Antiandrogen
Reviews
4.1
1326 Reviews
Antiandrogen
Efficacy
68%
Based on All Available Studies
Strength of Evidence
1
2
3
4
5
Antiandrogen
Side Effects
High
Antiandrogen
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.
Antiandrogen
How to Get It
Have a dermatologist? Make an appointment to get this medication. Don't have a dermatologist? See The American Academy of Dermatology Physician Database to find one.
Read All About Spironolactone
Compare To Other Treatments
5
51.1%
4
28%
3
10.1%
2
4.9%
1
5.9%

Used Spironolactone? Rate It:

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August 27, 2019
Broke me out - Not just an "IB"

I went to my dermatologist for something non-acne related and she noticed I had 1-2 pimples. She asked me if this was typical for me. I told her that I usually only get 1-2 pimples around my cycle and she told me that spironolactone would be perfect for me - that it would clear the hormonal "acne" I was suffering from during my cycle. I don't usually jump on the pharmaceutical bandwagon, but I was getting annoyed at the monthly pimples so I figured I'd give it a shot. I had heard a lot of good things about spiro, and I even have a good friend who has benefited from taking it.

The first two weeks were great. After that, my entire face was breaking out in all kinds of ways. Deep, cystic pimples, whiteheads, blackheads, etc etc. I had acne in places I've never had acne before. It was awful and lasted weeks, if not months after I stopped using the spiro. I had persistent flesh-colored non-poppable bumps covering my entire forehead for a long time after. I also blame the spiro for a few other medical things that happened to me after that. Overall, really regretted trying this. Glad it works for other people, just didn't work for me.

August 25, 2019
Spiro worked to a degree...

My journey with acne and Spironolactone is a very long one. I apologize in advance for the extreme length of this review.

