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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February 6, 2021
Starting Spiro

I’ve been on spiro for almost 6 weeks. The texture of my skin has improved but i’m still breaking out every day. My chin is covered with cysts which i’m confused about because i’ve never had issues with acne on my chin. I have many white heads also on my cheeks. I just feel really disheartened and not sure if any one else has experienced the same. I’m trying to give it more time but I don’t know how much longer to wait. 

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April 6, 2020
Starting Spiro

I have struggled with moderate acne both on my face and my back since I was about 13, and I'm now 19. I started spironolactone 2.5 weeks ago, and I take 50 mg every night. I've rated it 3 stars because I have no side effects but I also haven't noticed much of a difference in acne.

Week 1: I noticed a decrease in oil production at the end of week 1. I haven't noticed serious side effects, but there were a few days when I felt anxiety which resolved as soon as I drank more water and electrolytes. 

Week 2: My acne improved at the beginning of Week 2, but it worsened slightly at the end of week 2. I've seen an improvement of acne along my jawline, but I still get some small bumps on my cheeks (not full cysts though). Back acne has improved slightly and the frequency of new cysts has decreased a little.

Week 3: I'm now about halfway through week 3. I noticed some small bumps on my chest and stomach that are not itchy like hives, but they have a red appearance similar to hives. I don't know if these are related to the medication or if they're due to a new allergy. If they don't resolve soon, I'm going to see my derm again. My derm also recommended moving up to 100mg after two weeks, but I've stayed at 50 mg because I'm a little concerned about new side effects. My acne has improved slightly, but I still have new pimples. My hair is noticeably less oily.

End of week 3: The weird red bumps on my chest and stomach have diminished but they are still noticeable. The acne on my face has definitely improved but the past breakouts are still healing. The acne on my back has improved somewhat but I'm still getting some new pimples. I'll update the rating at the end of 4 weeks. I'm also going to call my derm to see whether I should still move up to 100 mg, but I'm optimistic that staying on 50 mg will help since I'm beginning to see an improvement.

End of Week 4: I have noticed an improvement in my back acne, but it is not clear yet. I'm not sure what the red bumps were, but those disappeared. I tried going up to 100mg (50mg in AM and PM) and noticed severe side effects, such as numbness and tingling in my hands and feet. I'm back to 50 mg in the PM now. Can't yet tell if my face has improved much.

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March 3, 2020
Is itchiness a normal reaction?

Does this make anyone else extremely itchy? Is this a symptom that will go away with time? My skin itches- then when I scratch it- it welts. Is this something normal to push through- or am I having a bad reaction. It didn’t bother me the first 2 weeks of taking and now for the last week I am super itchy. I’m only taking25 mg. 

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smiles23
November 5, 2020

Yes, it made me a bit itchy but rarely. not extremely. If you are very itchy you may be allergic. Check with your doc

