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Active Ingredients:
25 mg, 50 mg or 100 mg of Spironolactone.

Inactive Ingredients:
Calcium sulfate dihydrate, colloidal silicon dioxide, croscarmellose sodium, crospovidone, hypromellose, lactose monohydrate, magnesium stearate, peppermint flavor, polydextrose, polyethethylene glycol, povidone, pregelatinized (corn) starch, sodium lauryl sulfate, titanium dioxide and triacetin.

Items marked with orange can be irritating and over-drying, especially to acne-prone skin.

The list of ingredients above is provided for informational purposes only. Always check the actual product label in your possession for the most accurate ingredient information due to product changes or upgrades that may not yet be reflected on our web site.


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Better but not perfect
Reviewed on June 4, 2015

I have moderate stubborn acne and even though it didn't clear me up, it did make my breakouts less frequent. At any given time I would have about 10 pimples on my face and while this I'd only have about 4 or 5. It's definitely for hormonal acne though. I did only take it for a month though before trying something else so maybe I just didn't give it enough time.

This medication saved my life. Figuratively, but almost literally.
Reviewed on May 27, 2015

I've suffered from adult hormonal cystic acne for the last 7 years, ever since my senior year of college. I've tried absolutely everything: all kinds of topicals, supplements, birth control... nothing worked. For a couple of years, the regimen kept me somewhat in check, but I still got big, painful, itchy zits. At one point when I went off the regimen, my face broke out so badly that I went back on the regimen and completely overdid it, far beyond Dan's recommendations. Well, I ended up with an actual chemical burn on my face that caused EXCRUCIATING pain for 3 months. Yes, you heard me. 3 months. And then, the acne started coming back, and I couldn't cover it with makeup. I was mortified. I didn't want to live anymore. I ended up on disability from work due to severe anxiety and depression due to an acne dysmorphia that caused massive breakdowns throughout the day. I couldn't focus on anything. I felt so lost and hopeless, like no doctor would ever help me figure it out, and the pain on top of it was unbearable. I tried to kill myself, it was so bad.

Now, in June before the chemical burn happened, a new doctor had started me on 50mg of Spironolactone. I'd been on it for only 2-3 months at the onset of this disaster, so I knew it wasn't likely to be working just yet. I was in agony, constantly praying it would start to work. After around month 3, I asked my doctor to up me to 100, which had about the same results. Finally, in month 7, she agreed to up me to 150mg. Within weeks, I had stopped producing new pimples. I had finally found my magic number. I watched as my face began to clear, and my scars continued to lighten with it. At the same time, my chemical burn had stopped hurting and was starting to show slight improvements. I had already started to get better about my acne dysphoria, but finally seeing the itchy, painful, unsightly problem go away took so much stress and worry off of my mind.

I do still get small pimples here and there--even some that are fairly deep, but there are days where I will miss taking my spiro, as well as times I pick at things I shouldn't, so I completely blame those on myself. I do still have some healing to do from the chemical burn as well as some indented scars and hyperpigmentation that has been present for over a year since the initial big breakout, but I've been working on them with a dermaroller and vitamin C serum. Not sure if the roller really does much, but the serum definitely has improved things for me. I highly recommend it as part of anyone's nightly routine.

Anyway, it is so much better than it was, if I think about it too much I could cry at the relief. I can scratch my chin mindlessly if it itches, now. I can snuggle up to someone without worrying that their dirt will give me a zit (which didn't turn out to be true, anyway). I can run to the store for something I forgot without feeling like I have to endure a 20-minute makeup routine just to feel okay enough to go.

I ABSOLUTELY recommend trying spiro if your acne appears to be hormonal (around the chin and mouth, possibly deep and cystic feeling, painful, spiking at a certain point in your cycle, etc.), and if you're not planning on getting pregnant (it's not good for the baby/pregnancy, as it directly affects the expression of hormones. I was fine with this, as I'm in a lesbian relationship and have no intentions of ever carrying a child via artificial means). It took me about 5 months to find the right dosage with my doctor and see the real results, and trust me, it was HORRIBLE having to wait. But it was so, so worth it. Please try it, please stick to it. It saved my life.

