Antiandrogen
Reviews
4.1
1330 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%
4
28%
3
10.1%
2
4.9%
1
6.1%

Used Spironolactone? Rate It:

Choose from 1 to 5 stars
March 16, 2017
This is it!
I have struggled with adult acne increasingly over the last few years. After going off of oral BC and switching to an IUD, I noticed that my acne had gotten to a frustratingly chaotic level, not immediately, but over a couple years such that I never seemed to fully put 2 and 2 together that hormones were causing my skin issues. No matter what I seemed to do, I would have frequent/daily breakouts. At any given time, I would have anywhere between 3-10 active acne spots on my face of all the varieties of pimples-- clogged pores, under-the-skin pimples, simple whiteheads, blackheads, everything. To combat the breakouts, I tried all kinds of things: washes, scrubs, dietary changes, increased water intake, exercise regimens, more frequent washing, water filters, various acne-friendly makeup brands, prescription creams, antibiotic pills, OTC spot treatments, salycylic acid, benzoyl peroxide, glycolic acid, exfoliating masks, and natural skincare alternatives. Nothing consistently worked. Even if something momentarily alleviated the breakouts, it wouldn't be long before an irritated spot would crop up that would turn into a hellacious and many times painful pimple. An odd series of events led me to try spironolactone, despite previously being convinced that accutane would be my last hope-- trying sprinolactone became my last ditch attempt to clear my skin before the final option of accutane... and lo and behold-- IT WORKED! THIS IS IT! Now, granted, this is not an overnight, life-changing kind of medicine. Rather, over a period of weeks, it involves minute changes in the amount of hormones that affect your skin. It works well paired with another prescription cream or wash to help clear surface level dirt. What it does is it essentially blocks androgens that circulate in your system from actually connecting with receptor sites. For those with hormonal acne, this should result in less breakouts and formation of pimples. I've been taking this for almost 6 months now and my skin is about 97% clear. So what is this other 3% that's not perfectly clear? Well, about once a month at this point, I may get a single pimple. The other bit, is that I occasionally have a few blackheads, which I manage to treat with a blackhead extractor tool, so they don't end up becoming anything worse. I'm almost at the point where I could feel comfortable going out of the house without make-up on. For me, that is HUGE. Previously, I was mortified to be seen even by any relative with my bare skin showing because it was so red, hyperpigmented, and spotty. Now, my complexion feels and looks literally relieved-- clear, not congested, calm, under control. I have a tiny amount of healing still to do on my hyperpigmentation, but undoubtedly at this rate, I expect it should be healed within the next 3-6 months. If you're like me and you've tried everything with no relief from your adult acne, you should really give spironolactone a try. It may do wonders for you.
This Was Helpful

28 user(s) found this helpful

Report
April 3, 2017
Thank you for this review!! I'm currently on 50 mg of spiro for a little over 2 weeks. I broke out alittle with cystic acne near my ears and on my upper lip and chin area. But that's been a normal thing for me recently. Not sure how much worse it's going to get. Did you have an initial bad breakout?. I also don't have any side effects so far.
July 24, 2012

Pros:

Clears acne 100% after 6 months
Less body hair

Cons:

Some head-hair loss (thinning)
Major weight gain - I went from 112lbs to 135
Initial breakout - requires patience
Dehydration
Irregular menstrual cycles & spotting

I had pretty severe cystic acne and bacne in High School, and ended up going on accutane, which cleared me up for a while. 5 years later it ended up flaring up again and I was put on 100mg Spiro. After 6 months I was completely 100% clear and was loving the drug. About 6 months after that I started noticing unnatural amounts of shedding hair, and I noticed I had gained quite a bit of weight while not changing anything else in my life (I'm a very thin, active girl.) Even though I had perfectly clear skin I wasn't feeling good in other ways, so I decided to slowly wean down my dose to 50-75mg. All of the side-effects have gone away -- the weight has melted off and I have noticed less shedding. I do get a few zits around PMS and if I'm stressed now, though. I'm not sure if I'll keep weaning off or stay at this level. Overall I would recommend Spiro... It's absolutely perfect for clearing hormonal acne. However, there are quite a few side effects that may not show up until almost a year after taking it.
This Was Helpful

