"when i was a teenager i had *mild* cystic acne---mild meaning i would only get one or two cysts a month, but the ones i did get were huge, red, painful, ugly, and often left a scar.  years later, approaching the age of 30 and having exhausted every treatment under the sun, it was not getting any better.  my dermatologist suggested spironolactone (100mg/day)... my skin got worse for the first few weeks, almost like my body was expelling everything... but i stuck with it and it&#039;s been a miracle!!  my skin is smooth and acne-free.  the only side effect is i&#039;m groggy for a few hours so i take it at night.   don&#039;t give up on it if things get worse initially, it is a hormonal treatment and might take a while for your body to adjust.  i love it!!"