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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December 18, 2011

Pros:

Normalize your skin!!
Not carrying my concealer around anymore!!

Cons:

None so far

I had written earlier after having my initial breakout but really had to update because I wish I had taken spiro YEARS ago! I finally have normal skin...not greasy, pores are small, no pimples on the horizon!!! I swear I always had a new one popping up. I take 100 mgs and just got my labwork back & it was normal. I was so afraid I would have to stop taking it. If you try it, be patient..
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December 3, 2011

Pros:

Clears acne
Clears blackhead
Skin smoother

Cons:

Thirsty thirsty thirsty

I have suffered with acne for the past five years since my son was born. I have tried three courses of accutane benzaclin birth control pills facials peels nothing worked. I was very hesitant to start taking the medication because accutane gave me such a bad Inital breakout .. I had no initial breakout thank god. My skin has been doing so good since I started the best feeling is my mom saying what are you doing different. In conjunction with spiro I use cosmedix facial cleanser and haven been getting a chemical peel and facial both once a month to help clear the blackheads. I am so happy this has changed my life I would reccomend this to any female who thinks shr has hormonal acne . The accutane did nothing but caused pain . So glad I changed dermatologists.
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November 19, 2011

Pros:

annihilates hormonal acne
taking the pill becomes routine
diuretic made me lose ~3-5 lbs (woohoo)
worked when nothing else would

Cons:

need to drink a lot of water to avoid negative side effects from diuretic (dizziness, dehydration, etc)
can cause irregular periods
effectiveness may wane over time (may need to combine with other treatments)

If you're a woman who gets nasty, gnarly, painful cystic acne around the time of ovulation and menstruation, THIS IS THE DRUG FOR YOU. During my teen years, Accutane was magical. Thennnnn I hit my mid 20s. BIG, knotty, painful cysts erupted on my cheeks, jawline and temples. They took FOREVER to die down and heal -- like, a month! And for the first time, my skin scarred. You think acne is bad in high school? Try it in the workplace... mortifying. My former derm gave me antibiotics, gels, creams. I finally tried Accutane again -- the magic was gone. I stopped taking birth control pills a few years after going off Accutane. The 25 lbs I had been struggling to lose for years just fell off. There was no way I was going on the pill again, but my old derm insisted it was the only solution to my acne. I found a new derm, who educated me about hormonal acne and the wonders of spironolactone! I've been on it for years -- so long that I don't remember the early days, but I'm pretty sure there wasn't a big initial breakout. I recall it working very quickly and wishing I'd known about it sooner. I can't say enough good things about spiro. It wiped out my hormonal acne, made my skin a lot less oily and even made me lose another 3-5 lbs - sweet! Yes, there are side effects and drawbacks. You have to drink a ton of water or risk lots of dizzy spells and super dry/flaky skin. It may also affect your period if you're not on the pill (I got my period every 2 weeks at one point, but my cycle corrected itself after 2 months or so). Still, I'll take those over having my face look like a war zone. It's a personal call. Over the years, spiro's effects have somewhat waned. I now pair it w/a low dose of doxycycline and 0.1% tretinoin cream, and still get the occasional breakout/cyst, but it's manageable. I could up my spiro dose, but my derm says it'll make my period more wonky. I'm willing to deal with a small breakout once a month
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November 18, 2011

Pros:

no more blackheads
no more cystic acne

Cons:

got my period immediately after starting it
some dryness

I've been on spiro for about 4 months now, and so far it has been a miracle cure. I've had cystic acne (particularly on my chin and jaw) for about 7 years and NOTHING worked. Spiro made my acne much worse at first, but it's now almost completely cleared up. I don't think there's been a day since I was 16 that every pore on my nose didn't have a blackhead...until now! I know some people have terrible side effects, so be wary...but I've experienced none of them, so this might work for you too :-)
November 15, 2011

Pros:

Clear skin
Less Oil
Inexpensive

Cons:

Initial breakout

For the first time since I was 12 my skin is finally clear!! I have tried everything out there except Accutane and I mean everything. I didn't have cystic acne so doctors were reluctant to give me Accutane but I begged for it many times. Acne has ruled my life for so long and I am finallly, at 35, clear. This was a miracle...I was really at a point where I was about to give up but decided to try once more with another doctor visit. My acne was apparently hormonal which makes perfect sense because the only other times in my life my skin was clear was during my 2 pregnancies. I have been on spiro for almost 5 months now and haven't had a pimple in about 3 months. I broke out during the first 3 weeks with some pretty big cystic acne, which I had never experienced, maybe a total of 5-7 different bumps that took a while to go away but it was totally worth it. If you've tried everything, I urge you to ask your doctor about this and give it a try. But be sure to give it some time and keep taking it through the first breakout! It's truly changed my life and I finally feel free!! I started on 50mg/day but after 2 weeks started on 100mg/day and that's where I am now.
November 3, 2011

Pros:

Cleared skin up

Cons:

seems to be a little more tired than usual

I have never had terrible acne, but it has been persistent since 7th grade. I have been on antibiotics, retin-A, differin, and multiple birth controls. Although never terrible at all, I was always self conscious about my skin. I would never go to the pool without concealer or even go to bed with my boyfriend without makeup on. It was a constant stress in my life and I spent hundreds of dollars on crazy products trying to finally have a clear face. Finally right before my 21st birthday I decided I would bite the bullet and go back to the dermatologist to see if they had any other solutions. I was given spiro and after 3 months my face was completely clear. I do have the occasional zit but they are manageable and go away much faster than before. Spiro gave me confidence I never had before. I could finally go to class without worrying about who was staring at my face. It may sound vain and I tried to rationalize with myself that it was just my skin, but when I finally had clear skin I felt so much better. I hope this is helpful to others who are having the same problems I did. My acne was never cystic and never terrible, but it was just always there. I think anyone should try it if nothing else has seemed to work for them.
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November 3, 2011

Pros:

more effective than antibiotics and any other acne treatment that dermatologist would suggest for those of us with acne. i highly recommend using this b/c it has very little side effects (it's a dieuretic sp?)