by Brittz0rz on 05/27/2015 19:48
I should note that the reason I went off the Regimen in the first place was due to some dehydration that was going on that no amount of moisturizer would help. I wanted to not only cut out the BP (which my skin was clearly too sensitive for in the long-term), but also cut down the amount of time it took me to get ready for work/bed.
by KlC89 on 05/31/2015 17:19
Reading this has given me some hope in this long and painful acne situation I have been stuck in for 14 years. Very much similar to my situation including the body dysmorohia associated with the worsening of acne and not wanting to go to the store because of the make up routine beforehand. Spiro is really my last hope
by KlC89 on 05/31/2015 18:06
Reading this has given me some hope in this long and painful acne situation I have been stuck in for 14 years. Very much similar to my situation including the body dysmorohia associated with the worsening of acne and not wanting to go to the store because of the make up routine beforehand. Spiro is really my last hope
Works, but at a cost
Reviewed on May 12, 2015

My derm put me on Spiro to get rid of the cysts on my chin after switching from birth control pills to an IUD.

I hated it. It worked, after two months I had no cysts, but I was SO dehydrated. I could not keep enough water in me. Felt like I had to pee all the time, was constantly worried I had a UTI, etc. Went to my primary care physician twice because I was convinced I had a UTI, and both times it came out negative. I stopped taking it after 2 months and thankfully, the cysts were completely gone after that.

My Spiro Journey (weekly update)
Reviewed on February 21, 2015

I'm really hoping it works! I've been on Accutane, but that was 5 years ago. Since then, my skin never came back to what it used to be. For 4 years i had pretty flawless skin, but this last year i had a hard time trying to fix my skin. So here i am, still trying to fix it . Let's see if it works!

Keep in mind i have fair to medium skin, with yellow undertones and it used to be SUPER (cant stress this enough) oily skin, but thanks to Accutane i have combination skin now.


***WEEK 1: breaking out a little more than usual; no noticeable reduction in oiliness; pimples healing INSANELY fast even though i get new ones almost everyday; terrible headache in the first day (so i don't even know if it was because of spiro)

***WEEK 2 (PMS week): at the beginning of this week i was breaking out like crazy but in the last 4 days i got only one small pimple; NOTICEABLE reduction in oiliness; pimples healing reeeally fast; terrible stomachache yesterday

***WEEK 3: skin was doing GREAT at the beggining of this week, but 3 days ago i started breaking out again, it's not a huge breakout though; NOTICEABLE reduction in oiliness; pimples healing fast; my period didn't come this month

***WEEK 4: skin was doing GREAT but today i got a new pimple, a big one, but it is smaller than the huge cysts i was getting before i started Spiro; noticeable reduction in oiliness; pimples healing fast

***WEEK 5: skin healing from horrible breakout i had this last weekend (maybe beacause i upped my dose to 150mg); noticeable reduction in oiliness; pimples healing fast

***WEEK 6 (PMS week): skin is doing GREAT, it feels like it was purging and now there is nothing more to come out; INCREDIBLE reduction in oiliness; pimples healing fast

***WEEK 7: skin was almost flawless in the beginning of this week but since yesterday i got 2 pimples (one medium and one small); incredible reduction in oiliness; pimples healing fast

***WEEK 8: awesome skin!!! NO new pimples this week (since i haven't reached the 3 months mark, there's a chance i break out again though); oiliness is GONE; pimples healing fast

***WEEK 9: FLAWLESS skin ( better than when i was on Accutane!!!!!!!!!); oiliness is gone; can't tell if pimples are healing fast because i haven't got any new pimple this 2 last weeks

***WEEK 10 (PMS week): Awesome skin (no new pimples at all); oiliness is ok (maybe beacause is pms week); once again cant tell if pimples are healing fast because I haven't got any new pimples this last 3 weeks

***WEEK 11: after weeks without having any pimples i got a little one yesterday but it's already clearing up (but this was one of the most stressful weeks of my life, so keep that in mind); pimple is healing pretty fast; terrible stomachache (but i also think is stress related)