28 user(s) found this helpful

Report
January 6, 2012

Pros:

It works!
less oily skin
helps reduce water weight

Cons:

terrible breakout when stopping
Initial breakout when starting

This product works great, but be sure to USE CAUTION when discontinuing use. I have always had moderate acne since i was a teen (im 30 now)- mostly your typical papules and postules. I had tried several products- over the counter and dermatologist prescribed. My derm prescribed spiro about 3 years ago and I used it for about a year and a half. The initial breakout that occured in the first 1-3 months was pretty bad, but it seemed to pass quickly and after that my face became clearer than it had ever been. I also have excessively oily skin, so this product actually helped somewhat with the oil as well, which no other product had. My skin was pretty much flawless! I surely thought I had overcome acne for good. My husband and I were ready to start trying for a baby, so I quit taking the spiro a few months prior to, because I knew that I wouldn't be able to take it while pregnant. I would say that my skin stayed clear for about 3-4 weeks, and then BAM- I started to develop cystic acne. I had never had a cyst in my life. Within 2 months I had cystic acne so severe that it hurt to chew food and I could not smile. My entire face was swollen- my derm said it was one of the most severe cases she'd seen. The cysts were extremely painful. I ended up having to postpone baby plans to go through 6 months of Accutane, which has gotten rid of the cysts but I am left with pretty severe rolling and ice-pick scars that will remain forever. I know that spiro has a hormonal effect on your body, and I can only chalk it up to the fact that my hormones suddenly went outta whack when i discontinued the product, leading to my outbreak of cystic acne. I'm not totally against the product, because it may have been a freak incident, but I'm currious to know if others have experienced the same. Just be sure to take caution when getting off of spiro- maybe your derm can slowly wean you off or something so that your body has time to adjust.
This Was Helpful

28 user(s) found this helpful

Report
January 6, 2012

Pros:

Easy to take
Cleared persistent acne completely at around 2 months
Inexpensive
Improved self-esteem
Hair is less oily

Cons:

Difficult to obtain
SEVERE initial breakout
Takes months to work
Black box warning
Can raise potassium levels
Dry skin
Lowered libido
Frequent thirst

I have had moderate acne on my face and back since I was twelve (thirteen years), and despite monthly visits to my dermatologist and countless topical creams, washes, antibiotics, and oral contraceptives it never even came close to going away. My acne humiliated me, making it difficult for me to stay overnight anywhere and I refused to go swimming because the water would wash the makeup off of my face. I took a backpacking trip over the summer and over half of my backpack was full of acne products. My acne dictated so much of my life. About three months ago (after a few horrible crying spells) I did some research and discovered Spironolactone. My dermatologist wouldn't prescribe it so I went through my Gynecologist to get it. I started on 50 mg and got a SEVERE initial breakout. I never had much of a problem with cysts, but this medication caused numerous deep cysts to form on my face that were very red and took weeks to go away. After a month I increased the dosage to 100 mg, and after a small breakout, I am completely clear. I have gone off all topical creams and only use TriNessa (birth control) and the Spironolactone. My face and back are completely clear and I have never been happier. This medication changed my life and I am so grateful to have discovered it. On a side note, it dramatically reduces the oil your skin produces and I am happy to report that I no longer have to wash my hair twice daily. I can get away with washing in twice weekly. It does make your skin very dry and if I don't moisturize my body, I get dry skin patches. Given enough time, this medication will work wonders. It does NOT work in days or weeks. It takes months to see results, so anyone claiming to be cured in four days should know that it is probably only a coincidence. Be prepared for a wicked initial breakout, but try to endure it!
This Was Helpful

28 user(s) found this helpful

Report
July 20, 2011

Pros:

-it works!
-acne 99.5% clear
-oily skin gone

Cons:

-takes a LONG time
-could have side effects

I already reviewed this, it was working after a little over 3 months, but my skin was still pretty oily i started on 25 mg, 50 mg, than 75 after 3 months, and it started to work, now at 5 months i am on 50 mg and my skin is not at ALL oily, its amazing! It is so clear! but a little dry, so i am going to go back to 25 mg and see if i can't balance it out a bit, but still for now i am just so happy i am not an oily faced freak with giant cystic acne :D but you need a lot of patients with this medicine, so take your time, if your acne is hormonal there is a good chance this will work for you
This Was Helpful

28 user(s) found this helpful

Report
July 20, 2010

Pros:

WORKS WONDERS!!! 95% Better on breakouts.

