What is spironolactone? (Aldactone)

Spironolactone is a water pill that prevents your body from absorbing too much salt. In some cases, it’s prescribed to prevent high blood pressure and heart failure, but it can also be used for hormonal acne. Furthermore, it is primarily effective at treating acne caused by hormonal fluctuations (i.e ane that appears during menstruation, pregnancy, or puberty), not acne vulgaris or cystic acne. In many cases, it is taken alongside oral contraceptives and/or topical acne treatments

Spironolactone is a great option for individuals seeking a long-term solution for their hormonal acne. Read on to learn if this treatment option is right for you. 

Woman with long hair

How does spironolactone work for acne?

Oral spironolactone can treat acne by blocking the effects of androgens (a.k.a male hormones) on the skin.  It serves as an anti-androgen, as it limits fluctuations that can lead to breakouts. Although the Food and Drug Administration does not list spironolactone as an anti-acne drug, it is recommended by many doctors and dermatologists. That being said, it has been found to cause adverse side effects in men, so it should only be used by women.

How to use spironolactone

Spironolactone is taken orally via pill or liquid medication. The most common dosage is between 50mg and 100mg daily, though some individuals may require up to 200mg to see changes in their skin. While it can be taken on an empty stomach, taking it with food can help prevent an upset stomach. Additionally, it is recommended that you take it earlier in the day to avoid having to get up during the night to pee. 

Spironolactone pills

How long does it take for spironolactone to clear acne?

Spironolactone usually takes a few weeks to start working when taken as prescribed. While it may not clear up all of your acne right away, it gradually works to decrease breakouts and oiliness. Regardless of whether or not you notice changes in your skin, it’s important to communicate with your doctor so they can monitor your progress and determine the correct dose. 

What are the possible side effects of spironolactone?

Possible side effects of spironolactone include drowsiness, dizziness, lightheadedness, upset stomach, and headache. These symptoms are typically mild and can be treated with adequate rest and hydration. More serious side effects are as follows: increased thirst, excess urination, mood fluctuations, unusual fatigue/weakness, muscle spasms, heavier periods, breast tenderness, persistent fever, and easy bruising/bleeding. If you experience one or more of these symptoms, contact your doctor as soon as possible. 

Allergic reactions to spironolactone are rare. However if you experience a rash, itching/swelling (especially of the face, tongue, and throat), severe dizziness, or trouble breathing, get medical help right away. 

What happens when you stop taking spironolactone?

Unlike an antibiotic, spironolactone can be taken for a prolonged period of time if it’s successful at treating your acne. If you want to stop taking it, consult a doctor so they can help you devise a plan for weaning off. Stopping the medication suddenly may lead to excess fluid retention and increased blood pressure. 

woman with hands on her face

Should I take spironolactone for acne?

Spironolactone is typically only prescribed when other methods are unsuccessful at treating hormonal acne. While it is very effective, it may lead to side effects that could outweigh the benefits. Additionally, you should not take spironolactone if you’re pregnant or breastfeeding. Being that this treatment requires a diligent routine (taken as prescribed at the same time each day), it may not be for everyone. 

How can Pandia Health help?

When used in combination with birth control pills, spironolactone is typically more effective. Speaking of which, don’t forget to sign up with Pandia Health to get your birth control delivered for FREE. If you have an existing prescription, you can transfer it to our pharmacy and get it shipped right to your mailbox. We also prescribe the pill, patch, and ring to patients in select states. Check out our resources today and join our community of people with uteri who are empowered to take charge of our reproductive health.

Frequently Asked Questions

What is spironolactone?

Spironolactone is a water pill that prevents your body from absorbing too much salt. It is commonly used to treat high blood pressure, but is also prescribed for treating hormonal acne in adult women. 

How long does it take to work?

Spironolactone typically takes a few weeks to start working. Progress should be monitored by a doctor, who can help determine the appropriate dosage.

Is it safe to use? While pregnant? While on Birth control?

Spironolactone should not be taken by individuals who are pregnant, as it may negatively impact the fetus. On the other hand, it is safe to take alongside birth control. In fact, taking both medications may cause skin to clear up even faster.