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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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A true miracle
Reviewed on May 10, 2017

After 10 years of being embarrassed of my own face i finally feel confident. Ive taken 100mg for 6 months and i finally see results. Stick with it, its worth it

by Justme4 on 05/20/2017 02:34
I've been on it for 6 weeks and spots are worse and healing is much much worse. Did you see an improvement immediately?
by Laury21 on 06/28/2017 20:03
For me was the same 50mg per day during 1 year and after 6 months my skin got very sensitive and healing would take fo ever!!! I stopped for about 6 months because was causing me pain on my stomach, but after those 6 months under control, now big cyst again, like from nowhere!
Miracle Drug for Cystic Acne! On it for 3 weaning off.
Reviewed on April 22, 2015

Updated review: I've been using Spiro for about 3 years now with significant success. I had severe cycstic acne after taking myself off of benzyl peroxide and salacylic acid products after using them for years (Don't do them. Your skin gets highly addicted and they cause premature aging). My dermatologist initially put me on 50mg/day and increased it to 75mg/day after one month. I started noticing results after a month of being on it. I didn't notice any initial breakout but my face was in rough shape when starting. By month 3, I was significantly improved and after a year of being on it, I was transformed. It's worth the wait. I was also on a tretinoin (Retin-A) cream at night. I had to increase to 100mg/day for a breakout for about 4 months but I've now been slowly weaning off the medication for about 6-7 months by a rate of 25mg every 2 months. My body takes about a month to adjust to the dosage decrease. I would get a minor breakout but it would even out after about the month mark. My dermatologist also switched me to a clindamycin cream in the morning and a potassium azelaoyl cream at night. I'm weaning off it it due to starting a family and I thought I'd have much more trouble. So far, with such a slow decrease of the medicine my body has responded really well. My dermatologist did the face cream switch about a month before stopping Spiro as to not shock my system too much too. So far so good. I've found this drug to be a miracle for severe/cystic acne. In my experience, it is way better than any birth control pill I've ever been on, which seem to just mess with your hormones quite a bit. I know which medicine I'll be using if I ever have acne in the future. After being on everything as a teen and trying to manage it with over the counter products all through my 20's, this has been a real life saver. Also, diet helps significantly. Limit dairy, processed carbs, sugar and caffeine...which make acne much worse. Try to stick to more lean protein and veggies. A great book to read about that is Clear Skin Forever online. I hope this helps. I've been battling acne my whole life. I'm so grateful for Spiro and knowing that diet plays a huge part of it too. I hope this helps!

Older Review:

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.
by HeatherSC on 04/03/2017 17:56
Update: I've been on Spiro for almost 3 years. I had to increase my dosage to 100mg/day for a breakout. I was on that for about 4 months. I've now been slowly weening off the medication for about 6-7 months at a rate of 25mg every two months. My body takes about a month to adjust to a dosage change I've noticed. I'd get minor breakouts after a dosage change but then it would clear up. I was also on a tretinoin cream at night which I've also weened off. I'm now on a clindimycin cream in the morning and a potassium azelaoyl cream at night (which I started using about a month before stopping Spiro). My dermatologist said it's best to slowly ween off of it to give time for your body to adjust. That seems to be working great.
This is it!
Reviewed on March 16, 2017

I have struggled with adult acne increasingly over the last few years. After going off of oral BC and switching to an IUD, I noticed that my acne had gotten to a frustratingly chaotic level, not immediately, but over a couple years such that I never seemed to fully put 2 and 2 together that hormones were causing my skin issues. No matter what I seemed to do, I would have frequent/daily breakouts. At any given time, I would have anywhere between 3-10 active acne spots on my face of all the varieties of pimples-- clogged pores, under-the-skin pimples, simple whiteheads, blackheads, everything. To combat the breakouts, I tried all kinds of things: washes, scrubs, dietary changes, increased water intake, exercise regimens, more frequent washing, water filters, various acne-friendly makeup brands, prescription creams, antibiotic pills, OTC spot treatments, salycylic acid, benzoyl peroxide, glycolic acid, exfoliating masks, and natural skincare alternatives. Nothing consistently worked. Even if something momentarily alleviated the breakouts, it wouldn't be long before an irritated spot would crop up that would turn into a hellacious and many times painful pimple. An odd series of events led me to try spironolactone, despite previously being convinced that accutane would be my last hope-- trying sprinolactone became my last ditch attempt to clear my skin before the final option of accutane... and lo and behold-- IT WORKED! THIS IS IT! Now, granted, this is not an overnight, life-changing kind of medicine. Rather, over a period of weeks, it involves minute changes in the amount of hormones that affect your skin. It works well paired with another prescription cream or wash to help clear surface level dirt. What it does is it essentially blocks androgens that circulate in your system from actually connecting with receptor sites. For those with hormonal acne, this should result in less breakouts and formation of pimples. I've been taking this for almost 6 months now and my skin is about 97% clear. So what is this other 3% that's not perfectly clear? Well, about once a month at this point, I may get a single pimple. The other bit, is that I occasionally have a few blackheads, which I manage to treat with a blackhead extractor tool, so they don't end up becoming anything worse. I'm almost at the point where I could feel comfortable going out of the house without make-up on. For me, that is HUGE. Previously, I was mortified to be seen even by any relative with my bare skin showing because it was so red, hyperpigmented, and spotty. Now, my complexion feels and looks literally relieved-- clear, not congested, calm, under control. I have a tiny amount of healing still to do on my hyperpigmentation, but undoubtedly at this rate, I expect it should be healed within the next 3-6 months. If you're like me and you've tried everything with no relief from your adult acne, you should really give spironolactone a try. It may do wonders for you.