***WEEK 12: got a new pimple this week, but its a little one; oiliness reduced; pimples healing pretty fast

by adwhite17 on 02/22/2015 00:22
I started Spironolactone a little more than month ago for my hormonal acne, and I was told by my doctor to be extremely patient with it, as it could take months before I see any effects. As far as your breakout, it seems a bit soon and could just be your skin misbehaving. Good luck and do keep us posted!
by Natalia P on 04/18/2015 22:00
Hi I was just wondering did you experience any weight gain, at all, from the spire?
by robertathaise on 05/13/2015 23:01
eu acabo de descobrir que tenho ovario policystico , esse eh o problema da minha acne, depois de deixar de tomar diane 35 . estou usando accutane por quase 2 meses e estou gostando… minha boca fica seca e tenho que beber muita agua , quando minha menstruacao vem minha pele piora um pouco e por isso estou tomando a spirolactona….
20yo on Spiro feeling impatient
Reviewed on November 22, 2014

Hello so I will be 30 days on Spiro 50mg a day on 11/27/14 I haven't noticed an impact yet but I am trying to stay patient even though their are days I feel hopeless.. a bit of background of myself I will be 21yrs old in December I was on the birth control implanon (implant on arm) since 2012 of june recently got off of it in May 2014 because I wanted a break from b.c but I have never suffered from acne problems just the normal breakout (2-3 small ones a month) just started breaking out in the end of august 2014 lower of my face mild acne around mouth on jawline n chin so I figured it had to be hormonal sincr I got off the implanon so my gyno put me on orthotricyclen lo I been on that since Sept 21, 2014 but I still have mild acne on lower of my face get new pimples evevery day can SOMEONE give me SOME ADVICE OR SHARE THEIR EXPERIENCE WITH spiro. Please and thank you I have become so unhappy and my confidence has decreased alot!

************8months on pill

Hello everyone so I have now been on spironolactone 50mg a day for about 8 months now i did have an initial break out but after the 4month on it i cleared up i didn't have any breakouts just a few small ones that werent noticeable i do still have my red n dark marks from post acne but recently i have noticed that i have been gettin new ones out of nowhere and Im scared that my skin will go back to what it was..I only missed one pill which was on april 27th so what i did was take 2 pills the next day since i missed one the day before..could that have anything to do with why im starting to break out? Can someone plz help me or give me some advice, im freakin out

by hll406 on 11/22/2014 15:25
I am 35....benn on Siro 50mg 2x/day for 1.5 months and have noticed nothing except constipation and about a 2 pound weight loss. Should I really keep going?
by brinyoung on 11/23/2014 05:46
Spiro notoriously takes a while to kick in, just like any hormonal treatment. But keep going! Spiro is the only thing that eventually cleared my acne completely.
by bm93 on 12/01/2014 05:27
I still keep getting new acne and have many red and dark blemishes from the cystic acne that I was gettin everyday..just trying to hang in there! I hope to see results soon! Today marks my 33 day n spiro 50mg
by gmailgrl on 12/05/2014 04:14
stay hopeful! 6 months after starting, along with yaz and I haven't had a breakout since! it's been over a year now! I still take it faithfully!
by bm93 on 12/12/2014 05:13
I hope too see full results soon staying Patient!!! Also my dermatologist prescribed me bactrim its an antibiotic pill that im taking twice a day she says it should help speed up the process plus im using retin-a at night! I hope this works, good luck to everyone!
by tbos94 on 12/13/2014 03:58
Stay patient! This medicine worked really quickly for me, but this medicine works for females with hormonal acne. My acne was severe, so if yours is mild and have been experience some acne it may just be because of getting on and off birth control. But, give it more time!! Don't be impatient because all medicines especially acne topicals and medicines take weeks to a few months to really start working.
by bm93 on 12/13/2014 19:07
Sinve alot of ppl on here are taking 100mg a day should I tell my dermatologist to put me on a high dose since im jus on 50mg a day or stay at 50mg because im pretty small I weigh 115lbs and im 4'11 in height
Like Night and Day!
Reviewed on April 30, 2015

