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%

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October 13, 2014
Please give this time to work its magic
I'm 23 years old, and like just about everyone else on here, I've tried quite literally everything except Accutane to clear up my mild-moderate hormonal and cystic acne. This past July, I had been on Doxycycline for 3 years and it just wasn't as effective as when I started. I'm just now realizing long-term antibiotics are a no-no. So there I was, sitting in my dermatologist's office, crying so hard that snot was pouring out of my nostrils because in my mind, I was out of options (and I was terrified of the potentially permanent side-effects of Accutane). She prescribed me something I'd never heard of before: Aldactone (Spironolactone), 50 mg 1 x day. Skeptical, I left to fill my prescription and read some reviews on here. ...And let me tell you, without the encouragement/motivation to continue with this medication from reading these reviews, I would've stopped a HELL of a long time ago. These reviews really helped me to learn how to tailor a regime that worked best for my specific skin needs. Within 2 weeks of starting on 50 mg I perused some posts on here and decided to up my dosage to 100 mg, add in Yaz, and add in Bactrim (with the consultation of my Dermatologist, of course); Yaz has ~25 mg of Spironolactone in it so they work well together, and Bactrim was only to be taken temporarily to reduce the severity of a potential initial breakout. 2 weeks into starting 100 mg, I had the worst initial breakout of my life. My face, neck, chest, shoulders, and back were covered in hundreds of tiny bumps, as well as larger cysts. It lasted about a month, and I cried almost every day of that month and was a complete shut-in. When I was about to quit (practically every day), I'd come here, read the reviews, and promise myself I'd give it at least 4 months, then go from there. Well, it hasn't been 4 months yet (3.5) and my skin is the clearest its ever been. I'd say it took me about 2.5 months to see significant results. All those hundreds of tiny bumps and dozens of larger cysts are completely gone. My insanely oily skin has been tamed, and my pores appear visibly reduced. Even though it didn't feel like it would ever get better, it has. And even though I didn't think all of that would ever be worth it...it was! So...if anyone's reading this comment, I'd like to say this: If you're at your wit's end but don't want to take Accutane, try this If you're going through a horrible initial breakout, hang in there - it will get better And if you have been on this for a few months and haven't seen results, don't give up!
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October 2, 2014
Feeling uneasy...
I have never really had Acne until about a year ago. After reading several posts I think the factor that caused me to suffer such a sever breakout was going on and off of birth control 3 times in the last year and stress. I would have to say the end of 2013 and most of this year has been extremely difficult. A little background about me... I am almost 29, and have suffered with thyroid disease for the last 14 years having been diagnosed with hyperthyroidism at the age of 15. Then having radioactive iodine therapy at age 17. Which sent my body into a complete shutdown causing my thyroid to become hypo. For a really long time I was taking synthroid and it wasn't helping me at all. I was gaining massive amounts of weight, extremely depressed worst part was the excruciatingly unbearable pains in my joints, no energy couldn't stand to be cold, always getting severe colds almost pneumonia all of the time. Until about 2 years ago when I found this wonderful doctor who in a way saved my life. Since then I dropped all the weight, feel happy and healthy. No pain and then this....... About a year ago my skin went crazy. My cheeks and neck became inflamed with nodules, cysts, and huge disgusting white heads. Then the picking and popping began. Everyday it was another and another and there wasn't one day that went by that I didn't get another one. I started seeing a derm by my office who would give me creams, washes and more and more antibiotics. for months doing everything as prescribed and not seeing any light at the end of the tunnel. I changed my diet (which I was already eating very health to lose the weight) . I used organic this and no dairy and went for facials, even did Photodynamic therapy with and without levulan leaving more acan and now holes, scars and dark spots.... You name it I did it. After not seeing any results with the first derm about 2 months ago I started seeing another one. She started me the same way blu U, anti biotics, aczone, acyana, epiduo, etc, etc... Last month I went there just heart broken. I was about to host my boyfriend's 30th birthday and I couldn't even bear the thought of going into public like this. All I wanted to do was crawl under my covers and hide. The derm said lets try spironolactone.... She prescribed me 50mg's 2 times per day also kept me on minocylcen 100 mg once a day and creams aczone in the AM and epidou in the pm. wash 2 times per day with neutrogeona ultra gentle hydrating cleanser and cetaphil oil control moisturizer. Today marks my one month on this medication. The only side effects i experienced were in the first few days a little lightheaded and dizziness.. that has pretty much subsided, I am very thirsty and Pee a billion times per day. I did have terrible initial outbreak in the second week which still has not gone away. I have ugly cysts on my check but I have noticed the amount of acnem i normally get is reduced and the length of time a pimple takes has increased. I don't know how much more patient I can be. M skin is still oily and I don't want to wear make-up but walk with my head down out doors because its just so heartbreaking. I am supposed to go back to derm on Monday. Hopefully something with give for me soon. My heart is just so heavy I can't even look in the mirror. If i have to go somewhere i have to cake on pounds of make up and that doesn't even help. I just want to feel pretty again. All I do lately is cry because I have done everything as directed and just nothing. I hope everything I read is true and I start to see improvement soon. I don't know how much more I can handle. I will update again in a few weeks. Good luck everyone out there going through this.
