How Effective is Spironolactone for Acne?

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  • Written By: Kelly Ferguson
  • Edited By: Heather Bailey
  • Last Modified Date: 06 October 2019
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Spironolactone is not primarily used as an acne medication, but it is sometimes prescribed off-label for this purpose. Taking spironolactone for acne will work for some people but not for others. Specifically, women with acne due to certain hormonal imbalances are likely to find relief by taking spironolactone. Those with acne from other sources will probably not have much luck with this drug.

Most women who take spironolactone for acne have excess levels of androgen, or male, hormones, sometimes due to an underlying disorder such as polycystic ovary syndrome (PCOS). Acne is one of the side effects in women who have an excess of androgen hormones. Spironolactone works by reducing the levels of androgen hormones and regulating the hormonal fluctuations in the body. Men are cautioned against taking this drug because of the potential side effects from reducing the levels of male hormones, including gynecomastia, or breast growth in men, along with other possible effects.


Those women with PCOS or similar problems may experience other issues besides acne that are related to hormone levels, including hirsutism, or hair growth that often resembles that of males. This may include thicker than normal body hair or even female facial hair, which is sometimes coarse and difficult to manage. Even when primarily taking spironolactone for acne, these women may find a more normal, female pattern of hair growth is slowly established after taking the medication for several months. In fact, reducing hirsutism is a second off-label use for this drug.

Many women find using spironolactone for acne to be very effective, experiencing significant skin improvements and reductions in acne breakouts. A few experience little or no improvement, but sometimes these results can be improved by altering dosage levels, dosing schedules, and using additional medications. A dosage increase should be supervised by a doctor to reduce possible side effects. Spironolactone is also often used along with birth control pills and separate acne treatments to help further manage hormone-related breakouts.

Most people can use this medication safely, but there are a few side effects. Spironolactone is also sometimes used as a diuretic and a blood pressure regulator, so people taking his medication should take care to stay hydrated and those with low blood pressure should make sure to pay attention to worsening symptoms of the condition. Additionally, pregnant women should avoid taking this drug because it may alter the hormones of the fetus and disturb normal development.


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Post 5

I asked my family doctor to put me on Spironolactone for hormonal acne that I was experiencing. He had never heard of it being used for that but prescribed it anyway. About 10 days into treatment, I started noticing a strange rash all over my face and body. One morning I was contemplating what could be causing it and thought about the Spironolactone that I had started taking, so that day I didn't take it. That night I looked up Spiro side effects, and I was terrified when I read them. I was experiencing about seven or eight of the uncommon but potentially serious side effects such as a rash with pinpoint red or purple dots, round lesions that are

flat or slightly raised on the skin, itching, leg numbness, and several others.

It has now been about a month since I quit the Spironolactone, and I'm still dealing with the face rash. The rash on the rest of my body has mostly cleared, but my face looks horrible. I have sores all over it that look really strange and are hard to explain. It had actually started clearing up too, but I think taking a dose of Doxycycline may have made it flare up again. My doc that prescribed the med said he'd never seen a rash from this drug so he didn't provide much help, and I saw him when the facial rash was going away so I didn't push much further.

Now I'm definitely worried and am going to have to see a dermatologist asap. My face looks a million times worse than it did with just the acne, so I'm kicking myself for ever wanting to try the Spironolactone. Beware, but also know that this is extremely rare, I think maybe 1-5% of people who use the drug will experience these side effects. It is absolutely horrible.

Post 4

This is a very important topic and you just did an amazing job presenting it in a simple and clear manner.

Post 3

I've been on this drug for a month and still no improvement with my acne. My doctor said to wait at least two months though, so I'm crossing my fingers. I hope it works!

By the way, has anyone been experiencing dry skin and irregular periods on spironolactone? My skin is abnormally dry lately and my last period was shorter than usual.

Post 2

I'm not taking spironolactone as an acne treatment but I did notice that I am having less pimples on it. I started birth control pills simultaneously, so I wasn't sure if it was those or the spironolactone reducing my acne.

Post 1

My sister cured her acne with this medication. She had been suffering from acne her whole life. She tried just about everything. She took antibiotics for long periods of time and those did help. But when she stopped, her acne would come right back.

She moved to a new state a few years ago and naturally started seeing a new dermatologist. He suggested this hormonal acne treatment to her and she started taking it. It's been two years and her acne is completely gone. It's also a fairly safe drug, it doesn't have side effects like antibiotics. She can continue to take it forever.

She's so happy now, like a new person. If anyone else is experiencing the same things, please ask your doctor about this medication. It's definitely worth a try.

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