I was on 50mg and was happy with the changes I saw in my skin overall, but at the 3 month mark I decided to ask to bump up to 75mg because I was still getting some closed comedones on my neck and the sides of my face. They cleared up pretty fast with the help of azelaic acid, but now after increasing my dose a few weeks ago I'm breaking out in cysts again around my mouth. I even woke up with one on my forehead today which I'm super sad about because my forehead was the first thing to clear up on spiro and it's stayed that way pretty much the whole time until now :(

My question is, how much time do you give your hormones to adjust after upping your dose? Do you give it three months every time? I just don't know how I can tell if the breakouts are my hormones shifting after a dose increase, or if it means my dose isn't high enough yet to suppress new breakouts. 

The reason I wanted to take it slow instead of jumping right to 100mg or more is because I've seen lots of posts on here from people who started breaking out again a year into their treatment so I wanted to give myself room to move up if needed (plus obviously a lower dose means less chance of side effects, which I've been very lucky with so far). But honestly I'm getting so impatient at this point and just want to be done with acne. For the last several years the first thing I do every morning is check my face for new breakouts and I'm just so tired of living this way :(

Appreciate any advice! I'm getting my spiro through an online doctor so they're pretty hands off (though in fairness, all the derms I've ever met in person have also been pretty hands-off, ha).