I have been on spironolactone for 2 months now. I'm 19. My face was completely clear until last summer. I started breaking out with cystic acne all over my chin, forehead, jawline, and cheeks. It was horrible and I tried everything natural and Otc to get rid of it. Nothing worked. I was so afraid to go to the dermatologist because everyone said it doesn't work. I finally decided I had to go because it was my last hope. I went in and my doctor said it was hormonal and new exactly what to put me on. He gave me spironolactone and started me off on two 25 mg pills a day. 50 mg total. Within 2 weeks I started seeing improvement. After about a month my face looked so much better. Everyone was commenting about how my face was clearing up. I went back and he now upped my dosage to 100 mg a day. Two 50 mg pills a day. My face looks 100% better! I felt bad about myself when my face broke out of no where with like 10 pimples on my chin. I now am lucky if I get 1. I even took before and after pic. Amazing what this did for me. I also have the most sensitive skin ever. My face is continuing to clear the more I'm on it. The only thing that bothers me is sometimes I get headaches and I get dizzy. It comes and goes. It also is making my time of the month fluctuate. Last month I had 2 in one month and now this month I havent had it yet. I'm going to ask him about that when I see him next week. That kind of concerns me. Even though I have side effects it's worth putting up with them to keep my face clear. I highly recommend this product to anyone! It's a miracle! My scars are fading every month.

Just starting out.
Reviewed on April 26, 2015

I cannot really give a full review, since I've only been on it for barely a week..but these reviews keep me hopeful. I'm a 25 year old female, and while I've always struggled with mild to moderate acne, my face recently broke out in the worst hormonal acne I have ever had. It started off as a few cysts on my chin, then went to my right side of my face, and then to my left. It was horrible. I'm still breaking out, but I feel like my skin may be starting to calm down. I was also out on a birth control for acne, called Estrostep. I've read a lot of mixed reviews for it, but I'm hoping it helps when paired with the spiro. Wish me luck!

by AmberLynn89 on 05/06/2015 20:29
Just a 2 qeek update. I don't want to get my hopes up, but I have had only one small pimple since I started taking this, and it was going to be a deep one, very painful. It healed and went down within 2 days! I haven't had any since. And I currently have no active pimples, whereas 2 weeks ago, I had at least 7. Unfortunately I still have post inflammatory hyperpigmentation, but those marks are healing quickly. I am very hopeful. I want to get to the point where I don't have to wear makeup. When I get there, I will cry. I hope this keeps working!!
by AmberLynn89 on 05/11/2015 00:21
I definitely spoke too soon! I believe I am starting the initial breakout after almost 3 weeks. I have gotten two on my left cheek, pretty small in size, but tender. One on my left side of my chin, also small, and tender. And now I have a larger, deeper one on my right cheek. I'm just hoping it's not like the cysts I used to get. I am also hoping this breakout does not last too long, heals quickly, and does not get much worse. I'll probably keep posting my progress.
Miracle Drug for Cystic Acne
Reviewed on April 22, 2015

I'm a 33 old female and have managed acne and cystic acne my whole life from age 12. I was managing it well by using a combination salicylic acid and benzoyl peroxide products for many years in my 20's. Neutrogena Grapefruit wash, Clean and Clear ointment and Clearasil were my usual products. I'd get an occasional cyst or small amount of acne from time to time, but I started noticing my skin was visibly aging more than my identical twin sister, who didn't use these products. Her skin was completely clear. I did some research and read an online book called Clear Skin Forever, about the harmful effects of benzoyl peroxide and salicylic acid products for your skin long term. I took myself off of the ointments and face wash and immediately started breaking out. For several months my skin got far worse (with really bad cystic acne) until I finally took myself to a UCLA dermatologist who put me on Spironolactone and a trentinoin cream (along with a sulfur wash in the morning). She also said how harmful salicylic acid and benzoyl peroxide are and recommended Cera-Ve fashwash and lotion. It took a month to start really seeing results, but I've been on it for a year and my skin is 100% clear. My scars are still fading and I get an occasional pimple from time to time, but it's no where near the level it was before starting it. Every month you will notice it getting better and better. Have patience with it and it will pay off. I took pictures of my face every month to track the progress. From my starting point to where I am now, I have completely transformed.