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September 12, 2014
Good for those who have self discipline with diet.
The biggest cause for Spironolactone not working is a bad diet. You simply cannot go onto this medication without understanding it's used for high blood pressure first and foremost. Unless your doctor also gives you a referral to a dietitian to work on a low potatssium, low sodium diet, you will find that mood swings, bloating and feeling fatigued are because your potassium levels are out of wack. Spironolactone works as an anti-androgen but for those of you who are under the age of 30, I would suggest going with a mono-phasic birth control pill for several months and changing your diet to omit anything dairy related. It is a well known, documented fact, that -all- cow milk, organic or GMO, has hormone inducing ingredients that can wreck havoc on your body. If you find that nothing works and your doctor gives you an RX for anti-androgens it means your diet is crap and you have to change it because as soon as you get off the drug, your hormones will go back to fluctuating and you'll break out again. As for me, I went on a no-dairy, low glycemic diet, cut out coffee, soda, etc. I also use the oil wash method along with honey masks at night instead of chemical cleansers. After six months I only had mild improvement and after only one month of Spironolactone, I had zero breakouts and my skin healed. After that first month I didn't go back onto it and because of my diet and exercise I'm 100% breakout free. Please do a lot of research before you jump into such a harsh drug.
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August 31, 2014
I never thought something would actually work
I started my struggle with acne when I was in about 5 grade. First my mom let me try using Acne Free products and ProActiv and of course those did nothing to help my face. So I went to the dermatologists for years and used everything. They started with rosacea medications. Then I moved on to countless pills and topicals throughout middle school, (Monodox, Solodyn, Differin, Epiduo, Acanya, Ziana, etc.). However, I never tried accutane, I have problem with needles and I'm just not willing to do the bloodwork every month. Even though I was rigorously treating my skin, middle school was the most severe time for my acne. Then I moved into high school and got lazy with the medications the doctors had prescribed not really believing anything would work. Then when I turned 15 I was finally able to go on birth control (kariva) to help my skin, and it did help. My skin went from moderately severe, to maybe 1-3 big pimples at a time with a good amount of little things. Finally my junior year the doctor prescribed 50 mg once a day Spironolactone to go along with my BCP. It seemed so simple to her and I have no idea why she didn't prescribe this years ago. After only about 3 months I started to see improvements then, after 7 months all the sudden everything changed. For the first time in 7 years I had basically had no acne. I had some discoloration still and some clogged pores but thats it. These pasts couple months have been great for me... Basically I now only wash my face if im in the shower and I just use a Norwex microfiber facecloth to take off my makeup at night, my skin is perfectly fine with these natural oils. I honestly never thought I'd see the day where I can go out without any makeup on and still feel good about myself, now I do it all the time. I'm going to try using some natural remedies like apple cider vinegar and coconut oil for my less than perfect skin texture and coloring now. Spironolactone was the fix for me and I recommend it to everyone. I know you might be scared off by the side effects listed online but I didn't experience anything. My doctor even said it's fine for me to continue taking NSAIDs for my headaches. Coming from a girl that tried everything, trust me, this stuff works.
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August 30, 2014
Hey I updated my review! So happy!
