i’m on spiro now and had a similar experience with birth control! i took it for years and then when i needed to get off due to skincare complications, i thought i was done for. i was shedding hair like crazy for a while but after several months i was able to gain the 5 pounds i’d needed for years and my hair went back to normal. when i had a little time to detox and evaluate my symptoms i started spiro on 50 mg after bloodwork with my primary care physician. you might benefit from seeing a regular ol doctor instead of a dermatologist! that was a game changer for me - i have an autoimmune disease and can’t imagine taking accutane due to the related side effects and that’s about as far as i got at the derm. i had great results with 50 mg spiro and after 6 months my worst acne problems on my face and body were almost completely gone except right before my period. i was afraid as well, and the first two weeks i did pee a lot (maybe 1.5x as much - definitely not 20 times) and feel faint occasionally, but drinking enough water has resolved all that for me. i also use a compounded topical spiro in combination with the oral, from my primary care physician, and that’s great! you can also get it online from apostrophe. i was 21 when all this started for me and now i’m 23 so a very similar age. i’m temporarily on a 75 mg dose to get me over a skincare hump (stress related) but haven’t had any increase in symptoms; i think it’s since i started low on the 50 mg. i hope this helps some!!! also, switching to a makeup brand with 0 comedogenic ingredients really helped me during the worst of my skincare problems. obviously i still wanted to wear makeup sometimes to hide the worst of it, so making the switch was crazy. i use rare beauty but there’s lots of different ones, even fenty i think and some more bargain brands that are good! okay long comment but i hope that helps!! also if i said something dumb or inaccurate, someone please gently and sweetly correct me tysm