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MoonlitRiver

How Long Did Spironolactone Take to Clear Your Acne?

Reposting this here because I got absolutely zero responses in the hormonal acne forum and my dermatologist appointment is tomorrow so getting kind of desperate, sorry!

Hi guys, looking to hear some experiences of Spironolactone treatment courses please! Question is in the title really.... Did Spironolactone successfully clear your acne and if so how long did it take?

I've been taking Spironolactone now since the last week of December, so about 16 weeks in total, but in that time I did increase the dose gradually, starting initially on 50mg a day, then 100mg, and now 150mg for the past 6 weeks or so. My skin has definitely improved and I have experienced some clear periods lasting up to a week at a time on occasion, but I always seen to regress and break out again every time I think it's finally working and clearing me up for good. 

Anyone able to share experiences of how long it took to clear you? Should I persist with this treatment or try something else? (My dermatologist is planning to try a long low-dose course of Isotretinoin if this doesn't work but I'd much rather stick with this if it will properly clear me).

Thank you :)

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i've been on spiro for about 11 months now, 25mg twice a day, and i'm 95% more clear than i was but definitely still get break outs. not usually cysts, but i currently have two. it's the worst breakout i've had in a while.

i've heard it can take 18-24 months of continual and gradual improvement to be fully clear, but if you're on sprio and it's working it's not something that you can really get yourself off of or else everything will just come back. at least that how i understand it in the most general sense? if you've seen improvement from it then wouldn't that indicate that you do have some sort of hormonal imbalance? and wouldn't you want to keep taking it anyway?

how long have you been on epiduo? could it be that you're also purging from that while the spiro is getting to work?

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20 hours ago, skinlessInSeattle said:

i've been on spiro for about 11 months now, 25mg twice a day, and i'm 95% more clear than i was but definitely still get break outs. not usually cysts, but i currently have two. it's the worst breakout i've had in a while.

i've heard it can take 18-24 months of continual and gradual improvement to be fully clear, but if you're on sprio and it's working it's not something that you can really get yourself off of or else everything will just come back. at least that how i understand it in the most general sense? if you've seen improvement from it then wouldn't that indicate that you do have some sort of hormonal imbalance? and wouldn't you want to keep taking it anyway?

how long have you been on epiduo? could it be that you're also purging from that while the spiro is getting to work?


Hello, thank you so much for your response! Sorry to hear about your breakout. Do you remember at what point in the treatment you thought your skin was definitely improving by any chance? 

The only reason I would come off the spiro is to switch to isotretinoin if the spiro isn't going to properly clear me because you can't take the two together. I got pretty much clear once before on Dianette (though it took a painfully long time....) and my current skin problems started after I came off that so I am fairly convinced that my acne is the result of hormone imbalance. I saw my dermatologist yesterday and she wants me to give the spiro 6 more weeks before deciding on isotretinoin, so that's the current game plan. Just really hope the breakouts reduce during that time as I'm kind of despairing. :( I've been on the Epiduo for around 4 years so that's definitely not a factor in the current breakouts. 

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i am sorry it's not working for you as fast as others, I haven't tried spiro but I don't know if I even should, im 32 so I am trying to stay away from antibiotics or any oral meds, im using a cream and other stuff from a dermatologist here in Toronto, she created her self it's a good line I heard, its been okay but not near clear yet, I was given some treatments but they are so expensive and the downtime is nuts I can't do that it's called PHOTODYNAMIC, my second plan she offered was peels and blue light still pricey but I will do it  if it comes to that, I stress a lot and worry about my face which def makes it worse but what can we do we can't help it.
If I were you, try using loose powder for cover up ( I use that never used foundation in liquid)
wash ur face twice as day
exfoliate gently and apply pea size of benzoyl peroxide on area then moisturize , my skin right now its horrible, so dry I peel skin off with a tweezer I know horrible but it's hard to even wear powder on my skin, I am going to go see two more dermatologist for more opinions and see what they say, I wanna see if they tell me the same stuff this 1st dermatologist told me, shes located downtown Toronto, it's a high end location so pricey she told me my acne was hard to treat and not curable which upset me so much, my huisband  said no way lets get more opinions so I have one end of this month and May 3 so I will see what they tell me and offer me, sometimes these high end locations even tho they are rated # 1 derma they are all about  money, it's a private clinic so you know what I mean, I prefer to have three opinions then just one so I wish you luck with your progress it will get better but I feel your pain there are days I wish I didn't have to leave the house and with summer around the corner it depresses me even more I love being out, sun, beach and I feel like if I still look like this I will not feel like going anywhere
in my opinion I would go see another dermatologist
good luck!!!

