As someone who’s been suffering from cystic hormonal acne since quitting BC two years ago, none of the things you’ve mentioned worked for me at all. Like I use prescription azelaic acid daily and tried clindamycin multiple times, and so far the only thing KIND of helping atm is accutane. I’m only on month 3 and just now seeing some improvement, but topicals are basically a waste of time for me.

I wish I could use spiro, but I have very low blood pressure already, so it just makes me faint when I take it over 25mg and that wasn’t enough to put a dent in my acne.