Purging?

My acne has never been this bad. Even throughout middle school and highschool my skin was clear. It was until my 20’s that I started having issues and I am feeling so discouraged and just at a loss.

I just started spironolactone not even a week ago and I am breaking out around my mouth, jawline, and cheeks more than I was previously. Is this normal when starting? No one said it would make my acne worse first, since purging usually only occurs with a topical exfoliation.

Any insight? It is pretty painful and I am supposed to be bumping up from 50mg to 100mg on Wednesday. I just want to feel pretty in my own skin again :(