Cystic acne is hormonal, not bacterial, and can't be treated with skin ointments. Spiro helps block the over production of testosterone in the body and it's a miracle drug for people with hormonal acne. I've been on every medication imaginable. Including two rounds of Accutane as a teen. It has always come back. Do yourself a favor and see a dermatologist immediately who's willing to put you on this medication. It's not yet FDA approved to treat acne (it's a blood pressure medicine), so some dermatologists won't prescribe it, but it really works. More research is being done to prove it. Also, avoid getting your skin addicted to salicylic acid and benzoyl peroxide products. It's very difficult to ween yourself off of them and they do more harm than good in the long run. I use Cera-Ve face wash and a sulfer facewash in the morning with Cera-Ve lotion. At night, I use Cera-Ve wash and occasionally use an apricot scrub (without salicylic acid) to exfoliate. I have huge pores so this helps. Always use the Cera-Ve lotion after washing. Your skin tends to get dry on this medication but it's a small side effect to the benefits it brings. I gave this medicine a year before I gave a review, and I can honestly say it's changed my life. My dermatologist started me at 50mg a day and increased it to 75mg after 3 months. I'm still on the 75mg/day dose, which works for me.

by HeatherSC on 04/28/2015 18:14
I also have minimal side effects with this dosage. I've found avoiding sugar, dairy, and too much caffeine also helps with managing acne. A diet high in processed carbs, dairy, sugar and caffeine makes a perfect breeding ground for acne. Getting your gut on a healthier diet helps your face so lean protein, lots of veggies, and some fruit not only helps your overall health but your face as well.
Didn't work as a teen, but is working as a young adult
Reviewed on April 21, 2015

I was put on spironolactone when I was 18, but my acne was not hormonal then like it is now so it wasn't effective. I am 22 and have been battling acne throughout college. Its been a nightmare having to deal with something I thought you only had to deal with in high school. My acne has changed throughout this time, at first it was everywhere, but now it is hormonal, limited to my jaw line and chin. I also speculate that I have PCOS since I have never had a regular period, have abnormal hair growth, acne (obviously), among other symptoms. I started taking spiro about a month and a half ago. At first I did experience side effects at 100mg/day; irregular heart beat, muscle weakness, fatigue, diarrhea, dehydration, but after week two things calmed down and now I don't have any side effects at all unless I don't drink enough water. I also did lose about 8 lbs (which is awesome!) I assume it was just water weight. At about week two I had the rumored "initial break-out." It was not horrible, but much worse than my acne was before, almost cystic-like and very tender and painful. This lasted about two weeks and then suddenly it stopped and now my skin is clearing up! Apart from the spots leftover from my last break-out (hopefully the last one forever apart from the occasional blemish which I can deal with) my pores look very small, my skin is glowing, hair on my face and body doesn't grow as fast, the weight loss was a surprise (no I haven't gained it back like some other people), and my skin feels soft. I must recommend that to make this medicine work optimally that you eat healthy, cut out all dairy, salty/sugary foods, and caffeine, exercise, keep your hands off your face, RELAX (reduce stress), and drink LOTS and LOTS of water! My routine is very basic; Cetaphil cleanser, CeraVe AM/PM, occasionally I will use Neutrogena benzoyl peroxide topical, Make-Up - IT Cosmetics Illumination Powder.

I will update once more time has gone by. All in all I highly recommend for people with hormonal acne! Specifically if you have elevated testosterone levels or have PCOS.

Love spiro...
Reviewed on April 12, 2015

This has been my savior. I started breaking out as a teenager and struggled up until age 30 with persistent break outs. In college, I probably should have been on accutane. I have tried everything under the sun; every regimen and product. Some would work for the short term but then the acne would just pop up again. I went to numerous dermatologists who always prescribed a lousy drying product with a bogus antibiotic. It was an endless cycle. After turning 30, I couldn't handle having acne anymore. I researched a TON online and speculated that I could have PCOS....(when I was 18, I stopped getting a period for 8 months. I was told it was because I had low body weight and was a Division 1 athlete, I was put on the birth control pill....which helped a bit). The BCP basically masked the fact that I had PCOS. So... fast forward to age 30, I tell my OBGYN what I'm thinking and sure enough, I have PCOS! I have been taking spiro for a year and half now and I haven't had any break outs. Maybe the beginnings of one tiny pimple but then it magically disappears. My skin is smooth, glowing and I don't even wear make up, just a little bronzer...people ask me what I use and tell me I have amazing skin-it's extraordinary. I always say thank you and am flattered but little do they know the pain and torture I went through for years. For me, the spiro kicked in right away....I would say withthin two weeks my skin was flawless. It was truly miraculous. My only hope is that this medication is safe long term because I won't be going off....

by elodiecoulter on 05/06/2015 01:15
I just started on it and hope to have the same report soon - how many mg a day do you take? - Thanks in advance for your feedback