I started Spiro roughly a month ago. I'm a 28 year old female who has had moderate cyctic acne with some scarring since I was about 14. What I tried in the past:

Minocycline
Doxycycline
Bactrim DS
Retin-A
Sulfacet
BCP: Ortho tri-cyclen, Triphasil, Alesse

Currently:

Spiro 100 mg/day
Differen gel
Clyndamycin lotion
BCP: Desogen
Clinque clarifying makeup
Clinique exfoliating scrub in morning
Clinique acne bar soap in evening

I've been to 2 derms and 2-3 other doctors in the past 10 years, and only recently did I see a nurse practitioner at my college who prescribed the spiro. I feel I am getting better results from it than any of the antibiotics I've tried. Accutane in my opinion is not an option for me (too risky since I tend toward mild depression and don't want to even think about pregnancy risks). My skin is much less oily than before, no initial breakout, only a couple of small pimples since starting. Side effects: I was very tired initially and I have to work to stay hydrated (I know I need to drink a lot of water as this is a diruetic but I am rarely thirsty), and mild increase in urination. I am excited about the results so far but cautious as you never know with acne treatments!

Hopefully this info will be of use to someone considering a similar treatment. Let me know if I can answer any questions.

msmalojo