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April 9, 2018
week 4 still waiting...
I know that it might be too soon to review but I am so sad. I am 19 and I've always had what I thought was acne prone skin. Looking back my skin used to be perfect and I took it for granted. This all started in December when I decided to stop taking my birth control,about 2 months later all hell broke loose on my face. I went to see my dermatologist as soon as possible and she prescribed me spironolactone 50 mg twice a day. I started taking Spironolactone almost 4 weeks ago and I have not noticed any changes in my skin. My dermatologist says it will take 8 weeks to start showing signs of improvement, but im feeling so discouraged. However, I know that if I stick with Spiro my skin will get better. I have been taking progress pictures and noticed that around 2 weeks after starting Spiro my skin began to break out or "purge". Then around 3 weeks my skin started to clear. I thought I was seeing the light at the end of the tunnel and my skin was improving, I was SO happy(I was wrong). Within 2 days after the 3 week mark my skin broke out so bad. I am still in the middle of this breakout. Wondering if the "purge" stage comes in waves? Has anyone else had this experience???
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lucy123
April 20, 2018
Hi Ava, I am writing this because I experienced exactly what you were experiencing, I was on birth control for 2 and a half years and my skin was beautiful but when i came off it i developed acne all over my chin, horrible big cystic acne it was horrendous so i went to the dermo and they prescribed me spiro 100mg a day with retin a cream to put on in the evening to help with marks on my face .. after the first 2 weeks i broke out so badly then it slowly started to get better, then bam after a month my spots kept at bay, then a few weeks later i was still having breakouts .. not as bad as before but lots of pimpled and then on and off for another month .. but i am offically at the 3 months mark and trust me when i say .. it will get better, my skin is now completely spot free apart from a little spot that came up due to the time of the month but thats it! my face is free of cystic acne, only thing i have left is tiny little lumps that arent dormant from my purging stage that i guess will go with time as they were so bad! so please stick with it because i read a million reviews obsessing over my face taking progress photos but its something you have to stick with and over a period of time itll get better, about a month ago i felt like i was at a standstill with my skin but a whole month later and its kickstarted again and really i can see such a dramatic change! dont be discouraged and stick with it!
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AvaGrace
April 21, 2018
thank you for responding Lucy, this was so helpful! I am wondering though, did your skin clear before 3 months or at 3 months exactly? I am now at 5 weeks and I feel as though my skin is starting to get worse again. Your message really gave me hope.
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lucy123
May 29, 2018
Hi Ava, at 3 months mark, at the 2 months mark i was still struggling with breakouts and feeling frustrated! but between 2 and a half months and 3 i just started to notice a difference! and i am at the 4 month mark and i have had no spots for exactly 1 month! so stick with it girl trust me it will be worth it! i was getting disheartened at your point, but everyones reviews kept me going and i am so glad i stuck with it!
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November 15, 2017
Hopeful
I'm a 35-year-old female and never had acne before in my life. Even during my teenage years, I stayed completely clear while all my friends suffered from puberty acne. Having said this, my life changed drastically beginning of 2017. My derm and obgyn came to the conclusion that I have late-onset adult acne caused by hormonal imbalance. My cheeks, jawline, chin, back, and mouth are covered in painful cysts, blackheads, and whiteheads. Every morning, I wake up to at least 8 or 10 new cysts and zits. My life has completely turned upside down. I can't think of anything other than my face and how disgusting I look. My self-esteem is pretty much non-existent. On October 3rd, I started to take Spiro 50mg for a week, then after a week 100mg, and after the second week 150mg as my derm instructed. I also was prescribed doxycycline 100mg together with the Spiro and a topical Finacea 15% foam. It has been over a month now and I have yet to see any improvement. I still wake up to a dozen new zits and my face seems to be breaking out worse than before. The topical and the doxycycline haven't shown any improvement either. Yesterday, I saw my derm and he said that I should have seen some type of improvement by now and that my acne should not have gotten worse. This comment worried and confused me a bit, since I have been reading on the internet and on here that Spiro takes a while to kick in and that some women have an initial breakout (the whole spiel of it has to get worse before it gets better). Then my derm suggested I stop taking all of the medication and go on Accutane. Now, I made my research on Accutane and it is not something I want to try, especially since my acne is caused by hormones. Accutane would not cure my hormonal imbalance, and so after Accutane eventually my hormonal acne would return. I told him this but he was very persistent about the Accutane. I told him that I would like to continue with the Spiro since I'm not experiencing any side-effects. He then switched the antibiotics to minocycline and prescribed me tretinoin and clindamycin, which I started taking yesterday. Here are my questions for you: Has anyone of you been resistant to Spiro? How bad was your initial breakout? How long did it take to see results? Does the improvement come in steps (from cysts to small zits)? I really want this to work for me!
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ellyfant
November 23, 2017
Go on accutane. It doesn't matter if its hormonal acne, because what the drug does is permanently change the oil production of your skin which causes all acne. I'm one of the first groups ho took it in the 80s and I haven't regretted it in nearly 40 years.
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ashleybauchert
December 11, 2017
You should read up on something called Estroblock. Heard it’s really helpful for adult severe acne. Let me know if you have any luck!
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weid(wo)man
January 8, 2018
