What Is It?
Spironolactone is a type of oral medication called an anti-androgen that is sometimes prescribed to females. Androgens are male hormones that are present in both males and females that lead to more acne, and spironolactone helps reduce androgens.
Strength of Evidence
Average 68% reduction in acne after 12 weeks
- Berman, H. S., Cheng, C. E., & Hogeling, M. (2021). Spironolactone in the treatment of adolescent acne: A retrospective review. Journal of the American Academy of Dermatology, 85(1), 269–271.
- Burke, B. M., & Cunliffe, W. J. (1985). Oral spironolactone therapy for female patients with acne, hirsutism or androgenic alopecia. The British journal of dermatology, 112(1), 124–125.
- Charny, J. W., Choi, J. K., & James, W. D. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International journal of women's dermatology, 3(2), 111–115.
- Goodfellow, A., Alaghband-Zadeh, J., Carter, G., Cream, J. J., Holland, S., Scully, J., & Wise, P. (1984). Oral spironolactone improves acne vulgaris and reduces sebum excretion. The British journal of dermatology, 111(2), 209–214.
- Grandhi, R., & Alikhan, A. (2017). Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study. Dermatology (Basel, Switzerland), 233(2-3), 141–144.
- Isvy-Joubert, A., Nguyen, J. M., Gaultier, A., Saint-Jean, M., Le Moigne, M., Boisrobert, E., Khammari, A., & Dreno, B. (2017). Adult female acne treated with spironolactone: a retrospective data review of 70 cases. European journal of dermatology : EJD, 27(4), 393–398.
- Layton, A. M., Eady, E. A., Whitehouse, H., Del Rosso, J. Q., Fedorowicz, Z., & van Zuuren, E. J. (2017). Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review. American journal of clinical dermatology, 18(2), 169–191.
- Muhlemann, M & Carter, G & Cream, J & Wise, Peter H. (1986). Oral Spironolactone - An Effective Treatment for Acne Vulgaris in Women. The British journal of dermatology. 115. 227-32. 10.1111/j.1365-2133.1986.tb05722.x.
- Patiyasikunt, M., Chancheewa, B., Asawanonda, P., Noppakun, N., & Kumtornrut, C. (2020). Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double-blind, placebo-controlled trial. The Journal of dermatology, 47(12), 1411–1416.
- Roberts, E. E., Nowsheen, S., Davis, M., McEvoy, M. T., Newman, C. C., Sartori Valinotti, J. C., Sciallis, G. F., Torgerson, R. R., & Wetter, D. A. (2020). Treatment of acne with spironolactone: a retrospective review of 395 adult patients at Mayo Clinic, 2007-2017. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(9), 2106–2110.
- Roberts, E. E., Nowsheen, S., Davis, D., Hand, J. L., Tollefson, M. M., & Wetter, D. A. (2021). Use of spironolactone to treat acne in adolescent females. Pediatric dermatology, 38(1), 72–76.
- Sanai, M., Shaukat, S., Ghias, A., Asghar, A., Nadeem, M.A., & Ahmad, T.J. (2019). Efficacy and safety of spironolactone in moderate to severe acne in females. Journal of Pakistan Association of Dermatology, 29, 101-109.
- Sato, K., Matsumoto, D., Iizuka, F., Aiba-Kojima, E., Watanabe-Ono, A., Suga, H., Inoue, K., Gonda, K., & Yoshimura, K. (2006). Anti-androgenic therapy using oral spironolactone for acne vulgaris in Asians. Aesthetic plastic surgery, 30(6), 689–694.
- Shaw J. C. (2000). Low-dose adjunctive spironolactone in the treatment of acne in women: a retrospective analysis of 85 consecutively treated patients. Journal of the American Academy of Dermatology, 43(3), 498–502.
- Turowski, C. B., & James, W. D. (2007). The efficacy and safety of amoxicillin, trimethoprim-sulfamethoxazole, and spironolactone for treatment-resistant acne vulgaris. Advances in dermatology, 23, 155–163.
- Yemisci, A & Gorgulu, A & Piskin, Suleyman. (2005). Effects and side-effects of spironolactone therapy in women with acne. Journal of the European Academy of Dermatology and Venereology : JEADV. 19. 163-6. 10.1111/j.1468-3083.2005.01072.x.
High side effects and adverse reactions
Acne.org's Real World Take
“Spiro” has been shown to work in a real and noticeable way most of the time. However, messing with hormones is messing with hormones and it’s best to proceed with caution.