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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August 31, 2023
Spironolactone – worked wonders for us!
Spironolactone- my 15yo daughter had severe cystic acne. She had tried lots of skin remedies and medications including doxycycline and the pill (Brenda) with no results. We then went to a dermatologist and were prescribed spironolactone, which started to work after about 2 to 3 weeks, and now 3 to 4 months later, her skin is 90% improved. She really only has the acne scarring left now which is also getting better over time. She started on 25 mg, then went up to 50 mg after six weeks and has been on 75 mg for the last six weeks or so. It’s been a very effective treatment for her and we are super happy with it. She hasn’t had a period since commencing the medication though so we will bring this up with the dermatologist at the next appointment. Highly recommend!
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April 30, 2020
Don't Give Up!

I would give 5 stars, but I have just entered the "clearing" phase, so I want to make sure this continues and I will update later. I am 27 years old and started getting pretty bad hormonal acne two years ago on my jawline, neck, chest, and back. Jawline and back being the worst areas. I haven't been on birth control for years so it has nothing to do with this. I would get moderate cysts (I've never had super severe acne), but they were deep enough to stay a week or so, and leave a scar behind. I haven't felt confident enough to wear a low cut shirt or tank top in years, and I always have to wear makeup with the exception of one week after my period when I seem more clear on my face. 

I started Spironalactone 50mg (25 am and 25pm) a little over two months ago. I will say I was one of the unlucky people who had a dramatic initial breakout. I got about 10 hard cysts on my neck in places I have never gotten them before, and they stayed there for about 3 weeks. Nothing helped I tried tons of spot treatments. My chest and back also got worse. I have a new guy I'm seeing and I was so embarrassed to be around him. I was so discouraged by this initial breakout and it felt like it was going to last forever. Because I wasn't seeing improvement, I asked for a topical and I was put on Aczone. This seemed to dry out newer smaller pimples, but not the cystic ones. I also just started curology in order to simplify my skincare. Surprisingly since starting curology my skin has improved leaps and bounds and it did not make me break out. My cysts are 90% gone and I have only been on it a week. The struggle is knowing whether this was just convenient timing and the Spiro is starting to work, or if the curology has accelerated the process. Either way, I am going to stick to this regimen because my skin is GLOWING and I am finally at a place where I don't need to wear makeup. I still don't have a fully clear back or chest, but it's getting there. I was told to use Zinc soap to help with this and I've noticed a difference since using this as well. I ONLY use this on my body.

Anyway my point is that as difficult as it was to push through the initial breakout, I now see why everyone says to be patient. I am well on my way to perfect skin- I can tell. I am starting 75mg tomorrow and will let you know how i progress. Please don't give up! I am rooting for all of us to get our confidence back. No side effects besides frequent urination and some bowel issues the first week. Feel a little more tired, but it's manageable. 

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March 5, 2020
Spiro

I will update as I go along.

I'm 44 and have suffered from cystic acne on and off for the last 10 years.  I've been on all the different antibiotics but all stop working after around 6 months.  I've also been on all of the topicals. Epiduo being the most effective but still not preventing the cystic acne in the first place.

End of week 1 - 2 x 50mg per day.  My skin is noticeably less oily. No new acne, existing acne little difference, some small acne which was already under the skin coming up but no more than usual.  Days 5-7 terrible terrible diarrhea.  I have had to reduce to 2 x 25mg per day as I have been unable to leave the house and am in the bathroom every other hour including throughout the night.  No other side affects.  Am hoping the reduction in dosage will make it more tolerable.

End of week 2 - reducing the dosage thankfully sorted the diarrhea problem!  Since dropping from 100 to 50mg per day I have noticed a slight increase in oil in my skin again, and the acne which was already under the skin is still coming out. I have a few new ones, but its the week before my period so its hard to tell if this would have happened anyway - at the minute I wouldn't say I have had a Spiro related outbreak.  

End of week 3 - increased dosage to 75mg per day due to oil increase when dropped from 100 to 50.  Seem to be able to cope with this, with occasional but controllable bowel issues (tmi!). Skin looks good.  No new breakouts so far. No weight loss.  Boobs same size.  Potentially a little bit of weight gain but hard to tell as we are all housebound due to COVID19 lockdown so not getting any exercise.  We will see.  No emotional changes.

End of week 4 - still on 75mg, stomach issues under control. Skin generally quite good though have had a couple of new cystics.  No weight loss.  Boobs tender but same size, very minor weight gain but could be to do with social isolation. No emotional changes. All in all pleased with results so far.  Certainly not "clear" yet but seems to be making a difference, skin definitely less oily and its good not to be on antibiotics having been on them for years.  Unless anything drastic changes I will report back after month 2.

End of week 8 - very much the same as week 4. No further stomach issues, skin is generally good - I had an outbreak of 3 cystics on my jawline around week 6 which I was a bit disheartened about as it was the first real set back, but they didn't seem to last as long as normal, they are now pretty much gone with some minor colouration all that is left. They weren't as painful or as "angry" as usual so I'm seeing this as a good sign.  Boobs still tender, have gained a few pounds but have also eaten a lot of cakes.  I know that 3 months is when most people see the most benefits so I'm holding on in there.  Am due the results of my first set of bloods next week so I will update again then. No problems with periods or mood swings etc. Am hoping the weight gain is more about the cakes than the pills.

