Hi, Chances of pigmentation and scarring in acne depends upon severity and inflammation of acne lesions. As you have cystic acne, your acne are more prone to heal with pigmentation and scarring. To treat pigmentation multiple options like depigmenting creams, peels, microdermabrasion or lasers are available. As you are still having active acne lesions, application of a pigmentation reducing cream containing Kojic acid, Azelaic acid, Glycolic acid or hydroquinone over the pigmentation spots would be helpful. Taking chemical peel sessions of Glycolic acid or salicylic acid would be very effective not only in reducing the pigmentation but also active acne lesions. From the medicines you are taking it seems you are having acne due to underlying hormonal derangement. For the same hormonal pills have been added, these might require couple of month s time to show good response. Adding oral isotretinoin along with the drugs you are taking would help. Hope that answers your query. Take care.