Recommend taking in the first place?

Hellooo. My dermatologist put me on spiro and cabtreo after a consultation. I told her I get the jaw line acne and it flares during my period. I used to have HORRIBLE acne when I was a teenager (24 now) and birth control just magically erased all of it. However I find my skin to still look dull, discolored (like orangish when the rest of my body is paper white), and very porous. It could be a lot worse I know. Just wondering if I should even start and risk purging with skin like this? Or if anyone has similar skin and has seen changes using meds like this? Pretty sure I have body dysmorphia and a slight change could easily cause me to be depressed and anxious. Felt like they just threw a couple things at me so it doesn’t hurt to just see some experienced opinions here :)