First off, I am a 34 year old female and have 4 sons. I started getting mild acne at the age of 13. Very minimal, normal hormonal breakouts that were easily controlled by topicals. In high school I went on a few different antibiotics and also birth control (Ortho-Tri-Cyclin) to help clear it up and those things combined worked for me. My skin generally was clear in my late teens. I went to 1 year of college and during that time I went back on birth control (Ortho-Tri-Cyclin-Lo) and was on that during my engagement and first year of marriage. (Along with topicals; benzoyl peroxide, tretinoin, salicylic acid etc). I used proactive on and off as well. I NEVER had cystic acne. Only surface type; white heads, black heads etc. I went off the pill and at age 21 and I got pregnant and through that first pregnancy my skin was flawless and also while breastfeeding it was beautiful. My second pregnancy (age 24) the same thing; mainly clear while pregnant and throughout breastfeeding. After I was done nursing my second boy my skin started getting gradually worse. (Aug/Sept 2011) I finally went to a dermatologist and he put me on an antibiotic called Cephadroxyl. It worked awesome and my skin cleared up within a few months. I was on that for about 8 months. This takes me to Spring 2012. I wanted to get pregnant again so I weaned off of it. Throughout these years I used cetaphil for face wash and some type of Rx topical benzoyl peroxide. I think I used proactive again too. I got pregnant in May of 2012, had absolutely FLAWLESS skin through that pregnancy, gave birth in February of 2013 and again, while nursing my 3rd son had beautiful skin. (I would occasionally get a zit here or there - I'm talking maybe one a week) Once I was done breastfeeding my 3rd son in Feb. 2014, my skin was great over that spring/summer. Then something happened that fall and once again my acne came back. At this point my husband and I were at peace and knew we didn't want to have any more kids. I had heard about Spiro from my mom (she has also suffered with adult acne and had been on it for a few years and it worked great for her) I was hesitant and afraid to take it because of some reviews I had read. But my skin was getting bad enough I was starting to scar so I decided to go for it. I went on birth control (November 2014) because as we all know Spiro is NOT proven totally safe to take while pregnant and neither my husband or I were sterile yet because we weren't even 30 years old. So I started taking the Spiro in January of 2015 at 50 mg. within 4 weeks I felt like I could see a huge difference in my skin. I was SO SO happy. I had some minor side affects; my period was a bit erratic and I had to pee more. Well............ low and behold in mid-February I find out I am pregnant. (the real reason I had skipped my period!) Birth control did not work for me obviously; despite the fact that I religiously took it, did not skip it or anything. You can imagine my horror because of the fear I had for my precious baby possibly having birth defects from the Spiro etc. I immediately stopped taking it. Fast forward again.... 4th pregnancy was completely normal, and my 4th baby boy (born Nov. 2015) was 100% healthy and whole. Thank you Jesus. It was a VERY emotional pregnancy to say the least. What is odd though is that my skin through that pregnancy was NOT good. I had acne and I had eczema at the same time. After I gave birth and was breastfeeding my skin never cleared up. It wasn't awful but it was not clear like all my previous experiences of pregnancy and while breastfeeding. I was also dealing with the eczema which was very very hard. Understand... I was trying to treat eczema which is dry itchy skin, while treating acne which is caused by greasy oil/dead skin cells. It was a very frustrating time for me. (sorry this review is SOOOO freaking long) Fast forward again to April of 2017. I breastfed my fourth boy for almost 18 months. That summer my skin magically was clear. I was using a brand called Carly's which I heard of on this website and it worked for like 3/4 months. Then...... you can guess. The fall of 2017 all hell broke loose and my skin got horrible again; the worst it has EVER been. I was EXTRA stressed because I was homeschooling my 3 older boys. I do believe this had a huge part to play in my skin. So once again I decided to revisit taking the Spiro. (This time around was a completely different story though because I had my tubes tied when my 4th boy was 8 months old -July 2016-) I didn't have to worry about getting pregnant so I went for it. My doctor was very close to putting my on Accutane because my skin was so bad and he was worried of scaring. I begged him to let me have a chance to take the Spiro and he reluctantly agreed. I started taking it in October 2017 and was on a very low does initially of 25 mg, then gradually worked my way up to 100 mg by January of 2018. My skin took FOREVER to start clearing up. It was absolutely awful. I was so ashamed. Here I am a mom of 4 boys in my mid 30's and I'm still getting acne. Finally, by the spring of 2018 my skin was 80% clear. I still had zits here and there but it was way better then when I started. As time went on I would have weeks where it was totally clear and beautiful; and then I would have weeks where I had a handful of zits. My skin has NEVER been "healed" or consistently clear at all. I always have something going on somewhere on my face. I have messed with the dosage many times, going up to 150 and back down to 125 to see if I just need to find and tweak the "perfect" dosage and it doesn't make a difference. And here I am now, August 2019 and my skin is still not 100% clear. Even today I woke up with 3 new ones and I am taking 125 mg. I am wondering if now being on it for almost 2 years, I am becoming immune to it. I feel very defeated and I am ready to seriously consider Accutane. Thats why I got back on this website; to read (again) the reviews of Accutane because I am afraid of the side affects) BUT I am so sick of having to think about my skin every day. I don't have time to be worrying about my skin and who I am going to see and if I need to wear make up. I want to enjoy just raising my boys and being their mom. If anyone has made it this far in reading my review I thank you for taking the time to listen to me. I don't have any special advice other then just go for it and try it. (oh I forgot to mention that during my 2 years of taking it I have definitely had some crazy issues with my period. I went almost 8 months with no period. Then this past summer I was getting it every 2 weeks! Now it is almost back to normal, every 28 days. Other than that I've not had any serious side affects. Maybe some hair loss/thickness but that is it) If anyone has any advice for me, Id appreciate. Thank you and God bless.

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July 17, 2019
A MIRACLE

I've been a lurker on this website for many years and I thought I'll share my story in hopes it'll help someone else. I've been struggling with mild to moderate acne since I was 13 and at age 27 it was only getting worse. I've tried all the acne products/medications under the sun except for accutane (a line I refused to cross). I've tried benzyol peroxide, bhas/ahas/chemical peels, retin-a, antibiotics, anti-fungal treatments, laser treatments, natural remedies (spearmint), birth control pills, etc. you name it I probably have tried it. For all of them it always started out promising but after a month my acne came back again as if it became resistant to the treatments. From all that I've tried the only thing that worked long term was birth control pills (YAZ specifically). My skin was clear when under Yaz and I was happy. However, after reading up on all the potential side effects, I stopped taking it  and the acne came back again but much worse than before. 

