne triggers don't go forever, so after some years I can slowly stop (she said at least 1 years of full dose)... But anyway, I gladly take my magic revolutionary pill every morning (on a empty estomach, and it doesn't hurt anything!). 

I didn't had an hormonal problem apparently, all my hormones were normal, but damn, everytime I ovulated or had my period, there they were, new internal pimples... So yeah, you can call my acne "hormonal". I used everything (except Isotretinoin) for 10 years, Epiduo, the Acne.org regimen, etc etc, and they helped in some phases, in some years, but they never cured anything even if I did exactly what aaaall the doctors said). They help if there aren't new pimples coming, but every 15 days, bang, all the work were lost with new acne arriving in my poor face. 

About hormonal disbalance: my recent dermatologist said that most people that have hormonal acne don't have any disbalance of hormones, the problem is that our skin is more SENSITIVE to the ups and down of a month's cicle. 

SKINCARE REGIMEN (HOT HOT TIPS coming from 10 years of mistakes):

Sunscreen: you just HAVE to use it, especially if you use something to treat acne (usually things that make your skin super sensitive to sunlight). If you skip this you are screwed BUY JAPANESE BRANDS like Biore or Hadalabo (Rohto), they have real tested standards, not like USA where the worst sunscreen are made (because there's no rule for UVA protection there). Go with the japanese. I use the Biore Aqua Rich because my skin is super dry (the forehead is super oily, so I use a translucent powder on it), but they have great options for oily skin, in fact, the best options out there. I've used La Roche Posay and Vichy's sunscreens for years, they are awful for sensitive skin, but can be an ok plan B if you don't find the japaneses.

>>> I use the HadaLabo Gokugyun Lotion and I freaking LOVE it, you can really feel the water being replaced in your skin, I will never let go of this powerful and yet light liquid lotion. My skin is very sensitive, and this baby is gentle as it can be, seriously. My skin is super dry by the way, I had a difficult time until I found this one, NOTHING seemed to give me enough hydration until this one. I use it a few times a day, after 3h you will see your skin is not sooo hydrated as before, so a refil is always welcome. I believe this is a very important step of my cure, you can't have a healthy skin without a proper skin barrier, and today I see I was not taking enough care of this water reposition in my skin (all dermatologists used to give me gelly creams with salicylic acid, but man, RUNNN from this kind of cream, all they do is irritate your already damaged skin). Run from CeraVe and Cetaphil if your skin is very sensitive, my assss they are for sensitive skin, maybe in the past they were, but not now.  

>>> I lock all the hydration above with Aquaphor around my eyes and mouth at night, and even at day time, since I use a faceshield in my work so my face will be blurry behind it anyway. I intend to do this at night forever, there's no better way to lock all the water in, and those areas are the most sensitive and the susceptible to damage and wrinkles. The formula is pretty minimal by the way, it's like, 4 ingredients, awesome. 

>>> I wash my face with La Roche Effaclar or Vichy Normaderm liquid "soap".

>>> If you use makeup or some kinds of sunscreen, you HAVE to use some Cleansing Oil, I like the Hadalabo one. Oil removes oil, so that is not only the best way to remove your makeup COMPLETELY (and without using cotton, that irritates skin), it will also melt aaaall the superficial sebum of your pores. The Aqua Rich sunscreen I use don't need this, but the others Biore sunscreen do. For years I used those sunscreens that requires a "double-cleasing" and I skipped that part out of ignorance, today I know that played a big part in my acne. Efficient and GENTLE cleaning is a big important part.

>>> Epiduo: DON'T use everyday! No, your skin wont get used to it if your skin is slightly sensitive, I tried it (before starting Spironolactone) and it didn't helped my acne that much to be worth all the pain it causes if used everything... I did peelings and one session of laser, and let me tell yah, they didn't make my skin as sensitive as Epiduo, I almost cried when I had to apply makeup everyday to go to work... Use every other day or skip two and the results will be the same.  IT HELPS ACNE A LOT, yes, because it unclogs pores and make it change the cells quickly, but if you don't wear sunscreen like a vampire you will gain another problem, an awful skin full of spots, been there done that (when I was 20, 10 years ago). So don't be dumb to use this thing without using sunscreen, even to be inside, just near windows. If you don't you will be destroying your skin. Again: japanese sunscreens! 

Obs: I used the Acne.org Treatment and their product was less irritating than Epiduo, I was able to use it everyday with no problem.. My dermatologist said it was less effective but they seemed to have the same effect to me (they help but not cure anything for hormonal acne)... The game changer, as I said, is the Spironolactone. That shit is the bomb. Freaking miracle. 

Extra stuff I use but are not necessary:

- Ordinary Niacinamide (100% pure powder), I mix with the Hadalabo Lotion. I SWEAR it makes the moisturizing feeling feel  a lot longer, and I think it made my skin less sensitive... Scientists say it's awesome to fade away scars and yellowness of the skin and make the skin barrier a lot stronger;

- La Roche Posay eye cream for dark eye circles (that shit works!);

- Melano CC Vitamin C serum (this formula is safe for acne). 

That's it girlsss, I hope you can use all my tips to have a miracle in your lives too. Don't forget: 2 litres of water or more a day and a good (japanese!) sunscreen are just as important as Spironolactone to have a healthy and beautiful skin.