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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April 5, 2011

Pros:

Clears acne and blackheads/comedones
Cheap

Cons:

Messes up my menstrual cycle
Insomnia

I know it sucks to hear, but you MUST be patient with spiro. I came here to give spiro a negative review after 1 month but after seeing other people warn to be patient, I decided to wait longer. After a frustrating initial breakout in the first month, I'm now almost completely clear in month 4. I'm 29 and have had acne for more than 15 years which of course has been maddening. I have moderate acne on my face and body and very "congested" skin with LOTS of comedones. Spiro has slowly cleared my skin which is awesome, after struggling with this crap for so many years! I was taking 100mg but was getting my period every 2 weeks so I dropped down to 75mg. It seems to be working just as well. So my advice is to give it time to work even though it's frustrating to wait :)
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March 31, 2011

Pros:

clear skin

Cons:

dry skin
expensive without insurance

great product.I feel like myself again.it reduced my acne to almost not existing in 1.5 month! it worked so fast probably because I take it with bcp (femcon).I recommend spiro to every women with hormonal acne. I had some initial breakout for the first 3 weeks.besides that I don't have any real side effects.I take 100 mg daily. my advice- give it a try and be patient.
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March 26, 2011

Pros:

clearer skin
increase in confidence
better mood

Cons:

takes a LONG time to work
really weird dreams
of course can't help w scars :(

Sorry this will be long bc when I was really suffering it was reading these reviews that kept me going. I had acne since my teen yrs, but it never impacted my social life. In Dec 2010 it got REALLY bad, like horrendous. One day I counted about 40-45 on my face, even with foundation on I felt like a monster. I wasn't going out, I was crying all the time. I was paranoid about daytime lighting, store lighting (fluorescent lighting & bright pot lights should be outlawed). I called in sick to work, I skipped school, cancelled events...acne was CONSUMING all my thoughts. I went to my doc in Dec & did a blood test, somehow my hormone levels came out "normal" yet my doc still prescribed me spiro. She prescribed me 25 mgs a day but I convinced her to give me 50 mg a day. And eventually it started to work! 30 days in- I had moments where I thought it was getting better (would last a day or 2 max) & then I'd be back to feeling atrocious and getting new pimples. 60 days in- would still get a LOTof new ones but they were a tiny bit smaller (I made a skin log and it shows i had 6 active on my left cheek and 2 active on my right cheek and oodles of scars of course) 90 days in- maybe will have one (max two) at a time and it will go away pretty quickly. So I'm not completely cured yet, but I really do feel it's a step in the right direction of course! I still have gross scarring but I'm feeling a lot better and can start making social plans! I wanted to say... through this I was so embarrassed. But then I told my friends, bf, and fam what was going on (even the ones w fab perfect skin).. & I must say, it really helped me. They comforted me, and I felt better knowing they knew I wasn't bailing on stuff bc I was being rude or anti-social, but bc I psychologically couldn't take that hit on my self-esteem. I'll update again at the 4 month mark and if anyone has any questions feel free to send me a message directly! I pray for everyone, every
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Bunnybombom
January 26, 2025
Thank you for your review and feedback! I’m 69 years old and developed cystic and regular acne 1 1/2 years ago when I went off HRT, which I’d been on since a hysterectomy when I was in my 30s. My body did not know what to do without hormones! My PCP retired and my new one refused to put me back on hormone replacement therapy (I’m back on it w a new dr but acne still here. Guuurrr). My acne kept getting worse and worse. I cancelled plans, declined plans, isolated, and even covered my bathroom mirrors with tissue paper. In the meantime I saw a Derm and we have tried Accutane plus all the other usual suspects. So I get your story. Acne is depressing as hell. My Derm just put me on spiro and I pray it will work. I started at 50mg and she’ll bump,me up,to 100mg if needed. I read on this site that others take 100mg. Hang in there!
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March 25, 2011

Pros:

none

Cons:

made acne worse!
mood swings
dehydration

I have been dealing with adult acne since for 10+ years! I have been on accutane, antibiotics, laser treatments, dermabraisions and etc to control my acne. Accutane did wonders but after a year, it came back but not as bad. I didnt want to go back on it because of the side affects. So anyway... I have recently been struggling with moderate acne which becomes worse during the spring and summer months. So after being on 5 different medications since last Sept, I became fed up and decided to go the hormonal route. Well, after the first week I noticed that I was getting acne in places I've never had pimples (forehead, temple, nose, upper lip and chin). Then the usual spots that I normally get acne is on my cheeks and jaw line which exploded with nodule type of acne. I have never seen my skin dry, yet severely clogged in all my life. After 3 weeks, I simply stopped taking it and couldnt bare going in public looking like a pizza. Now I am back on benzaclin, epiduo, and triluma. Its been a week and its starting to control my acne much more than spiro. I guess its not for everyone. Food for thought. I have tried Ortho Tri. in the past which helped manage my acne when I was in my early 20's but after 4 months into it, it started breaking out pretty bad. Much like my experience with Spiro. I also tried Yaz and got the same results. So maybe its just my body that doesnt do well with hormonal treatments. I am glad for those whose body does accept the treatment. Congrats! It just sucked for me.
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March 24, 2011