Hi HasiE82, I was just wondering what you decided to do with the Spiro? Have you continued taking it or did you stop? If so has your skin improved at all? I am also in my 30’s and have adult acne and have been on Spiro since mid-November and I am up to 100 mg which I’ve been on for a month now. I’ve seen very very minor improvements but I still wake up with new zits almost every day. It’s so so frustrating and so embarrassing. I’m a mom of 4 boys and I just can’t believe I’m dealing with this right now in my life. I have read countless reviews from women saying to stick it out because it can take up to 6 months to see results. That feels like a lifetime when we’re in the moment.... I do not believe Accutane is the answer either because it doesn’t not give lasting results most times. But I guess after Spiro it could be our only option.
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HasiE82
February 13, 2018
weid(wo)man, sorry for responding so late but I just saw your comment on my post. Yes, I'm still on spiro. March 3rd will mark 4 months for me. This is what I can tell you: the wait is worth it! I had a terrible initial breakout around month 1 and my acne was worse than ever. To be honest, I didn't have as many cysts, whiteheads, and blackheads until I started my treatment with Spiro. In my case, my acne got worse before it got better. I would have 4 to 5 cysts and every day! And it seemed as if the spiro wasn't working at all. Everything changed for me at the 2 months mark. I stopped having cysts all together and would only get whiteheads (although it was still around 6 or 8 of time at a time, better than having cysts that take forever to heal). Once I hit the 2 months mark, with every day my face got better and I would get fewer whiteheads too. Now, I'm completely free of any spots on my face (knock on wood). My face is much smoother and the only thing I'm waiting for is for the hyperpigmentations to fade. I'm also using tretinoin 0.25% every night and that has been a gamechanger. I have absolutely no blackheads. They are literally all gone (my face used to be covered in them). All in all, I'm so happy with the results and am so glad that I stuck it out. I know how hard it is, trust me. However, these are my experiences and every person is going to respond differently to spiro. I hope it will work for you too. Best of luck and hang in there!
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October 30, 2017
Worked great - at first
Long time hormonal cystic acne sufferer, got bad in my early 30s - tried to avoid oral meds and anything with a systemic effect, but it got so bad I got desperate. Prescribed by my Derm initially at a higher dose, I think 75mg. Slowly but surely my skin improved, and the course of the next year I was titrating down from 75, then 50, then 25 - then tried breaking the 25 in half to 12.5mg doses (hoping to get off it altogether) and nope, the cysts were back. Even at 25mg it has never been perfect, just "good enough". But when I went back up to 50, I for a high potassium lab back, so Derm now won't let me go higher than 25. After about 4 years at 25mg, my acne has been getting progressively worse again... so, IMO Spironolactone was part of the fix, but obviously (unfortunately) not the whole story...
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July 26, 2017
Has anyone experienced an IB?
I have only been taking spiron for about 2-3 weeks and I am experiencing a pretty interesting breakout. They are deep underneath the skin & I'm noticing a lot of comedone acne which I didn't have much of before either. Could it be that the medication is purging the skin? Im just wondering if it "gets worse before it gets better" and if anyone with more experience with this medicine can vouch for that.
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prettypinkbows
August 7, 2017
I started spiro a week ago and I am a experiencing similar outbreak (little-closed comedones and cystic acne coming to the surface). A lot of reviews I've read said an initial breakout should be expected but doesn't always happen. Some people don't see improvements until 3-5 months. We just have to wait it out!
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HasiE82
November 21, 2017
I was wondering if you're still on Spiro and if so, did it start working for you? I've been on it since Oct. 3rd (started on 150mg on the 2nd week) and my face is breaking out terribly. I've yet to see any improvements.
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July 4, 2017
MUST HAVE FOR HORMONAL ACNE
I've only been taking Spiro for 6 months now, but I am loving the results! I started with 50mg, then my doctor bumped me up to 100mg. The side effects were too much for me at 100mg, so I'm now back at 50mg. After about 5 months, I couldn't remember the last time I had a pimple. I love everything it's done for my hormonal acne, oily skin, and oily hair. Unfortunately, I really notice the side effects. Once I started taking it on a full stomach at lunch, most/all the issues went away. I am just now starting to worry about its effects with Alcohol. I decided to go down to 25mg and see if that would help while drinking, but after 4 days I've started to break out again, so back at 50mg!
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Angel177
September 5, 2017
About to start taking 25mg of Spiro. Anxious about the SE. What type if SE did you experience with 25mg? And any improvement while taking 25mg?
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sweet_sunshine
October 29, 2018
Were you noticing side-effects when drinking alcohol?
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February 8, 2017
Still unsure!
I have been using spironolactone for nearly 2.5 months now. I start in Nov. 2016 and have been taking 100mg per day before going to bed. I have not experienced drastic side effects like some people luckily, so I've tolerated the medication well. I haven't not seen an improvement yet :/ I am sticking it out for 3 months though before my next check up with the Dermatologist. I know it takes time for it to build up in your system, but when I talked to my dermatologist the other week she felt that there should be SOME sort of improvements by now even if they are small. This is so hard to measure though unless you're taking pictures. Hoping that this is the solution though and sticking it out is worth it!
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stacyxo
April 24, 2017
Have you seen any results since then ?? I've been on it for a little over a month and I have not seen that much improvement so far.
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October 21, 2016
Weight gain on Spiro
I have been on spironolactone for 1 year 3 months. I have gained 22lbs in total while being on this medication. I know its the medication because nothing changed in my every day routine. I stopped spiro about a month ago and already I've notice I lost a few pounds. I was on the 100mg. I will say when I was on the 50mg I didn't notice the weight gain, so maybe it's the increased dosage, but either way its such a struggle. I don't want to be fat with clear skin, nor do I want to be skinny with cystic acne. I'm on Natazia birth control pills, and so far 2 months its not doing it alone, so I may have to try something in addition to that, just don't know what.
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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