by stacyxo on 04/03/2017 12:42
Thank you for this review!! I'm currently on 50 mg of spiro for a little over 2 weeks. I broke out alittle with cystic acne near my ears and on my upper lip and chin area. But that's been a normal thing for me recently. Not sure how much worse it's going to get. Did you have an initial bad breakout?. I also don't have any side effects so far.
Most helpful acne medication
Reviewed on March 5, 2017

I started birth control at age 17 (orto tri cyclen) after trying doxy and minocycline and it cleared up my acne like a charm! Then shortly before I turned 21 I started getting acne on just my chin (combo of closed comedones and hard small cystic acne) and after about a month of dealing with the acne, hoping it would clear, I saw a dermatologist and asked to be put on spiro since I read good reviews. She told me it was for older women and just put me on tazorac .05% and aczone 7.5%. The tazorac completely tore up my face but after a month my skin got used to it and definitely was helping the texture of my chin but just not stopping the acne (plus taz made my skin super sensitive so when i would frown or move my face a lot my face/chin would turn kinda red... definitely unflattering and not a good topical for summer months) and the aczone was helpful but not stopping everything. Fed up with my derm, I saw a second derm who took one look at my face and suggested spironolactone and benzaclin (antiobiotic). I stopped the aczone and started the benzaclin which worked really well for a couple of weeks and then didn't work well so I stopped it entirely. I started on 25 mg spiro once a day for a month last November 2016. I didn't see results so my derm upped it to 50 mg in december. I started to see small results like decreased oil production on my face and hair but nothing truly impacting the acne. In january I went up to 75mg for a few weeks and then 100mg (50 twice a day) and that is where I am right now (march 2017) and my face for the first time summer 2016 is completely clear. I almost feel like i'm jinxing myself for typing that but it's been a full month without any sort of pimple (even during my period). I can also go two days without washing my hair and my hair would usually be oily by the end of the day so that is a HUGE plus... and the oil on my nose decreased by 95% I'd say. I don't have any side effects, maybe just prone to headaches from dehydration (so definitely drink lots of water) and I have to get my blood tested for high potassium levels since its a diuretic and can make the body retain potassium. I still work out everyday and I don't feel fatigued or anything! I would definitely suggest spiro, it can take 2-3 months to truly get complete clearing but i'm so happy I waited it out. I did get a slight breakout at upping to 50 mg on my temples which never get acne but it went away shortly and that was my only breakout from the spiro.

Induced neck acne and comedones
Reviewed on March 5, 2017

Unfortunately, this drug made my acne get significantly worse. Instead of getting the usual type of acne (chin, cystic) I developed closed comedones for the first time in my life on Spiro, as well as NECKNE and cysts on my back that I've never had. I was completely make-up and moisturizer free at the time, so it was NOT acne cosmetica. I've never experienced such hideous, bumpy skin as I did on this drug...I literally looked like I had grains of sand on my right cheek and the side of my forehead. Better yet, the comedones all ended up having to either be squeezed or turn into papules to go away. I still have some literally three months later. The worst of the Spiro-induced acne disappeared shortly after I quit using it. I now very rarely, if ever get cc's.

TLDR: Beware if this drug gives you new, strange breakouts in places you never get acne. Do not confuse it with an 'IB'. An IB is usually in places where you are most acne prone. I've read several reviews elsewhere online where people agreed Spiro caused closed comedones or generally worsened their acne, so this is possible. I suspect Spiro adds to an underlying hormone imbalance, namely estrogen dominance, by totally turning off testosterone receptors.

On Spiro for 7 years, too reliant on it
Reviewed on February 28, 2017

Hey guys - apologies for the very long review!

I always read these reviews and I figured I may as well share my story since I've been on Spiractin (Spironolactone) for over 7 years now.

