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I take 50mg of Sprio and Orthotricyclen after I eat food (otherwise I'll feel nauseated if I take birth control without food).

I wash my face in the shower with whatever kind of soap (or sometimes I just splash it with water).
I put on sunscreen and go on with my day.

Before I go to bed, I wash my face with soap and then take 50 mg of Spiro again. Then I take a cotton swab of hydrogen peroxide and smear it all over my face.

I have not had cystic acne since I began taking spiro and the acne I do get is like 1 - 2 pimples a month, if any. I was taking saw palmetto (usually 500-1000mg of it or more), but I have been forgetting to and see no need to since I am taking spironolactone.
Here's my routine and it's working extremely well.
Internally I take:
100 mg Spiro daily
Saw Palmetto (when I remember)
Inositol
Vit A

Morning Routine:

~Scrub skin gently with disolved aspirin (every other morning)
~spray with NaPca Aloe spray (for moisture)

Night Routine:
I alternate different products in my nighty routine that's how I keep my skin exfoliated properly.

Nght One
Wash with Alpha Hydrox foaming cleanser
Moisturize with NaPca spray let dry for about 15 min.
Apply Green Cream (06% retinol)

Nght Two
Wash with AH foaming Cleanser
Apply topical Clindamycin gel

Nght Three
Wash with AH cleanser
Apply Paula's Choice 2% BHA solution

I also mask with Paulas choice Skin Balancing Carbon mask or Milk of Magnesia throughout the week.

I've also stopped wearing liquid foundation which has made a huge positive improvement. I've experimented for years with many presciption topicals and also interanl meds but this routine has worked the best. I think I used to over due it. So by spreading things out throughout the week instead of applying each one on top of each other, has really worked great, plus my skin seems to adapt to routines and stop working, this way it doesn't have a chance.

Just a little FYI [B]Member86[/B] on Hydrogen Peroxide just in case you aren't aware of the new studies...

Hydrogen Peroxide
Given what is now known about free-radical damage, I no longer recommend hydrogen peroxide as a topical disinfectant for acne. Oxygen is clearly a problem for skin, and hydrogen peroxide is a significant oxidizing agent. The way hydrogen peroxide works is by releasing an unstable oxygen molecule onto the skin, and that generates free-radical damage. The extra oxygen molecule that makes up hydrogen peroxide is extremely unstable. That's why hydrogen peroxide is packaged in a dark brown, airtight container.

On exposure to air, hydrogen peroxide's extra oxygen molecule is released and the product becomes plain water. For skin prone to acne this extra oxygen molecule is capable of killing the bacteria that cause blemishes. Acne bacteria are anaerobic, meaning they don't like oxygen. [B]But because of the problems that stem from impacting the skin with a substance that is known to generate free-radical damage, other options need to be sought. [/B]
Paula Begoun





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