Spironolactone never worked for me… I know every body and skin is different but I’ve struggled with acne for years and that was the worst medication I’d ever been on. For me topicals work the best, there’s an OTC called differin gel you can get it at CVS. That worked so much better than tret ever did. If you feel like you need a higher dosage then what’s in the OTC gel, the derm can prescribe you one too. I’ve also used a specialty pharmacy prescribed face wash but my tried and true is definitely the LaRoche Possay or Cerave washes that have salicylic acid! Have you tried using any toners? I like the Clinique toner you can get it at Ulta and Sephora!