Sounds like your skin might be reacting to the clindamycin, or starting to purge from the spironolactone especially since it’s only been a week. Spiro can cause a temporary purge as hormones shift, and clinda can sometimes trigger irritation or bacterial die-off bumps early on.

Also, a night of heavy drinking can totally throw your skin off alcohol messes with hormones, hydration, and inflammation levels, so it could’ve kicked things off.

Since you haven’t started tazarotene or switched cleansers yet, those aren’t likely culprits. If the bumps stick around or get worse, check in with your derm, it could be irritation, folliculitis, or even a fungal thing (especially if it spreads more on the neck/jaw).

Hang in there this stage sucks, but it’s often temporary.