08/30/2014 I am 25 years old, and when I was sixteen I got bad acne on my back. Went to the dermatologist, and it cleared right up. Then after that I was fine, no real problems. Then I hit 22, my acne is not awful, its moderate. It feels awful though. I always pick at them I can't help it. So at 22, I was put on birth control to help, and antibiotics, then retin-a. I read it can take up to a year to work, I used it off and on for the first year, then I decided to get serious so I used it religiously, nine months go by and no change. I get maybe four days out of the month with clear skin. I noticed it got really bad the week before my period, and during. I changed my dermatologist about a month ago. I told my new doctor that I felt like my old doctor would just put me on a different antibiotic at a higher dose, and never really asked my too many questions. He said he didn't understand why I was on retina, because he said it was for smaller pimples, and black heads. He prescribed spironolactone, because my acne was is the right place as hormonal acne, and it corresponded with my period. I am already on birth control, so he said to stay on it. He also paired it with minocycline antibiotic to help with the initial breakout. He told me the first week to do 1-2 25 mg pills a day of sprinolactone, then the next week up it to 2-3 pils, then the final week to take 4 pills, so 100 mg. He left it up to my to decide what dose my skin responds to the best. I am on the first day of the 100 mg week. I am still in the breakout stage, which isn't any worse then one of my bad breakouts. I am really hopeful about this. He told me to come back in November to check in, and see if it was working. I will update my post then. This dermatologist was much more attentive. They that was three months ago above ^^^^^^^^^^ I am updating my review. Going from 3 to 5 stars. 12/08/2014 If you want my acne background scroll down to the August posts, and there it is. I have been on Spironolactone for three month's. I see a huge difference. My acne corresponds with my period. Last month there was still a breakout the week before my period started. This month nothing, no big breakout. My dermatologist wanted to be proactive so he wanted to do another check up 3 months after I started. Which was around my last period. Which was before thanksgiving. I still had a breakout going on when I went to see him. So he added a topical creme, to my birth control, and Spironolactone. I don't know if the spiro kicked in, or the topical put me over the top. Its probably a combination of both. My skin has been clear for three weeks now. Which is unusual for me. I only have moderate acne, but I still got pimples every week. Nothing since I started the topical. Its called AcZone, apparently is pretty expensive if you don't have insurance. My insurance covered the whole cost though. When I tried to fill it at the pharmacy, the girl said the insurance won't let me fill it, because they want to see I had tried other topical's. So she called the insurance and ask them to override it , because I had tried other things. It took only about ten minutes. I am pretty sure all three things I am on has helped me become totally clear. The birth control, and spiro helped the hormones. So that treated what was wrong on the inside, then the AcZone just put me over the top. I would recommend all three to you guys if your breakouts correspond with your period hormones! Birth control was free with insurance, AcZone was free with insurance if you have met your deductible, and I think spiro was 5 to 10 dollars with insurance! Oh and I didn't experience any of the negative symptoms on Spiro that some people have. No tiredness, no dizziness, or I have read some of you have had weight gain? I haven't gained a pound. I am really lucky, because I know all our bodies are different, and respond to things in different ways. It also only took 3 months to kick in for me, that might be because the other stuff helped too.
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August 21, 2014
Scared..but still hopeful
I have been battling with breakouts and mild/moderate acne for the past 2 years, and it seemed t be getting worse and worse. I am currently 19 going on 20 and never have I ever dealt with any breakouts in my early-mid teen years, even when I was going through puberty all I would get is the occasional pimple or two, otherwise my skin was flawless. Right when my senior year of high school started I started breaking out like crazy (I was going through an awful break up at the time but it was still bad) I looked "hive-y". I thought it was just me being stressed out, when I started noticing irregular periods and hair growth in places it should not be growing. YIKES! I still thought it was just my hormones being wacky and that they would work themselves out after I started college. However, they obviously did not. By the middle of my freshman year in college I was having a mental break down, I couldn't figure out why or how I was breaking out all of the time. The last time I could remember my face being pimple free was when I was 15?! Shouldn't I be done breaking out by now?! So I came back home this summer and talked to my parents. They figured it was time for me to see a doctor. I met up with 3 different doctors, the first 2 of whom were woman, and of course they just threw the birth control pill on me. Which I will not get into, but I am very much so against for many reasons I clearly will not waste my time with here. Long story short all it does is "cover-up" the symptoms. The third and final doctor I met up with an amazing endocrinologist/gynecologist who from what I've heard, knew his stuff. He knew I had PCOS by the blood work and from what I told him. I have elevated testosterone levels (almost twice the normal amount a woman should have) and weird LSH and FSH levels. He prescribed provera for 5 days of the month to take to help regulate my period and "restart" my menstrual cycle. He also prescribed me Spironolactone at 25 mg a day to help with my excessive hair growth and mild/moderate ace/pimples. I also would like to add that I am 5'8 and only about 125/130 lbs. I am considered someone with a "lean" case of PCOS. For the past 3 weeks and 5 days now I've been taking it, and at first, I had the typical head-aches, bloating, some diarrhea randomly, a little bit of nausea, and moderate insomnia (waking up for a good 2 hours in the middle of the night and struggling going back to sleep, thanks Netflix) by the 2nd week my skin was finally going back to being "flawless" I still had a pimple or two, and some scars from picking (which I am guilty of). The side-effects were going away and all I noticed was how I was peeing a little bit more and was a little bit more thirsty. I felt as if the medication was finally working. Entering my 3rd week I was thirsty, but it was just a dry-mouth kind of thirsty. Then out of nowhere, BAM, I broke out all over again! That was frustrating because I didn't know how or why my skin was going backwards. But, by doing some research on the oh-so-friendly internet, most people suffer from "initial-breakouts" meaning it basically gets better before it gets worse. Which in my case, made complete sense. My skin, as of today is on the near end of week 3. It just feels oily and is recovering from my initial break-out earlier this week. My blackheads/pores on my nose feel clogged and gross. I am so terrified that my skin is going to stay stuck like this all over again, or that this medication is just "done" working and is going backwards. Or that I should be on a higher dosage and that my doctor was wrong in telling me I don't need a "higher" one. I also would like to add that my hair has been shedding a little bit more than normal, it feels as if it's slowing down finally but I'm still a little worried about that awful side effect. I just hope I'm not alone in all of this craziness. Or that initial break-outs go away, or if my skin is stuck. I'll keep ya'll updated. I guess my problem is I'm just so darn impatient.
