On Spironolactone 100 mg week 3. Acne has worsened in areas where it’s the most persistent. (Photo)

If there is a hormonal component to your acne, spironolactone can be very helpful.  I would give it 4 to 6 weeks before changing anything, but you may need to increase the dosage.  The dosages are very individualized and each patient needs to figure out their ideal dosage.  Do this in conjunction with your doc.  
Microdermabrasion or other exfoliative treatments are perfectly fine while taking spironolactone, and in fact may help it work better to control breakouts.
Best,
Dr. Amy