When I was a teenager my skin was pretty great, I had a few little pimples every now and then, but nothing too extreme. Then at the age of 19, while I was living overseas in London at the time (I'm from a woman from Australia), my skin started to get a lot of painful pimples around my jaw line and cheeks. They worsened over a few months and eventually became full on red, painful under the skin acne. I had no idea how to treat this, so I bought Pro Activ. Probably the worst thing I could have done, it only made my skin more irritated and red.

When I came home from London, it was summer time over here. With a lot of sun and ocean swims my skin started to clear up and eventually it was back to normal. However, as soon as summer disappeared my acne came back with sore, under the skin pimples.

I went to a dermatologist and he instantly put me on 100mg of spironolactone and on the Yasmin pill. I suffered bad side-effects of being on such a high dosage of Spiro straight away, so he took the dose down to 25mg, moving up 25mg every 3 months. Eventually I was on 100mg. I started to notice that my body was not reacting well to the Yasmin pill, my skin was actually worsening from the Yasmin so I took myself off it and continued on 100mg of Spiro.

After stopping Yasmin, my period didn't come back for 3 years - this is a side effect of being on Spironolactone.

I started to notice my skin would become accustomed to the dosage of Spiro I was taking, so I started to increase my dosage so it would continue to work for me.

At the age of 25 I was on 200mg of Spiro (taking it at night time so the dehydration I would get from the drug wouldn't effect me during the day). The 200mg started to stop working and i was seeing pimples that i would never have gotten previously, like forehead pimples and big under the skin pimples under my eyebrows. I upped my dosage to 250mg of Spiro and this worked really well, however I noticed my breasts were larger and I'd put on a bit of weight around my hips.

I also got my period back, but it was random and sporadic, sometimes it would be every 1-2 weeks, sometimes it would be every month.

Because my period schedule was all over the place I decided to lower my dosage. I instantly dropped it back down to 200mg, my skin was fine. So i continued to lower it down to 175mg. My skin started to worsen and I noticed a lot of small bumps on my chin and my face was a bit oily. I lowered it down to 150mg after about 3 months on 175mg. My skin worsened almost instantly. After 2 months of being on 150mg I went back up to 200mg and my skin became clear again, with the occasional few pimples and bumps after a big weekend or something.

I also stopped getting my period again.

Now, I'm 27 years old. I was on 200mg of Spiractin and my skin has started to worsen again, I've started getting sore pimples along my jaw line (something which hasn't been an issue for years!), I always have bumps on my forehead which don't pop or come to a head, they just sit under the skin.

Yesterday I increased my dosage to 225mg to see if my skin will go back to normal again.

I still haven't had a period - so it's been about a year since my last period.

Conclusion: I rely on this drug far too much now. I have tried everything, from going vegan, exercising often, detoxing, Vitamin A serums, Vitamin C serums, benzoyl peroxide, salicylic acid, etc. But nothing has worked like Spironolactone has.

I would recommend going on this drug if you are ok with knowing you will most likely be reliant on it for the rest of your life, or at least until menopause (you need to go off Spiro if you want to get/are pregnant, which means your acne will come back during that time).

I would recommend going to see a Naturopath first and trying to sort out your hormonal imbalance naturally before jumping onto this medication. I wish someone had told me to do that when I was younger so I wasn't so reliant on this drug.

It's been a lifesaver for my acne, but also an inconvenience on having to adjust the dosage every year or so.

I'm lucky that the only side effects I've experienced is an irregular or no period and some breast tenderness/enlargement.

Inactive ingredients matter
Reviewed on February 13, 2017

Warning: long but worth it!!!

I like many others here have tried and been on everything under the sun. Tried topicals, tried natural, tried prescription. After doing accutane for years and miraculously getting “clear”, I went off of it, My skin stayed clear for a while and I was honestly just super happy to not have drugs in my system. When I hit 33, something in my body went haywire and my acne flared up worse than ever before. I was devastated. Not to mention, I was recently married, started thinking about a family etc. But I was just incredibly embarrassed, most of all in front of my new hubby.

Of course, I went to dr, explained that I had been on accutane before and although I was happy with the result, I was nervous about it and its side effects now. He prescribed me 25 mg. of Spiro, saying that likely this was a bout of hormonal acne at its worse, we could get on this and clear me up quick. Hindsight - I wish I had not just accepted what he said as truth and done some homework because if I had, I would have realized that there are even more potential side effects with spiro than even accutane!

So fast forward a couple of months, I was up to 75mg daily and my entire outlook on life has changed… for the worse. My acne was still terrible and in addition I now had daily stomach cramps so severe I had had to stay home from work, I was nauseous nearly every day (nope! not pregnant!) and on top of it all, my sex drive was near to nothing when before I couldn’t get enough of my husband. It was unbearable.