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August 19, 2014
Satisfied Customer
I used to have very clear, porcelain-like skin, until my junior year of high school when I started getting minor breakouts. I went to a derm, and she gave me clindamycin lotion and minocycline 50mg 2x Daily. It worked really well and my acne cleared up. Since my acne wasn't THAT bad, I would forget to take a pill here and there and eventually stopped getting refills of my prescriptions. I had occasional acne but nothing extreme. When I went off to college, I had persistent mild-moderate acne that I couldn't get rid of. It started after I began shaving my upper lip, and I thought it was just razor burn/bumps that would go away after a few days but they didn't. In addition to my pimples I had all these little bumps around the sides of my mouth. I didn't make time to go to a derm until the summer after my freshman year of college (this summer). My derm kind of sucks, but once you get referred to once it's hard to go to any others. I made an apt with her and she walked into the room to see me and immediately stated in a grave tone "Oh, that's not good" right when she looked at my face. As if my confidence was not already shot, having gross uncontrollable bumps all over my face. She said it looked more like perioral dermatis then acne vulgaris and she quickly wrote me a script for minocycline and clindamycin again, the same dosage as before. Out of desperation, I took my pills and applied the lotion exactly as directed, but after the first month I noticed no changes. I came back to my derm after the first month desperate for something different. The day of my apt (before my apt) I was googling about birth controls used to control acne (I've been on cryselle for a few years for PCOS) only to find that my birth control PROMOTES ANDROGENS and therefore is BAD FOR ACNE. I thought all birth controls helped with preventing acne, but I guess I was wrong. Anyways, I went to my derm apt that day and told her about my newfound knowledge about my birth control. She said she doesn't prescribe that type of medicine but suggested I stay on the BCPs I'm currently taking and begin taking Spiro 50mg 1x Daily and continue with the Clindamycin. I didn't want to start taking yet another medication if it wasn't necessary, but I was desperate for clearer skin. I've been taking Spiro for a month now, and my skin is really clearing up. I didn't notice a TERRIBLE initial breakout, I got a few pimples, but nothing worth freaking out over (even though after reading all of these posts, I was REALLY freaking out.) And after like 3.5 weeks, I started getting clearer. It was kind of crazy. It was like one day my skin was producing pimples like normal, and the next day it just wasn't. My skin was actually a little on the dry side this morning. All of my old pimples are healing and all of those pesky little bumps around my mouth are GONE. As for the side effects, I didn't really notice anything besides the dry mouth and the increase in urine output. That's a small price to pay for the confidence that accompanies clear skin. I plan to update this as I continue taking spiro.
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August 18, 2014
scared
I'm 15 & I've been going to a dermatologist for 3 years. I've tried every wash, every topical cream, even antibiotics to the point where he's said "we've tried everything." I want to take accutane but I have a tendency to acquire every side effect of every medication I take (the depression is a big factor.) My doctor just prescribed me Spirolactone & I should start it in a few days. After reading these reviews, I'm so hesitant. I'm dreading the initial breakout, I'm actually crying. I hate looking at myself, I feel so ugly, I've been getting made fun of since my acne started, I can't wear certain clothes because they don't cover it, I'm so self concious I barely wanna make eye contact, i spend so much money on makeup to cover it but it's still awful. The last thing I need is it getting worse. I'm so scared :(
August 13, 2014
Better than anything else out there
Six years on Spirano and just quit for the second time in that period. I would break through every so often, but it's more dependable and safe than antibiotics and BCP. BCP is supposed to increase its effectiveness, but there are risks to excess estrogen, most notably weight gain and emotional sensitivity. It's almost worth it for the clear skin and diauretic effects.
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August 13, 2014
SPIRONOLACTONE
It does work, but it's not a cure. It's a band aid like most antibiotics. As long as your on the medicine it will work, once you come off of it for a while it will come back if you have severe acne. If you're willing to stay on this medicine for a long period of time then it will benefit you. As for myself I don't like taking medicine for a long time so I'll give it 4 stars for doing it's job.
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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.