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5 hours ago, stressed123 said:

i am sorry it's not working for you as fast as others, I haven't tried spiro but I don't know if I even should, im 32 so I am trying to stay away from antibiotics or any oral meds, im using a cream and other stuff from a dermatologist here in Toronto, she created her self it's a good line I heard, its been okay but not near clear yet, I was given some treatments but they are so expensive and the downtime is nuts I can't do that it's called PHOTODYNAMIC, my second plan she offered was peels and blue light still pricey but I will do it  if it comes to that, I stress a lot and worry about my face which def makes it worse but what can we do we can't help it.
If I were you, try using loose powder for cover up ( I use that never used foundation in liquid)
wash ur face twice as day
exfoliate gently and apply pea size of benzoyl peroxide on area then moisturize , my skin right now its horrible, so dry I peel skin off with a tweezer I know horrible but it's hard to even wear powder on my skin, I am going to go see two more dermatologist for more opinions and see what they say, I wanna see if they tell me the same stuff this 1st dermatologist told me, shes located downtown Toronto, it's a high end location so pricey she told me my acne was hard to treat and not curable which upset me so much, my huisband  said no way lets get more opinions so I have one end of this month and May 3 so I will see what they tell me and offer me, sometimes these high end locations even tho they are rated # 1 derma they are all about  money, it's a private clinic so you know what I mean, I prefer to have three opinions then just one so I wish you luck with your progress it will get better but I feel your pain there are days I wish I didn't have to leave the house and with summer around the corner it depresses me even more I love being out, sun, beach and I feel like if I still look like this I will not feel like going anywhere
in my opinion I would go see another dermatologist
good luck!!!


Hi, thanks for the reply. I'm using the UK NHS and have had some really bad experiences with NHS dermatologists but this consultant is by far the best I've seen, I really like her and she really listens to me and my concerns. Just wish I could see her more often if anything! Though I know I'm lucky to be in the UK and able to get free appointments with a consultant even if they are infrequent and short.

I personally wouldn't go near my skin with tweezers, but that's just me. My skin is seriously sensitive to any abrasion so if I need to exfoliate I only use very gentle circular motions with the tips of my fingers when my skin's still wet from the shower. Hope you manage to find a dermatologist you can work with soon. I'm in a state of only leaving the house about once a week at the moment and dreading even that so seriously hoping my skin will improve soon (although I am aware that with me my mental health plays a significant factor in how I perceive my skin's condition and how it affects me). It's a horrible place to be though, I really sympathise.

Best of luck to you too!

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On 19/04/2017 at 9:06 AM, MoonlitRiver said:

Hello, thank you so much for your response! Sorry to hear about your breakout. Do you remember at what point in the treatment you thought your skin was definitely improving by any chance? 

The only reason I would come off the spiro is to switch to isotretinoin if the spiro isn't going to properly clear me because you can't take the two together. I got pretty much clear once before on Dianette (though it took a painfully long time....) and my current skin problems started after I came off that so I am fairly convinced that my acne is the result of hormone imbalance. I saw my dermatologist yesterday and she wants me to give the spiro 6 more weeks before deciding on isotretinoin, so that's the current game plan. Just really hope the breakouts reduce during that time as I'm kind of despairing. :( I've been on the Epiduo for around 4 years so that's definitely not a factor in the current breakouts. 
 
