What is spironolactone? (Aldactone)

Spironolactone is a diuretic. A diuretic is a medication pill that helps your body get rid of extra water and salt.

What is spironolactone used for?

Usually, it’s prescribed to prevent high blood pressure and heart failure, but it can also be used to help treat hormonal acne. It primarily treats acne caused by high Testosterone (i.e acne that appears during menstruation, pregnancy, or puberty), and it is not strong enough to treat acne vulgaris or cystic acne alone. In many cases, it is taken with oral contraceptives and topical acne treatments like tretinoin. 

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.

How does spironolactone work for acne?

Oral spironolactone can help treat acne by blocking the effects of androgens (a.k.a male hormones) on the skin.  It serves as an anti-androgen, lowering the levels of Testosterone in the blood. Although the FDA does not list spironolactone as an anti-acne drug, it is prescribed by many doctors and dermatologists to treat hormonal acne that doesn’t respond to birth control pills. I Spironolactone can cause feminizing side effects in men.

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Who can take spironolactone to treat acne?

Spironolactone requires a doctor’s prescription. For acne, it’s usually prescribed to women with hormonal acne. Spironolactone should NOT be used if you have: adrenal insufficiency, kidney problems, diabetes, acid-base problems, liver problems, new cancer, prostate cancer, or pregnancy (it can affect XY embryos). Although it has been shown to be safe, not everyone may be able to use it. If you would like more information about  Spironolactone’s use in acne treatment, please contact your doctor. 

Woman with acne on her face

Spironolactone dosage for acne

Spironolactone is taken by mouth via pill or liquid. 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. 

will my acne ever go away

How long does it take for spironolactone to work?

Spironolactone usually takes a few weeks to start working. While it may not clear up 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 she can monitor your progress and determine the correct dosage. 

Related content: Best Birth Control for Acne

What are the possible side effects of spironolactone?

Possible side effects of taking spironolactone include drowsiness, dizziness, lightheadedness, upset stomach, irregular periods, and headache. These symptoms are typically mild, often go away with time, and can be treated with hydration. More serious side effects are 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. 

will my acne ever go away

What happens when you stop taking spironolactone?

Unlike an antibiotic, you can take spironolactone for a long time if it’s successful at treating your acne. If you want to know how to safely stop taking spironolactone, consult a doctor so they can help you devise a plan for weaning off. Stopping spironolactone suddenly may lead to excess fluid retention and increased blood pressure. 

woman with acne on her face

Should I take spironolactone for acne?

Spironolactone is typically only prescribed when other methods are unsuccessful at treating hormonal acne. It is best for hormonal acne (i.e acne that appears during menstruation, pregnancy, or puberty)and is generally not used by itself. While it is effective, it may lead to side effects that could outweigh the benefits. Additionally, you should not take spironolactone if you’re pregnant. 

Related content: What are Oral Antibiotics for Acne?

How can Pandia Health help?

When used with birth control pills, spironolactone is typically more effective in treating acne. Pandia Health has expert doctors that can help you find the best acne treatment for you as well as prescribe birth control AND get your medication with FREE delivery. Sign up today or contact us if you have any questions. If you have an existing prescription, you can transfer it to our pharmacy and get it shipped right to your mailbox. With our free delivery service, it’s never been easier to consult a doctor for Spironolactone for acne and get it delivered along with your birth control. We also prescribe the pill, patch, and ring to patients in 14 states and expanding rapidly. Check out our birth control resources today and join our community of people with uteri who are empowered to take charge of our reproductive health.

Disclaimer: The following information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.