Pros:

clear skin and reduce oil

Cons:

none

I take a 25 mg a day of a generic of spiro along with using a facewash Panoxyl (10% benz peroxide) and a night cream Epiduo. I absolutely love my skin now. I tried everything for multiple years, proactive, murad, acne free, EVERYTHING, and finally tried this combination. For me, it cleared absolutely everything away, all combining together leaving nothing on my face after less than two weeks. My complexion has improved and I will get one little pimple right before my period and then its gone after I do my nightly routine. At the beginning, my skin became dry around my nose and mouth but an easy fix with cetaphil all skin types lotions. I definitely recommend everything I use!
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March 18, 2011

Pros:

Clear Skin
Skin not as oily
Cheap

Cons:

Upset Stomach (although eating something prior to taking the medication helps)
Frequent Urination

I am 34 & have had problems with cystic acne since my early 20's. My breakouts were predominantly on my chin, with the occasional cyst on my forehead, nose, etc. I would say my skin is borderline oily. I am on Ortho Tri-Cyclen Lo & about 10 months ago I started 50 mg of spiro once a day with Retin-A Micro. The only result I saw was dry, flaky skin & no improvement with my acne. My derm bumped the spiro to 100 mg a day & gave me Acanya gel for a topical treatment (applied in the morning, every other day). Within two months I noticed a dramatic improvement! I have not had a cyst since starting this regimen. Within the last month, I have not been using the Acanya all that much so I think my results can be attributed to the spiro. I definitely think it takes some time for the drug to work & to find the correct dosage, so do not lose hope!
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March 18, 2011

Pros:

So I have diligently waited to post about Spiro. I started taking 50 mg 2.5 months ago because I still had really oily skin and at least one breakout 1.5 weeks before the old monthly cycle began. It was like hormonal clockwork...and I would dread it! For the first 30 days I saw absolutely no change. NO CHANGE! You'd think after 30 days you would see something...small decrease in oil...anything. But no. This stuff takes at least 2-3 months to work. Now on 75 mg a day - perfect skin.

Cons:

None. I didn't even experience the diuretic effect. The only downside for me is I do notice more cramping / menstrual pains if I up the dosage. I think 75 mg a day is the best does for my body and size (I'm 110 lbs)

It works...just takes a little while. Way better than the pill because it doesn't make you crazy emotional. Its like a little governor on the production of testosterone from your ovaries/pituitary gland.
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March 17, 2011

Pros:

-25 mg seemed to be working really well
-reduces oil, but my skin wasnt really that oily, so if anything its a little more dry now
-hair comes in finer
-really cheap

Cons:

I think im having an initial breakout

I was on 25 mg for the first month, and my skin was completely clear, then i got bumped up to 50 about 11 days ago, and i cant remember the last time my skin looked this bad...probably not since before accutane. Im hoping its just my body getting used to the upped dosage, or maybe 50 is more than I need. I'm not sure. Gratned it is right before my period, and I do usually get a few small ones around this time, but never anything like this...I'm gonna stick it out, but wanted to share my experience at about the 6 week mark
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March 16, 2011

Pros:

At age 27 I finally have clear, beautiful skin!!!
Small, easy to swallow pills
Cheap

Cons:

Have to drink lots of water
Makes me pretty tired
Makes youhave to pee more
Have bad foot/leg cramps every once in awhile

I have had VERY oily skin since I was a teen (inherited from my mother). The only thing that has worked for me is Spironolactone as it works from the inside out. Topicals and antibiotics don't deal with the root of the issue. If your acne is more hormonal and due to overproduction of oil - this may be your ticket. It has been my miracle drug and acne is finally something I don't have to fight anymore!!!
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March 11, 2011

Pros:

TBD

Cons:

Tired, Diarrhea?

Not sure yet. I started taking 50mg 2x a day just yesterday morning, and almost immediately started experiencing diarrhea. I didn't see that anyone else had that symptom, so I'm a bit worried. Maybe it's a coincidence as I usually respond to most meds really well. Anyone have this symptom?
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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.
Find a Doctor Using The American Acacemy of Dermatology Website

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.
Find a Doctor Using the American Society of Plastic Surgeons Website