Dermatologist Recommended

Spironolactone for Adult Acne – Read this First!

woman with acne on spironolactone

Fifty million people in America struggle with Acne. The American Academy of Dermatology outlines the way to treat and prevent Acne. Treatment should start with an assessment of acne severity and skin type. For most people, the right combination of topical medications, such as benzoyl peroxide, with the proper medication and moisturizer should be effective enough to control Acne. 15-20 % of people with Acne would need the addition of oral medications. The most effective oral medication for Acne is Accutane (isotretinoin) (read more here about Accutane for hormonal Acne).

Nevertheless, it's not for everyone. It is contaminated in pregnancy and requires careful monitoring by a dermatologist during the treatment. Women with hormonal-related Acne can add to their medicated acne treatment, skin care, birth control pills, or Spironolactone.

Is Spironolactone a hormone?

Spironolactone is not a hormone. It's a diuretic that also works as an androgen blocker. It blocks the effects of male hormones in the body, like testosterone, which can contribute to oil production and Acne.

The chemical formula of Spironolactone

Who Should Consider Spironolactone?

Spironolactone should never be used without a proper topical skincare routine. It can be considered if there is no improvement with topical medications within six months. Spironolactone is suitable for healthy adult women with hormonal-related moderate to severe acne that did not respond to topical treatment. It is especially recommended for women with Polycystic Ovary Syndrome (PCOS).

Does Spironolactone Work on Body Acne?

In one study of adult women taking 75 to 150mg of Spironolactone per day, it was observed that there was a 50 percent improvement in facial acne and a 37.5 percent improvement in body acne.

Duration of Spironolactone Treatment for Acne

Spironolactone does not cure acne like oral antibiotics and birth control pills do. It is used to reduce acne breakouts to a controllable level. Dermatologists usually prescribe Spironolactone for 6-12 months to maintain the results in the long term.

When Can You Expect Improvement?

Improvement in acne is usually expected within 6-8 weeks. Studies have shown a significant reduction in lesion count after three months of taking Spironolactone. Results may vary based on the dosage, with some patients experiencing control of acne with as low as 50mg per day.

Adverse Effects of Spironolactone

The most common side effects of Spironolactone are breakthrough bleeding, amenorrhea, and lightheadedness. Other less common side effects include changes in menstruation, urinary frequency, dizziness, headaches, nausea, vomiting, breast tenderness, and breast enlargement. However, there is currently no evidence to support the hypothesis that Spironolactone increases the risk of estrogen-sensitive cancers in human subjects.

Effect of Spironolactone on Hair

Spironolactone counters the effects of androgens, leading to thicker and fuller hair growth in women with female pattern hair loss.

Foods to Avoid When Taking Spironolactone

When taking Spironolactone for acne, avoiding salt enhanced with potassium and potassium supplements is advised. Additionally, reducing the intake of foods high in potassium, such as low-sodium milk products, avocados, bananas, coconut water, spinach, and sweet potato, is recommended.

Usual Doses of Spironolactone

Spironolactone dosage typically ranges between 100-200mg per day.

Combination of Spironolactone with Other Medications

Spironolactone should not be combined with other diuretics or potassium supplements. Regular bloodwork should be performed every three to six months while taking Spironolactone to ensure potassium levels are within the desired range.


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