I know that the Mirena is causing my acne. I have always had clear skin, and it's just like everyone describes, its not just regular acne, its cystic deeply scarring acne. I never used to have to worry about acne, I cannot believe how bad it has gotten. I read all about Accutane being able to help, and I have been taking just Vitamin A (that you can buy at walmart), these seems to have helped the cystic acne a little, it's not as bad as it was, I just have to take about 20 Vitamin A pills a day, but its worth it. A Dr. just prescribed me some Clindamycin Phosphate, and I will be sure to let you ladies know if it helps me get rid of the rest of the acne. If it doesn't I will go ahead and get off the Mirena, it is just a shame because it's a contraceptive that I don't have to think about taking every day, and I paid 700 dollars out of pocket. but having my face scarred for life and having acne ruin my life isn't worth it either. I guess I should mention that my hormones have been kind of crazy, and I've been more irritable than ever. I have gained weight, but I think it may be to my eating habits more than anything...we will see.