Spironolactone for hormonal acne

[Localher0]

My DD has suffered from bad acne for a couple of years. She also had very heavy prolonged periods/bleeding and tried many contraceptive pills to try and treat both. Nothing really worked so she had a mirena fitted in December last year. It has been utterly brilliant for her periods but..... her acne has got worse and was not responding to antibiotics so the dermatologist put her on spirolactone. Within a couple of weeks her skin improved but has got worse again. At the moment she's on 25mg/day - I'd like to increase it to 50mg and see if that works - we're waiting to see the dermatologist to ok this.
Has anyone else had a positive response to spirolactone and at what dose?
P.S. she can't take roaccutane

Sorry 'spironolactone'

Just seen this, that's a really low dose, is this a GP? I'm seeing an Derm who specialises in adult acne and he said the baseline is 75 and we can go to 175, I'm currently on 150 which I have been since Jan (started on 75 last Aug) and worked up to 100 then 150, saw the best clearing at 150 but an effect at all doses. mine has suddenly got worse again but I'm on hol and think it's the sunscreen + hard water.

Acutane doesn't work for female hormonal acne anyway, always comes back. Had 4 times now and whilst it's never quite as bad it's come close and the sie effects just aren't worth it any more.

Thanks that's really helpful. Yes she's seeing a dermatologist and we successfully argued for her to go up incrementally - she starts at 75mg today. There has definitely been an improvement but not quite enough yet. She's
Meant to have 4 weeks at each 25g increment but I'm pushing for 3 weeks or less as long as she tolerates it. Our dermatologist is good and she did do more research between us asking for it and a follow up appointment so that at the f/up she said The max was 200 I think!

@WisteriaHysteria22 if you're in or around London would you mind sharing your dermatologist's details? DD is now on 75 and there's been a little improvement but our deem wants her to go up 25mg/month so we have to wait a few more weeks to go to 100 - it's a drag and poor thing wakes everyday with new, sore spots. How long did it take you to get to 150 from 75?
Thx