Spironolactone
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Spironolactone is a type of oral medication called an anti-androgen that is sometimes prescribed to females. Androgens are male hormones that are present...

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.

It is usually taken once or twice a day, around the same time(s), preferably with a meal.

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October 24, 2011

Pros:

it works and i had no side effects

Cons:

none for me

i have had a worsening in my acne in my 30s for some reason. my dermatologist put me on this a month ago along with retin a micro. love it! totally clearnow.
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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 14, 2011

Pros:

- helps HORMONAL acne
- cleared up face about 70% in 3 weeks
- cleared up light body acne around neck & chest

Cons:

- side effects (not everyday or consistent)
*dizziness
*nausea
*headaches
*light headedness
*fatigue
- cannot take over the counter meds for headaches or pain (talk to dr about alternatives)
- watch potassium levels & intake of high potassium foods (potatoes, tomatoes, avocados)
- lots of peeing (this drug is a diuretic)

It's really worth a try if you are suffering from hormonal acne. I had acne as a teen, it went away, & then poof...I woke up with crazy acne at 26 yrs old. My acne is not severe but at 26, having lots of tiny bumps all over my face was not cool! I tried several topical treatments (Metro Gel, Epiduo, ViDerm) for 6 months before I gave in & decided to take oral meds. My list of Cons may seem like a lot but the side effects did lessen once I adjusted the dosage that worked for me. My doctor first prescribed me 50mg 2x's a day. The side effects made me super uncomfortable for the first week, so I called my dr and she suggested that I just take the 50mg once a day instead. This helped lessen the side effects by A LOT. So pay careful attention to any symptoms (good idea to keep a daily log of how you're feeling for the first few weeks) & let your dr know if you're not feeling bright eyed & bushy tailed....even if you're not positive that you're feeling crappy due to the meds- take note! I've read a lot of reviews with people gaining (or losing) weight but I have not seen any change in my weight so far. The time period for results may differ according to each individual. It only took me a few weeks to notice my skin clearing up & others say it takes a few months. BE PATIENT. I have great insurance so it was at no cost to me. According to other reviews, seems pretty cheap ($5-$20) if you have insurance. TIPS: - drink PLENTY of water: you may get headaches b/c of dehydration. If you don't like drinking a lot of water, try some gatorade. - watch intake of caffeine & alcohol - keep daily log of any symptoms, tell your doctor ASAP about any severe or consistent side effects - do not take this if you're trying to get preggers
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October 12, 2011

Pros:

--Cleared my body acne (chest and back) almost completely.
--Cleared about 85 % of my facial acne.

Cons:

--Could not clear all of my facial acne.
--Side effects for the first 3 months included: dizziness, nausea, loss of appetite, fatigue, dehydration, frequent urination.
--Can cause birth defects so must be VERY careful about using birth control.

I've struggled with varying degrees of acne for about 15 years (since I was 12), from mild to moderate to severe. Most of my acne has been inflammatory, but painful, cystic acne appeared in my late teens, went (mostly) away for a few years, then came back to torment me in my mid-twenties. For the past two years, since I was 25, I have been aggressively trying to get rid of this problem for good. My skin is very sensitive, so all the topicals just made my skin worse. The antibiotics never made a noticeable difference, and several of them, especially Doxycycline, made me very sick (I actually vomited in a parking lot after taking my dose once...so thanks for that, Doxy). Spiro is the first and only medication that worked for me. It took several weeks to notice a difference, and I had a horrible cystic breakout the second week after starting it, so the beginning was pretty frustrating. But by the second month, I noticed that almost ALL of my body acne was gone! I was able to wear scoop-necks and sleeveless and open-back dresses and shirts for the first time in ages. It was so freeing and I was incredibly grateful. However, the breakouts on my face persisted. My doctor raised my dose from 50 mg/day (after my second week horrific breakout) to 100 mg/day (for about 4 weeks)), and finally to 150 mg/day. I've been on the 150 mg/day for about 16 weeks--so I've been taking Spiro for 22 weeks total (approx 5 and-a-half months). The acne on my body is gone. However, the breakouts on my face, while drastically improved, have not stopped. I still get occasional cysts and inflamed breakouts (usually 10-15 inflamed pimples at a time). So as of this week, I am starting my first course of Accutane. I am disappointed that Spiro was not my ultimate solution. However, I am so thankful for the improvement I did see with it. It's certainly worth trying. I started seeing results in month 2, and the awful side-effects subsided in month 3. Best of lu
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October 11, 2011