I started having hundreds of closed comedones all over my face with cystic acne along my chin line. I had so much acne scars and hyperpigmentation from acne that healed and then having new acne that would immediately growing on top of it. For me it wasn't even having clear skin but maintaining what I had without making it worse. 6 months ago I tried zinc pyrithione thinking I may have fungal acne since nothing else seemed to work and I had the worst breakout of my life. My whole face, chin and neck erupted in painful cystic acne, it got so bad that even wearing a turtleneck in the winter was painful. I thought this was it that I would never have normal skin and either have to go back to BCP or live with this terrible acne for the rest of my life. 

That's when I decided to see a dermatologist. I've had rough relationships with dermatologists. All my previous experiences have been doctors telling me to use harsh topicals and antibiotics that never worked for my skin. After spending so much money on worthless prescription medications and topicals, the conclusion they all came to was accutane or BCP. I went to a new dermatologist from a friend's recommendation and I'm so glad I did. She actually listened to my story and recommended I try spironolactone. At that point, I had nothing to lose. I started with 25mg for two months. It did nothing for my acne except my skin became less oily and I had more frequent trips to the bathroom. Then she bumped me up to 50mg for a month. My skin was still not clearing up. I also noticed some dizziness and fatigue. On the fourth month she recommended that I alternate between 50mg and 25mg every other day to ease my dizziness and that was the magic formula. Into the fourth month I noticed my skin started clearing. I had so little confidence with my skin that I didn't even notice the changes until my mom bought it up. Now at the fifth month, I can say that I still have acne but leaps and bounds better than what I started with. I'm 90% clear and seems to be getting better with each day. I still get a few pimples here and there during time of the month but now they disappear within days. I can't even remember the last time my skin has felt so smooth. For all the gals out there who are still struggling and want to throw in the towel, DON'T! Try spironolactone for least 3 months! You may be surprised! 

One other thing I want to end is that throughout this whole journey I noticed that my acne is also triggered by certain food specifically dairy and sugar. After reducing my intake of both I noticed significant clarity in my skin. Good luck gals and message me if you have any questions!

September 8, 2019

I’ve been on spironolactone for almost a year, and still i do breakout in cystic acne on my cheeks! 

November 21, 2019

Check in with your doctor! Might be time to check dosage!

June 29, 2019
Didn't work for me :(

I have been prescribed this twice within two years. First dosage was 100mg once daily and second dosage was 50mg once daily.

Both times I have not seen tremendous results. I have hormonal acne that would probably be considered minimal to moderate but is very stubborn.

May 22, 2019
Effected my vision

This product caused effected my sex drive increased tremendously which wasn't terrible lol but the blurred vision is why I had to discontinue using the product. I used it long enough to see minimal results but my eyes became very sensitive to light and my vision became blurry. 

April 22, 2019
Miracle cure

I would give it 100 stars if I could. I am on 25 mg every morning that's all it took for me. I have been taking it for 2 almost 3 months. I noticed a difference in the oil on my face within a week. I had very minor side effects the first few weeks. Increased urination, dehydration, tender breast, increased appetite. But th use side effects have subsided I feel better than I have in years. It's not only helped my acne but I feel it has somehow helped my mood too. My skin is perfectly clear just 3 months ago I had at least 5 small pimples and always one or two big cystic ones. I would rub my fingers along my skin and fell them hidden in my skin as well. I am now just healing from the old marks and the redish hyper pigmentation. The hyperpigmentation is healing much faster though now that my body isn't trying to heal so many at one time. I am starting to feel like myself again and wanting to go out and do things again. I am not avoiding mirrors and I am using less makeup. I do still get one or two around my menstrual cycle but they are small and superficial. I am beyond happy I finally found something that is working and isn't harsh on my skin. I feel great and people have been telling me how beautiful I look. 

April 9, 2020

Hey Aliza, 

 

How is it going now? I have just started and hoping to go down to a low dose and just maintain it there. I am curious as to whether the body eventually gets used to it over time!

 

Thank you :)

January 23, 2019
Fighting Hormonal Cystic Acne

The following is my experience. I wish someone would have shared something similar when I was struggling with this, so I hope there's someone out there who will find this helpful!

I've dealt with deep, painful cystic acne since I was 12. It's been normal for me at any given time to have 1-5 big, multi-headed cysts with a maximum base diameter matching the size of a penny and sometimes a nickel. Almost always on my chin, but occasionally elsewhere. I was put on a rotating buffet of antibiotics and topicals from 14-19 with minimal results -- the acne would always come back after a month or two of relative success. Starting at around 17 the acne got progressively better, but not totally controlled. I was put on birth control (the NuvaRing) at 20, which seemed to make matters worse, but I persisted, eventually trying a total of 5 different hormonal pill/ring formulations. None improved the acne, with the exception of Yaz. 

