"i started getting severe cystic acne after i turned 22 and have battled it for years. i tried absolutely everything, the problem was definitely hormonal, so it makes sense to target hormones, no oil or bacteria. i take 50mg 2x a day and love spironolactone. the first few days were a little weird but the side effects go away after 2-3 days. just stay hydrated, the medicine is really very mild. my hormonal cystic acne improved almost immediately but then did have a milk breakout at 2 months. now 3 months in and it is truly wonderful!! keep with it! it works wonders on hormonal acne. i now have no cystic acne or acne otherwise. if your acne is hormonal this is the treatment! i also love not having to feel bloated all the time (no water weight)."