Cons:

Once you get it in your system you must keep taking the med or the acne will come back worse than before. Did not work for the hair growth on my face, this may be due to the low dosage.

I've had hormonal acne for over 20yrs (40yr female) and have seen doctor after doctor, been put on so many different pills, antibiotics, creams and washes. Even gave the ones on tv a chance. Some may have worked for a minute, but none gave the results that I've seen with Spironolactone. This October will be 1yr that I've been taking it (25mg twice a day) and unless some major health issue presents from using it, my plan is to continue. Works great for me, hope it does for you!!! Would advise you keep to as low of a dosage as possible.
This Was Helpful

28 user(s) found this helpful

Report
July 7, 2010

Pros:

less oil, less cystic acne, smoother face.

Cons:

Very hard on your stomach, potassium is now high. Always thirsty no matter how much I drink.

This really works when nothing else would . I use to get big cystic acne that swelled and throbbed with pain and took forever to clear up. I have been on 100 mgs for 1.5 years however I watched my potassium slowly creep up on my blood tests. When I was at 4.7 my doctor put me down to 75 mgs and my face started to break out again, not as bad as before spiro but I am not clear anymore. Too much potassium can damage the heart so unfortunately if I can not maintain my clear face on a lower dosage I will have to go off this. My advice start out low and see if you can maintain a clear face at 50mg.
This Was Helpful

28 user(s) found this helpful

Report
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.
This Was Helpful

27 user(s) found this helpful

Report
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.
January 26, 2011

Pros:

Inexpensive

Cons:

Taste of mint
Takes time to see results
Flared up in the first week after using it

I have been on this for 4 months now, this drug works really well with birth control. I was on this by itself and still got an occassional zit. I went on birth control a month ago, and this drug is most effective with it. Its like a double sided coin. If I had known this I would have been on birth control from the very start. I dont get any zits at all. Im on 100mg a day. Right now am receiving consultation on laser therapy to soften my acne scars. I must tell you to try this with birth control and give it at least 3 months to see results. I didnt see results right away like other people, but it does take time
This Was Helpful

27 user(s) found this helpful

Report
May 27, 2010

Pros:

Clearer and less oily skin.

Cons:

Thirsty more often, need to drink more water to keep hydrated. Frequent urination.

A complete life saver for me. I had pretty bad acne all over my face, some on my arms and back as well. Nothing would work and I tried just about everything. Now my face is almost completely clear and the other affected areas are improving as well, just not as quickly as the face. I don't have to worry about the shiny, oily makeup face anymore. I still have to wear foundation to cover the scars but that's no problem as I would wear it regardless. I started off taking one 100 mg pill a day and ordered them online from InHouse Pharmacy. I stayed on the 100 mg for three weeks and was not satisfied, I was still breaking out but not as badly. So I upped it to 200 mg on the fourth week (I'm going on the 5th week now) and it has worked wonders. Even skipping a day of my usual facial cleansing and gel routine didn't cause me to break out terribly like it usually would. I'm still hoping for it to help reduce the unwanted hair so I'll write another review later with an update. I'm also hoping for the increase in breast size lol. I'm expecting this to only increase in its effectiveness as time goes on so I'm thinking (hopefully) it'll be totally clear everywhere by next month. I had initially tried birth control (ortho tri-cyclen lo) but that only made my acne incredibly worse. So I got off that and started solely taking Spiro.
This Was Helpful

27 user(s) found this helpful

Report

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.