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Accutane may or may not work. I had hormonal acne and I was accutane twice. While it helped to reduce the acne, it did not completely go away. Hormonal acne tends to be more resistant to accutane therapy.

I thought since spironolactone had to be taken in conjunction with a birth control pill because it has strong progestational effects?

Hormonal acne responds well to birth control pills. Yasmin and Diane 35 both work because the progestin in them has anti-androgenic effects (reducing sebaceous oil production and testosterone levels in the blood). Yasmin is also touted as having a diuretic effect which means the weight gain associated with taking a birth control pill is negligent.

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