From your brief history, I saw that the senior consultant at NSC thinks your case not serious enough for most doctors to start you on oral isotretinoin. I hope to remind you of the undesirable effects of oral isotretinoin, which include dry lips/mouth, skin peeling and itch, as well as risk of birth defects if pregnant while on the drug.
I use oral isotretinoin on male patients fairly regularly, but with ladies of childbearing age I prefer other medication, proper skincare and also laser treatments.
Laser treatments are seldom used in NSC to treat acne, because only the senior doctors there have access to the laser. Laser treatments are also very proven in acne treatment, with the erbium-glass laser shown to clear up to 40% of acne spots in just one treatment, and achieving nearly 100% clearance with long term control after an average of four sessions in one clinical study. This was active inflammatory acne and not just mild acne.
Please note that even spironolactone has possibility of systemic side effects like giddiness and blood potassium level disturbance.
Hence, I would recommend you to seriously consider laser treatments which provide other skin benefits (scar lightening) and which only treat the oil glands on the areas treated (unlike isotretinoin that dries up the entire body).
Hope this helps!
