Treating Acne With Spironolactone

An Acne Treatment for Women With Hormonal Acne

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Spironolactone is a medication that's used to treat many different disorders, from high blood pressure to fluid retention. Although the U.S. Food and Drug Administration doesn't officially recognize spironolactone as an acne treatment, it is often prescribed off-label to treat hormonally-influenced breakouts in women.

This medication isn't used as ​a first line of defense against acne breakouts. Spironolactone is only effective against acne caused by hormonal fluctuations, for example, women who break out around the time of their monthly cycle.

It's especially helpful for women with hormonal disorders that trigger acne or who suffer with other problems, like unwanted facial hair.

This is a treatment option for adult women only. It's not prescribed for men with acne or for young teens and tweens.

Spironolactone is available by prescription from your doctor. It is also sold under the brand name Aldactone.

Spironolactone Works by Limiting Hormonal Fluctuations that Trigger Breakouts

Spironolactone is in a group of drugs classified as anti-androgens. Hormones, specifically androgens, have been linked to the development of acne.

Androgen hormones, like testosterone, are typically thought of as male hormones. But androgens are also present in the female body, although in lower levels. Some women produce more androgen hormones than needed. Anti-androgens like spironolactone block androgen receptors in the body, preventing cells from absorbing androgen hormones.

Simply, spironolactone limits hormonal fluctuations that can contribute to acne breakouts. Because of the way spironolactone works, only women whose acne has a hormonal basis will see results with this medication. But for those women who have hormonal acne, the drug can do a good job in helping to manage breakouts.

Spironolactone Is an Oral Medication

When using spironolactone as an acne treatment, the most common dosage is between 50 to 100 mg daily. Many dermatologists start off prescribing 25 mg and work up to the target dosage over the course of several weeks. Your doctor will determine the most appropriate dosage for you, depending on your personal situation.

If your breakouts only tend to occur around the time of your monthly cycle, your dermatologist may have you use spironolactone for the week just prior to your period.

Spironolactone is often prescribed along with oral contraceptives. It can also be used in conjunction with other topical acne medications. It tends to work best as an additional acne treatment, rather than the sole treatment.

Possible Side Effects of Spironolactone

Side effects with low dose spironolactone aren't as common as with higher doses, but most often include:

Other side effects can include:

Both blood potassium levels and blood pressure should be checked periodically while you're taking this medication.

Also, you shouldn't get pregnant while taking this drug. In addition, this medication isn't a good choice for you if you have kidney problems, or a history (or family history) of breast cancer, uterine cancer, or ovarian cancer.

Take your pill with a meal if it upsets your stomach. And make sure to drink plenty of water daily as Spironolactone acts as a diuretic.

A Word From Verywell

Spironolactone isn't a first-line treatment for acne, so your dermatologist will likely have you try the conventional acne medications first: topical retinoids, topical antibiotics, benzoyl peroxide or a combination of these medications.

If your physician determines that your acne breakouts are triggered by hormonal fluctuations, he/she may then decide to prescribe spironolactone as well. You'll probably continue using topical acne treatments as well.

Either way, try to be patient. It will take several weeks to a few months before you really notice an improvement in your skin.


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