I’m a 43 year old woman who gets 3-4 cysts a year since I started Spironolactone 4 years ago. Spiro seems to be failing now and my dermatologist feels we have exhausted every type of topical and antibiotic options. She is encouraging Accutane. I am terrified of the purge process, but she feels my purge will only last about three weeks. All of my cysts have left pitted scars even though I leave them completely alone. I’m afraid of scarring. Also, I get permanent atrophy from steroids. Suggestion?