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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June 5, 2008

Pros:

It really works. My skin is completely clear! The texture is improving every day and the oiliness is no longer a problem.

Cons:

It took 3 months to really start working. My skin almost seemed to get worse before it really started to improve.

This has been a miracle drug for me. I am 37 years old and started to have cystic acne last summer. My skin was always on the oily side but never with the big painful bumps that appear along my cheek and jaw line. I was so depressed because I tried everything over the counter and then prescription antibiotics and topicals. Finally I went to a Dermatology Physician Assistant and she recognized my problem immediately. It was hormonal acne. She prescribed Spironolactone. I started at a very low dose and gradually worked up to my current dose of 100mg twice a day. My advice to everyone who is just starting on Spiro is to be very patient, it takes months for your skin to clear but if you have hormonal acne, it should help.
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June 5, 2008

Pros:

It works!

Cons:

dry skin, some spotting.

I am alergic to BP and my derm prescribed a bunch of things over the years. Nothing worked until Spiro. I am 39 and have been taking it for 18 months. I take 200mg per day which I see is a high dose compared to many reviewers. I do have to moisturize my face more often (I use Clinique oil free moisturizing gel) and my skin has never been so smooth and soft. My back and chest were my worst breakout zones and they are completely clear. I did try to reduce my dosage and my back started to break out again.
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May 29, 2008

Pros:

Cleared acne, drastically reduced oil

Cons:

made me slightly dehydrated.

I have tried everything in the book - Birth Control Pills, antibiotics (for years) and every topical cream out there - this finally did it! It took a good 6 months to completely work, although, I did see great improvement prior to the 6-month market. FANTASTIC!!!!!
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May 26, 2008

Pros:

It works.

Cons:

Frequent urination the first couple of weeks. Takes some time to work. I didn't notice much difference until after a month. I'm scared of the long term side effects and how it might affect pregnancy. Difficult finding a Dr willing to prescribe it

I've tried everything under the sun for acne and I found out that the best treatment is Dan Kern's regime, Ortho Tri Cyclin, and Spironolactone if you have hormonal acne. The combination of these three medications has made me 95-100% clear. My face used to be 30% covered in acne. Dan Kern's regime does a fantastic job on tiny pimples and decreases the overall number of pimples. However, it couldn't completely get rid of my acne problem. Ortho Tri Cyclin has helped tremendously. My friends commented on how my face was getting nicer and nicer. The combination of these two medications left me with pretty manageable acne, but it was still there and I still had pretty persistent acne on my back. After being prescribed sprironolactone, the acne on my back has completely disappeared and the pimples only appear when I'm stressed or eat badly. I've been prescribed 50mg once a day. Give it some time, it didn't work for me until after a month. Good luck :)
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May 21, 2008

Pros:

Clears up acne and keeps it away. I didn't like having cysts removed from my face since they leave scars.

Cons:

None

I've been using it for over a year now and I think I need to up my doasage since I'm starting to break out again. I've been on 25mg 2x day. Based on other people's usage it seems like a low dose. I had my potassium checked a month then 6 months after starting and not since then. It bothers me not to know.
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May 19, 2008

Pros:

no side effects (that i've noticed), 100% clear skin for the first time in my life. Oil control, no need to blot during the day. Smoother textured skin.

Cons:

may have to take this forever or wondering if my body will be able to overcome it.

I've had acne since i was 13 (I am 30 now) and have tried everything, including accutane which sorta worked but was too severe and such a pain to be on. After going off accutane, the breakouts started again. I wish I was on aldactone sooner! I noticed the results immediately. i also no need for drying products. i will get a little white head or a pimple, but it's not like an out of control pimple situation. It is cheap ($10 a month with my insurance) and I have noticed no side effects. Though I have had more frequent periods (more than once a month a few months back) and as long as that is not life threatening, I would recommend this.
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May 18, 2008

Pros:

I love this drug. I used to have continuous breakouts of these small pimples all over my body and spironolactone has changed all of that. Before that, I tried every topical ointment and antibiotic known to man, and nothing ever seemed to help.

Cons:

None really. Sometimes I forget to take my pill since I take it twice a day (50 mg morning and night), but thats it.

Fantastic product. Wish I would've known about it sooner.
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May 17, 2008

Pros:

Less oil and clearer skin

Cons:

Double periods

I'm 28 and on my third attempt at spironolactone--I've taken it twice before and then gradually weened off of it when I had success at clearing my facial acne (mainly chin area). In winter every year my face starts breaking out like no tomorrow, and then I start taking spiro and it starts to reduce oil almost immediately, but then takes about 9 weeks to fully improve skin texture and stop the painful cysts. During the initial treatment I am running to the bathroom, feeling dizzy, getting headaches and the acne actually gets worse, but at the 9-week mark it clears up and then I just have to be patient for a few weeks/months while the scarring fades. Meanwhile the side effects have stopped but I'm getting double periods (didn't happen the other times). On the flip side, I'm not cramping, and I'm one of those people who has passed out from menstrual pain at the onset of my period. So all in all, two periods a month is a small price to pay for clear skin and no pain.
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May 15, 2008

Pros:

Cleared up deep, cystic acne within a few days.

Cons:

Dry/itchy eyelids, some mild tiredness, foot cramps/charlie horse in the feet initially (got over it after a year or so)

I had acne in my teens/early 20s that seemed to subside after hitting my mid 20s and taking Ortho-Novum 777. At around 35 (after playing around with my birthcontrol) my acne returned worse than I ever remember it being when I was a teen. I started taking Spironolactone about 2 years ago and I wish I had access to this drug years ago. Definitely worth a try for anyone who has tried everything else with little success.
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May 14, 2008

Pros:

Clear skin!

Cons:

Irregular cycles

It took about seven weeks (one month at 50 mg daily followed by an increase to 100 mg daily) but for the first time in many years my skin has made a tremendous improvement. If I get any blemishes at all, they last about two days a month. They're typically tiny and non-inflamed and only noticeable to me. But I consider my skin to be "normal" finally. It feels smoother and healthier than ever. The cycle irregularity doesn't really bother me, though I realize that could get frustrating for some.
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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.
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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.

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  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

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