Yaz contains drospirenone, which is a synthetic progestin related to the chemical compound in Spironolactone. after about 5 months of worse acne when I started Yaz, my skin cleared up rapidly, and I had near-perfect skin for a little over a year. Unfortunately, Yaz also gave me painful ovarian cysts for the first time in my life, constantly sore breasts, excessive fatigue, and worst of all, completely unpredictable periods. I stopped it after two years and moved to a different pill (ortho-cyclen) with a less-androgenic progestin than other pills I'd tried. My periods got better but my acne came right back, and so about a year ago I was placed on Spironolactone.

Ah, the miracle that was Spironolactone in my first few months taking it. My skin returned to Yaz-level clarity within a month, and I finally believed my acne was under control. Around this time, I decided to switch to the copper IUD, believing that the Spiro had my hormones under control and wanting a gentler, long-term option for birth control. I began the combo of copper IUD for birth control and Spiro for acne in April of 2017 and felt fantastic about the switch from a general health and personal standpoint.

Unfortunately, my acne came back, despite being on the Spiro. It was gradual at first, but became un-ignorable after about six months. My skin had not been this bad since high school, and it was completely demoralizing. My doctor upped my dose of Spiro to try and control the acne, but it didn't help one bit.My periods also gradually got longer and longer, until I was bleeding all month long. I developed a massive ovarian cyst and would experience bouts of fainting, dizziness, and immobilizing fatigue. I was cold all the time, too, and didn't want to eat. I thought something was seriously wrong. But I wasn't anemic, and my hormone levels tested normal. I had full thyroid panels done, only to have everything come back within healthy ranges. I booked an appointment with a specialist, who told me to take supplemental progesterone to try and control the bleeding. But before I filled the prescription, I remembered that Yaz had caused similar, if less drastic, symptoms for me in the past. I skipped my dose of Spiro that night, and again the next morning, in a last-ditch effort to see if it would change anything for me. 

Within 24 hours of skipping my Spiro doses, my period stopped (after, I kid you not, 44 days of steady bleeding). My energy returned, and the pain in my ovary stopped. My appetite came back, and I could run without feeling like I was going to faint. But most miraculously, all acne production stopped. Every single lurker (how I refer to those bumps you'll get that inevitably turn into a gigantic cyst) began to shrink at once, and in over a month since stopping the Spiro I haven't had a single new pimple. My acne scars are healing, and my skin has remained calm and clear. 

I'm not saying Spiro caused my acne. Hormonal acne, especially in women, is very complex and when even one hormone is out of balance, it can cause a chain reaction. What I suspect happened is that in adolescence, I had typical cystic acne that comes with the territory for some people (every woman in my family, in my case). I went through puberty on the late side, and I suspect that my acne would have resolved itself on its own by the time I was in my early 20s. But being put on androgenic progesterones from the birth control flared my acne up more than it would have otherwise, and put my body into a state of increased androgenic activity. The Yaz, which is known to decrease androgens, brought all of the excessive androgens down so low that it somehow imbalanced my estrogen levels while causing testosterone levels to plummet far below normal ranges (blood tests from this time corroborate this theory), leading to the cycle irregularities, ovarian cysts, and fatigue. From this point on I suspect that the synthetic hormones in the final birth control pill I tried made things worse. Only once I'd gotten off all synthetic hormones and in favor of my plain old, beloved copper IUD, did all of this become apparent. 

Hormones are no joke, and Spironolactone can be an incredible medicine for women with excess androgenic activity. I suspect that during puberty, had I been prescribed this medication, it would have worked like a charm. But unfortunately, I began taking spiro once my androgen levels had already normalized, and without the synthetic birth control hormones to keep my estrogen and progesterone in balance, everything went haywire. 

If any of this sounds familiar to you, you've been on hormonal birth control for more than 3 years, and you're still struggling with acne, I would say this: before you try spironolactone, get off hormonal birth control for two to three full cycles. I would 100% recommend the copper IUD, it's been a literal dream for me. Once you've gotten the synthetic hormones out of your system, get a full panel of hormone tests from a qualified doctor (not just a derm) during the luteal phase of your cycle (just before your period). This will give you a baseline sense of whether you have excess androgenic activity and might be a candidate for Spiro.

