I'm a 20 yr old female recently put on spironolactone for acne most likely because of high testosterone. What should I expect?

A good result. Don't try to figure out the cause of one's acne. High or normal for a woman, spironolactone suppresses androgens that promote acne. This illness is a serious personal and professional liability. Your physician should be commended for thinking of this medicine, which is often overlooked as an option.