I agree with the above posts....you need to find a doctor that will listen and know a little about Spiro for acne. My derm did not want to prescribe it for me, he kept pushing the Minocin, Cleocin T, Retin A and of course the very expensive Photodynamic light thereapy. I did all of these and did have slight improvement but, I never had clear, makeup-free skin. Since I struck out with my derm I went to see my female gyno. Without hesitation she prescribed Spiro even though my testosterone levels were normal, but on the higher side. I walked out of her office feeling like I had control over my skin with that Spiro prescription in my hand!! Just my opinion, I feel that female doctors might sympathize more with female acne than male doctors. Most of my friends have gotten Rx's from female doctors either gyno, endo or primary care dr. It is frustrating trying to find a doctor that will prescribe Spiro because many do not know the use for acne. Be ready to educate the doctors and fight for that RX!!!!:)