Pros:

Face less oily
Acne/pimples have diminished 90%

Cons:

Scalp itchy
Frequent urination
Feel bloated after eating

I'm a post Accutane user (40mg once a day for four months) Accutane totally cleared my face up in three weeks. My face was gorgeous! After a year of coming off of it - I started to break out again. I was devestated! :( I have taken several orals...Tetra, Erthyo, Doxycycline and Keflex. They all worked, but caused frequent yeast infections. I have used many topicals... Differin, Metro Gel, Finacea and Tazorac - none of them worked for me. I came off Keflex (prescribed by my Derm)after 9 months and my face was beautiful (not using any topicals) I started to break out again within two months. Small pimples, white heads all over my face. My GYN recommended Spironolactone 50 mg once a day. I have been using it now for one week and honestly, my face has cleared up 90%. I may have 2-3 white heads and 3-4 small red bumps. My daily rountine is: AM: Wash with a warm white face cloth (no cleanser) and lightly moisturize with Aveeno Ultra Calming Moisturizer. PM: Wash with Aveeno Clear Complexion Cream Cleanser (Salicylic acid ), apply DailyClear Adult Tinted Treatment Cream (Resorcinol 2% and Sulfur 8%) and moisturize with Aveeno Ultra Calming Moisturizer. I use Proactiv Sulfur Mask once a week. Don't use benzol peroxide - it irritates my skin too bad. I hope this continues as I don't want to increase my dosage. I will stop using the Clearasil once all the pimples are gone. As of now, I would totally recommend Spironolactone as my side effects are minimal compared to those on Accutane.
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October 10, 2011

Pros:

Stopped my cystic/hormonal acne completely!

Cons:

Dry skin
Dry mouth
Always thirsty
Frequent urination
Moodiness
Weight gain

This product stopped my chin/hormonal acne within a week, but also made me gain 5 lbs. I've read a lot of reviews and side effects seem to vary from person to person, so I recommend at least giving it a try if you struggle with hormonal acne. This product worked great but I'll have to find something else because I won't tolerate weight gain.
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October 10, 2011

Pros:

-Skin less oily
-Scalp less oily (also a con)
-No noticeable new breakouts

Cons:

-Dry scalp (itchy/flaky)
-lower libido
-frequent urination
-dizzy if I don't drink enough water
-Dreams (not bad)

It's not a miracle pill. It has greatly reduced the oiliness of my skin, which I love. I wore makeup for the first time in months a couple days ago and it was wonderful. It didn't melt off or look like I was all greased up. I still have breakouts that were there when I started but I expect that. It's not a cure for the old is a remedy for the new. I've worked in pharmacy for almost 8 years and it took me researching and trying many treatments to come across this. My derm kept insisting I go on accutane. After the last 3 appointments and consistently refusing I went to my regular doctor with research in hand. (It also has been studied for hirsutism, Insulin resistance and NAFLD [non-alcoholic fatty liver disease] all of which I have.) It's always good to be educated when wanting to try a new medication.
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October 9, 2011

Pros:

Definately works
My hair and nails look amazing

Cons:

Weight gain
Sore breasts
Irregular Periods
Swelling and fluid retention

I have to say goodbye to this drug. After 18 months my body needs a break. It's like I was in the first trimester of pregnancy ALL the time. It got to be too much. I would still recommend this drug because it seems my symptoms are worse than others, perhaps a small reaction
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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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September 29, 2011

Pros:

WORKS for hormonal acne

Cons:

none

I tried everything, including two rounds of Accutane. Spironolactone has been the only thing to actually clear my face and keep it that way (I still get a couple small pimples a week before my period but no huge deal). I'm able to go every day without any makeup on my face. I've been taking it for about three years without side effects.
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Bunnybombom
February 1, 2025
Thank you for your review! I’ve done one round of high dose accutane, followed by 6 months of a daily low dose at 10mg and am now trying a second round of high dose accutane, without any appreciable results. My Derm told me not to get my expectations up because people who don’t have excellent results from the first go-round typically don’t the second time either. She’s put me on 50mg Spironolactone and I am praying it works. I’m 69 years old and the bottom half of my face is covered in acne. It’s so embarrassing I just want to stay home. I wear a mask in public and say it’s to keep me safe from covid - which is partly true. I’ve had long COVID for 2 1/2 years and that’s when this nightmare began.
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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.
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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:

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  • 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.
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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.
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