I am a 21 year old female with mild to moderate acne. When I was prescribed this med, my main concern was monthly pimples that were large, painful, and never formed a head. I would usually only get one at a time, and some whitheads. When I began taking Spiro, my acne got dramatically worse. I had closed comedones that stayed for months, actual "acne" breakouts on my forehead, and even the same larger pimples. I am off it now and am almost clear again. I was on it for 3 almost 4 months.