Your doctor may not want to put you on Yasmin if you are on spiro (since it has an extra 25mg). If not, other good choices are Desogen and Ortho Tri-Cyclen (NOT the lo!!!)
I started Desogen for the same problem you're having and I didn't have an initial breakout. Right away I noticed more clearing.
About the gyn visit, don't worry. I'm the biggest baby ever and it really doesn't hurt. Especially if you're going to someone your mom or your friends recommended.
And if you decide you don't want the pill, lowering your dosage of spiro might help. At 50mg my periods were regular, and actually my skin was almost as clear as it is now :)