Can I prevent Accutane purge by getting it first more controlled with Spironalactone and the Pill?

Your situation sounds challenging and I understand your concerns about the potential for an Accutane (isotretinoin) purge, which can sometimes exacerbate acne before it gets better.
Spironolactone, combined with oral contraceptives like Diane-35, can be an effective treatment for many patients with hormonal acne, especially in women with PCOS. They may help control your acne and potentially lessen the severity of an isotretinoin purge. However, it's important to note that each person's response to medication can be different and there's no guaranteed way to completely prevent a purge.
Differin (adapalene) is a topical retinoid that can also help manage acne. It's generally recommended to stop using other retinoids while on isotretinoin due to the increased risk of skin irritation, but your dermatologist can provide guidance based on your specific situation.
Remember that isotretinoin is a powerful medication with potential side effects, so it's important to discuss this thoroughly with your dermatologist. They can assess your skin condition, medical history, and current medications to provide the best treatment plan for you.