Desperate for answers, I started looking up side effects for this drug and sure enough! After doing my research I was just so upset with myself for allowing someone to convince me to put something so vile into my system. Chemicals have side effects and most likely, if you start a prescription YOU WILL BE ON IT FOR LIFE. There is no “cure” for acne so even if people here say it worked for them, it will only work if they take it. And by taking it, they are allowing some pretty terrible stuff into their bodies.

Now I am no hippy and I absolutely know from experience that the natural route for acne doesn’t work. But I have now drawn the line in the sand when it comes to prescriptions. No more!

In my newfound vigor and pissed-off-ness, I dug in deeper to solutions. From all testimonials, benzoyl peroxide is the best bet BUT you want to find a company that doesn’t have to add a lot of oils and preservatives which makes the benzoyl less effective. Once I read that, a light went off in my head. Why proactive had never worked for me, why Rodan and Fields hadn’t worked, Mario Badescu, Cetaphil, Neutrogena…. you name it, I have tried it and nothing worked. But they are all HUGE and obviously their products have to have a lot of preservatives. Try getting a list of all the INactive ingredients in most big names brands. Pretty tough to find! But look out for stuff like DimethiconeAcrylates/C10-30 alkyl acrylate cross polymer, isopropyl myristate, stearic acid and well loads of other ones. The names themselves are a mouthful and that is why people ignore them. But once you know what to look for, everything starts to make more sense.

I got more into researching. Finding companies that don’t use preserving oils is hard to find, let me tell you! I encountered a couple and called them. Exposed nearly convinced me but the one that impressed me the most was one you probably have never heard of, Ninja Skincare. The care they took with me to fully explain what was going on with me, my body, my face was truly unreal. Based on that alone, and some pretty impressive reviews, I gave them a shot. Now, 3 months later, after 2 full years of searching, my face is clear!!!! Any time I have questions, I literally text them and get a response within an hour. I have never bought products from a company like this before and would recommend them to absolutely anyone!!! Give them a shout, you won’t be disappointed!

Still unsure!
Reviewed on February 8, 2017

I have been using spironolactone for nearly 2.5 months now. I start in Nov. 2016 and have been taking 100mg per day before going to bed. I have not experienced drastic side effects like some people luckily, so I've tolerated the medication well. I haven't not seen an improvement yet :/ I am sticking it out for 3 months though before my next check up with the Dermatologist. I know it takes time for it to build up in your system, but when I talked to my dermatologist the other week she felt that there should be SOME sort of improvements by now even if they are small. This is so hard to measure though unless you're taking pictures. Hoping that this is the solution though and sticking it out is worth it!

by stacyxo on 04/24/2017 16:17
Have you seen any results since then ?? I've been on it for a little over a month and I have not seen that much improvement so far.
Spiro- 3 weeks in
Reviewed on February 6, 2017


This is the first time I have ever posted a review on here, but I am really excited to be trying Spiro finally. I have been experiencing breakouts since I was 14 (I am now 23) and literally have tried absolutely everything in the book. Some treatments temporarily cleared me up but initially dried out my skin so much they ended up causing even more breakouts. Finally I decided that my breakouts must be hormonal, possibly a sympton of PCOS. I have been on ortho tri cylen lo for about a year and it has helped reduce some of the breakouts but not all. That's when my gyno recommended trying Spiro. I am currently taking 50 mg a day and am 3 weeks in. I know it takes much longer than this to see the full results but so far it hasn't been that bad. I had a little bit of a breakout the first week I took it- but as of right now it seems to be clearing my skin. Has anyone had the initial breakout come after the first month of taking it?

Also my skin is dryer than normal right now but I'm hoping that evens out once my body adjusts to the Spiro even more. I will right another review in a few weeks with an update! Good luck to everyone trying this- I'm praying it works.

Took a Little Time, but Totally Worth It
Reviewed on January 25, 2017

I was on spiro for about 4-5 months before it FINALLY started to work. I had mild-moderate acne before, which i had under control for 3 years on Doxycycline. Of course, you can't be on antibiotics forever so I was taken off of Doxy and it came back full force. Then my derm put me on spiro and i started out at 25mg, which wasn't enough. I was bumped up to 50mg (once per day) after 2 months, which cleared everything right up! I never thought anything would work as well as Doxycycline at clearing my acne, but I get even fewer occassional pimples now than I did on antibiotics! I was on birth control for 3 years before I took spiro (and I'm still on it), so I think that really helped minimize side effects.

by GoldenLove on 02/06/2017 04:37
Hi! Thanks so much for your review. It gives me hope lol. I am currently 3 weeks in on taking Spiro and haven't had too many negative side effects yet. I was just curious if you had an initial breakout with this? I haven't yet so I'm not sure if I just got lucky or if it's coming lol.