TL;DR: Hormones are complicated, and Spiro caused me a full 6+ months of misery that went way beyond acne. If you have hormonally related acne, are a woman, and have been on hormonal birth control for years, do NOT do what I did, taking birth control continuously and stacking medications on top without first re-establishing a baseline of where your body is without synthetic BCP. 

 

 

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January 22, 2019
ONLY THING THAT WORKED

Please see my gallery for before and after photos 

I'm 23 and had been suffering with hormonal acne since 19 (just come off BC pill and skin went crazy). I would have 7-12 cystic pimples on my face at any time, plus small pimples. They were very painful and deep and I cried often. I was extremely self conscious and always had makeup on. I tried for 2 years to cure my acne naturally (supplements, skincare, dermatologists, Chinese herbal medicine, change in diet) and absolutely nothing worked and I wasted thousands of dollars. I went back on BC pill at 21, but still no improvements. 

I came across Spiro online and did months of research and read thru every single acne.org review on Spiro. It convinced me to try it. I asked my GP and she said yes. I started Spiro in May 2018.

 I started at 25mg for a week and had no side effects. Then bumped myself up to 50mg for 6 weeks. Then 75mg for 4 months. I believe I did not get an initial breakout thankfully. I also don't have any bad side effects like other women experience. First few months I had a few heart palpitations but not serious. Only thing I can think of is a touch dizzy when I stand up now and then. I do not pee all the time and don't have excessive thirst.

I started seeing positive results in first week on 25mg. Although I was still breaking out there was improvements every week. Less and less acne. Deep cysts went away faster. On 75mg my skin still wasn't 100% so I asked my GP to bump up to 100mg. I take 1x 100mg pill every morning at 8am. I always take with food. 

I have now been on 100mg for approx. 2 months and can honestly say my skin is 98% clear. PLEASE LOOK AT MY PHOTOS FOR PROOF. I am beyond happy with my skin. I now have confidence and go out often without makeup. It is a dream to wake up and not see new pimples every morning. I do still get an occasional pimple but it's small and goes away quickly. Rarely I can feel a cyst under my skin but it goes away in one day and never comes to surface. It has honestly chaged my life. I now look in the mirror and see my face and not just acne!!! I recommend Spiro so much!!!!

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January 26, 2019

wow!! congratulations, you must be ecstatic about the change.. so happy it worked for you :)

January 9, 2019
Worked Very Well with No Side Effects

This worked for me quickly and with no side effects. This pill rarely causes problems for anyone using it, and it is the type of medication you never have to stop taking. I absolutely love it, and I would recommend anyone trying to get rid of stubborn acne to recommend it your dermatologist. I had to bring it up to my dermatologist after doing research, and she didn't have any trouble prescribing me the Spironolactone for my mild acne because of the lack of side effects. I wish more people would know about this amazing solution to stubborn, hormonal acne. 

January 11, 2019

How long did it take before you saw results? I started it 2 weeks ago today. I am glad you are so happy with it and I hope and pray for similar results. 

January 3, 2019
The jury is still out...

I've read several of these reviews and every experience is different but helpful.  I'm a 41 year old woman who rarely suffers from acne, however almost 10 years ago to date I begin to experience multiple large and painful cyst around my jawline area.  These bumps would burst and leave dark spots, which if photographed at the wrong angle would give the appearance of a beard! NOT SEXY AT ALL!  After seeing several dermatologist I came across one who stated that I was suffering from hormonal acne and prescribed Yaz birth control pills, Spironolactone, and Differin Gel.  The three were to work aggressively against my acne if used as directed.  I saw results within 2-3 weeks!  And after 2 months my acne cleared as well as the blemishes.  Fast forward to now!  The acne is BACK and 10x worst than before!  People no longer focus on me but rather on these breakouts that are appearing daily!  The doctor has placed me on the same exact regimen but I'm not 31 anymore and the side effects are different this go around.  The meds don't seem to be working at all!  I'm on my 3rd week and every morning I'm greeted with a brand new huge cyst!  I'm trying to be patient but I think within the last 10 years I might have lost that characteristic!  LOL!  I'll keep you all posted on this journey in hopes that it gets better.....to be continued.....

Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.