actually, i had my mirena iud removed yesterday because of this issue. it made me very sad because other than the acne issue, i loved it.
i had very mild acne before i got the mirena iud, but the mirena really aggravated it. i tried many topicals but none of them worked. my doctor put me on spiro which helped, but not enough.
now i am continuing spiro for at least another 6 months to try to clear my skin completely, and i'm also on a low dose birth control pill which should help.