Cons:

frequent urination

I have suffered with acne my entire adult life (i am 43 y.o.). I believe dermatologist are treating the symptom w/o treating the cause. they often prescribe antibiotics and topical creams but acne is caused by hormone imbalance. Simply put acne can be treated with birth control pills and aldactone. I always feel so bad for people with severe acne b/c it doesn't have to be that way!
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October 29, 2011

Pros:

-Clears up hormonal acne really well
-Makes skin dewy and smooth looking

Cons:

-Hate having to take pills daily
-During the first week, had to pee really often
-Can be harsh if eaten on an empty stomach, but not really bad for me.
-First time I took it, it might have made me moody, but I'm not sure it was actually due to the spiro.
-Made my periods irregular

I'm 21 now and actually had pretty clear skin until I was 19. Then all of a sudden, I had horrible and out of control acne. My derm perscribed me spiro, and it def cleared up my skin quite a bit within 2 months-ish. However, during the time I used it, I was really moody all the time. However, this could have been due to other stressful factors--not sure. Then I stopped it after like 4-5 months for some reason (can't remember why). After trying a bunch of other prescriptions (antibiotics, mainly), most of which I was allergic to. After almost giving up on treating my skin, I decided to give spiro another try, and I'm so glad I did! I got back on it a few months ago, and have been on it for 4-5 months now and my skin has gotten really clear. However, it made my periods realllllly irregular (got them like every other week), so then my doc prescribed me ortho tri-cyclen. I've been on that for 2 months now, and I think the combination is working REALLY well. I think this was what I was missing the first time around, because my skin is absolutely FLAWLESS right now. I get compliments about my skin all the time by my friends, and honestly that's something new to me! I know a lot of you might be curious, so I first saw results (the first time I was on spiro) after about 2-3 weeks. I didn't have an initial breakout (maybe because my skin couldn't possibly break out more). The second time I started it, I saw results also within about 2 weeks. Didn't have an initial breakout then either. When I started on ortho-tri cyclen, I was afraid of the initial breakout, but I feel like the spiro prevented that. I also saw results with ortho within a week. My skin has been flawless ever since. So happy! :)
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October 23, 2011

Pros:

works really well for female hormonal acne.

Cons:

see previous review.

this is an update - i'm on my 2nd month (about half way in now). I had a severe breakout about midway through my treatment - just after I wrote my previous review. My skin had been clear and then one morning I woke up and my entire face - forehead, chin, cheeks etc.. had broken out - places that I hadn't broken out in years and my breakout continued for a few weeks until I went back and saw my derm. She put me on Retin-A micro .03% 2x a week (pea sized amount at night, every 3rd day) - and wow - that helped clear things up. I continued with the 100mg of Sprinolactone, and with the RAM my skin began clearing and healing within 3 weeks (I had no new breakouts, just lots of red marks and swelling from previous lesions) My skin is now fairly clear. My cheeks, nose, chin, are all smooth (no peeling, no flaking, no redness because I'm only using it every 3rd day, and I'm moisturizing after the RAM goes on) - and am using the RAM on my forehead every other day, because it's still breaking out and is still badly marked up. The big pluses to being on the Spirno is that I'm no longer oily. Before I went on it I was having to wash my hair 1-2x a day (I have thin, baby fine hair, with bangs that would be stringy within a few hours of washing it) - and now I can go 3-4 days in between washing my hair without it being oily - and the same goes for my face. I used to wake up with it looking like it was doused in baby oil - and my pillow cases would need washing every other day, and now my face is totally "normal" in the morning, and this is after moisturizing right before I go to bed. I also switched out my birth control pill for the Nuva Ring because I was having issues with breakthrough bleeding on the pill. The Nuva Ring eliminates fluctuations in hormones so no worries about that any more. I've also lost 10lbs ,most of which was water retention, awesome. I look forward to having clear, beautiful skin by the Spring, hopef
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October 5, 2011

Pros:

cleared and prevents hormonal acne cysts (especially on chin)

Minimal side effects

Decreases hormone-related facial hair

Cons:

took 4 months to work

continued to have large-ish cysts until the 4th month mark (including initial break out)

I joined acne.org just to review this medication. For the first time in years (approx 10), my skin is nearly clear. I never had extraordinarily severe acne, but bad enough to be notable, painful, and distressing. Went through previous rounds of antibiotics (minocycline, deoxycycline), which helped but never completely cured the cysts. I have been on spiro for 4 months, and despite getting frustrated with the initial breakouts, I am now very happy that I stuck it out (this message board helped a lot!). Now that I don't have new cysts forming as soon as the old ones clear, my skin is healing, and the acne scars are starting to fade. I also wash in the morning with benzyl peroxide and apply Aczone + 50 mg spiro, then wash with cetaphil and apply differin + 50 mg spiro at night. Definitely worked for my hormonal acne - just required a bit of patience!
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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.