Hey sorry for the delay, I would say mine started being noticeable after about four months, and then a whole order of magnitude clearer at month eight. It's fine about the breakout, I've been super unhealthy (not eating regular meals, not working out, not getting any sun) the past couple months because I'm finishing up my master's thesis in a week ha. Actually, since I first wrote my skin hasn't had any cystic breakouts, I just have one little whitehead. I would say I was real happy with my skin starting in January for the first time in a while where I just stopped getting breakouts, just a spot or two a month. It really is a slowish change but I'm still seeing improvement month-to-month and I'm on month 12 right now. I'd really try to give it a year if you could, there're other things that can help how effective it is. Also for reference I started getting acne in my early twenties out of nowhere and real aggressively. I went on antibiotics that cleared me up, but after I went off of them it came back. That's when I started spiro, which was about five years after I started breaking out.

Also are you on birth control? So I'm on Implanon, the implant in your arm. My total regimen is 25 mg spiro twice a day, retin-a at night, I've had a couple microneedling treatments, and then just a pretty healthy diet and pilates/the gym about six days a week. I use a real gentle cleanser and moisturiser, Dr. Bronners for shampoo because detergent irritates me, non-alcohol witch hazel toner, and then a sulphur wash on my face in the shower. I also shower every night, I live in a really gross city and so the thought of not washing all that off or getting it in my bed without being clean really gets to me. I think that's just generally good advice though?

If you're comfortable with isotretinoin then go for it, I guess for me I just prefer to get it at the source because I know it's hormonal for me and nothing else will really change that. I'm also pretty scared of the side effects of isotretinoin and would be worried about having to do more than one course of it. I don't have any side effects with spiro, none of the dizziness or weight gain that other people have had, and it's real easy so I just stick with it. The other big thing for me that helped were things that didn't do anything overnight but I can't imagine not doing now, like drinking heaps of matcha tea, almost daily exercise, water, silk pillow sheets, eliminating harsh chemicals, hand sanitser throughout the day, and I've been mostly vegan/a little vegetarian for about ten years now. I definitely notice on my skin when I've had a lot of dairy.

Hope some of that was helpful? I know the lifestyle stuff is harder than taking a pill, and might not be possible for you. Maybe some of it is tho?

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On 19/04/2017 at 3:22 PM, MoonlitRiver said:

Hi, thanks for the reply. I'm using the UK NHS and have had some really bad experiences with NHS dermatologists but this consultant is by far the best I've seen, I really like her and she really listens to me and my concerns. Just wish I could see her more often if anything! Though I know I'm lucky to be in the UK and able to get free appointments with a consultant even if they are infrequent and short.

I personally wouldn't go near my skin with tweezers, but that's just me. My skin is seriously sensitive to any abrasion so if I need to exfoliate I only use very gentle circular motions with the tips of my fingers when my skin's still wet from the shower. Hope you manage to find a dermatologist you can work with soon. I'm in a state of only leaving the house about once a week at the moment and dreading even that so seriously hoping my skin will improve soon (although I am aware that with me my mental health plays a significant factor in how I perceive my skin's condition and how it affects me). It's a horrible place to be though, I really sympathise.

Best of luck to you too!


Whoa yeah I just read this. Good thing you have NHS, that's a godsend. But only leaving your house once a week?? Are you in London? Is that just socially or is it affecting your job as well? I've felt the same way for sure, but you should really be out more! I honestly think exercise helps so much with skin and definitely helps with anxiety and depression to some degree (of course shouldn't necessarily replace any medication, but for levels I experience it every now and then it does wonders). Sorry I feel like I'm sounding like such a health freak I'm not really lol.

What exactly is the condition of your skin? Is it just super bumpy or really red? If you have cystic, red acne I can also let you know how I covered it up? I feel like that's something I got real good at real fast, and it sounds like we have the same level of sensitivity maybe. Mine was real awful in between my course of antibiotics and spiro. By no means is my skin perfect now, but at this stage I'm more worried about hyperpigmentation and light rolling scars. It both feels really good, because the actual acne doesn't weigh on my mind as much, but scarring is annoying and a whole other game when it comes to correcting.

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