spiro stopped working

20f & i started spiro back in january of last year, and it was working really well up until november, and ive been experiencing breakouts for the past couple of months now since. nothing has changed in terms of diet/sleep/ stress levels, so im not sure why the efficacy of the medication has declined. for context im on 100mg. i was wondering if anyone has had any success combining spiro with a combination birth control to help better manage hormonal acne? i dont have health insurance either, so this is all an out of pocket expense for me (though planned parenthood offers the pill at an affordable price so im not too concerned about that).