Spironolactone was effective in reducing hair growth in women with hirsutism.
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October 2003 Spironolactone is better than placebo for reducing excessive hair growth in women, but its effectiveness for acne is unclear due to small study sizes.
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December 2022 in “Advanced medical journal” Hirsutism moderately affects the quality of life for most women, linked to condition severity.
July 1989 in “British Journal of Dermatology” Women's acne improvement with antibiotics is not linked to signs of high male hormones.
The conclusion is that there's a link between high testosterone levels, insulin resistance, and certain skin conditions, regardless of obesity.