Spironolactone is used to treat many different disorders, from high blood pressure to fluid retention. Although the U.S. Food and Drug Administration doesn't recognize spironolactone as an acne treatment, it is often prescribed off-label to treat hormonally influenced breakout in women.
This medication isn't a first line of defense against acne breakouts. It is only effective against acne caused by hormonal fluctuations. But it can be especially helpful for women with hormonal disorders that trigger acne or who suffer with other problems, like unwanted facial hair.
Spironolactone is only available by prescription from your doctor. It is also sold under the brand name Aldactone.
How It WorksSpironolactone is in a group of drugs classified as anti-androgens. 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. Hormones, specifically androgens, have been linked to the development of acne.
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. Some studies found up to 66% of women who took spironolactone had excellent improvement or complete clearing of the skin. When used in combination with oral contraceptives this number jumps to 85%, according to one study.
Common Usage DirectionsWhen 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.
Possible Side EffectsSide effects with low dose spironolactone aren't as common as with higher doses, but most often include:
- irregular menstrual cycle
- breast tenderness
Other side effects can be:
- thirst, dry mouth
- stomach cramps, vomiting, and/or diarrhea
- increased blood potassium levels
- low blood pressure
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 it. And 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.
Tips for Using Spironolactone
- Take your pill with a meal if it upsets your stomach.
- Drink plenty of water. Spironolactone acts as a diuretic.
- Be patient. It will probably take several weeks before you really notice an improvement in your skin.
- Let your doctor know if you develop any side effects.
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