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a91
April 9, 2020

Hey RG001, 

 

how's it going now 8 weeks on? I have just started on 50, might go up to 75, nice to hear from someone on similar dose!

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RG001
April 29, 2020

Hey a91, hows it going for you? Have just updated post week 8. The outbreak at week 6 did feel like a set back but it wasn't as bad as usual and I seem to have escaped significant side effects. I might consider going up to 100mg if my bloods are OK but I don't know.... and I don't think I would want to go higher than 100mg.

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May 30, 2018
Getting tired of the side effects
I've been taking Spironlactone since January, I started with 50 mg for 2 weeks and then increased to 100 mg. I don't recall having side effects with 50 mg, but I did immediately when I increased my dose. I dropped back down to 50 mg for another 2 weeks due to severe breast pain, arrhythmia, and a very heavy cycle that also started almost 2 weeks early. I've been on 100 mg since mid February. I like my results so far. I noticed a big difference by Mid April. I still break out but they are small and go away quicker. The problem is that I have dizziness and headaches almost everyday. I am way more fatigued than usual. My breast pain comes and goes...usually worst around my cycle. My cycle has started consistently early every month since increasing to 100 mg and its a heavier flow as well. I cramp and have back pain also which is not something I usually experience. I might cramp every 3-4 periods but not every single one. Sometimes my heart feels like it flips and flutters in my chest. I've continued taking the medication as prescribed, convincing myself that its stress or anxiety. But I really feel that its the spironolactone because that's when I began experiencing these symptoms. I don't like that I can't take NSAIDs or magnesium with this medication either. Is anyone else experiencing these side effects? Does it get better with time? I'm giving it 4 starts because it absolutely works, but I took a star off for side effects.
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Melmas197
August 26, 2018
Did the fatigue and headaches eventually go away? I have been on 50 mg a day and those are my symptoms. I’m hoping I get used to this!
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March 22, 2018
PLS DON'T GIVE UP
I've had chronic cystic acne for the past 5 or 6 years. It started on my forehead, then traveled down to my chin/mouth area and then more recently reached it's very worst, covering my cheeks/sides of face/jaw line. I tried to treat it naturally with diet, etc (but was never perfect or very committed). I did one short course of accutane a year ago. It cleared me up but within 2 months of ending it, I broke out terribly and it's lasted for months. I have hypothyroidism and I know that must have started this spiral of hormone imbalances and subsequent bad skin. As a result, I also had high androgens and very low progesterone. I started taking Spironolactone a little over 3 months ago. It is only in the last 2 weeks that it has started working. So, when they say to wait 3 months... they mean it. I was SO discouraged the first 2 1/2 months. My skin was making NO progress. I felt it was getting worse. But I PROMISE it get's better. I had the SAME breakout for 3 months on my face. The blemishes would not budge. They were huge, red, swollen, and sore. And I kept getting more. In the past 2 weeks or so the breakout has cleared up and I have not gotten a single new blemish, despite being in my ovulatory phase which is always the phase I get a terrible break out in. Please keep at it and don't get discouraged! It takes time but it will work. I also advise you to go see an endocrinologist or other dr that specializes in hormones so you can get tested for imbalances or deficiencies.
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January 22, 2018
great with doxycycline but really awful side effects
I was originally prescribed 25mg once a day for a month, had a really bad IB a day before my period during that month but has since cleared up. I'm up to 50mg once a day now (second month in) and although i'd say 70% of my acne cleared up, the side effects SUCK. I've gotten my period 3 times already this past month month and a half (every 2 weeks), and the medicine tastes SOO BAD!! It leaves such a bad after taste in your mouth ugh... but it's so worth it. You also need to get bloodwork done every 2-3 months or so which kinda sucks. I'm also on 100mg of doxycycline once a day and that didn't clear up my acne alone but with spiro I feel like this combo truly is amazing for hormonal and cystic acne. Just be prepared to stock up on pads! I also started getting a weird feeling in my lower back down to my knee caps (sort of like a tingling feeling or the pain you get after working out without properly stretching?) and I was wondering if anyone else has similar pains?
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January 13, 2018
Back to the drawing board
This drug is primarily for high blood pressure, I took it for a few months and it worked fine for my acne then after maybe 8 months it just stopped working, I didn't really have any side effects from it but a year later I am now taking it for high blood pressure.
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December 9, 2017
amazing drug to try after trying everything else
I had very mild acne through high school and college (which I regret not appreciating at the time haha), but soon after graduating from university I decided to stop other meds (ADHD, depresssion), and the combination of that with finally getting some breathing room after 8 years of very intense schooling, probably released a bunch of toxins and caused my hormones to go into haywire. I tried antibiotics, Accutane, all the creams, facials. Nothing worked as well as spironolactone. I started on 100mg/day, but was really dehydrated, then went down to 75mg. After a year and a half of that dose, I went down to 50mg and am comfortable with this dosage. I and still get an occasional pimple but it will clear up in a day or so, whereas when I wasn't on spirono, I couldn't know when it would go away. However, I feel like I'm dependent on the medicine. I hope to, in the next year or so, go to 37.5 then 25, and eventually go off of it altogether, but I am anxious about the difficulty of that. Also, if you are hoping to get pregnant, you have to be off of this for at least a month before you can safely conceive. So if that is an immediate desire, I would stay away from this drug. If you don't want kids, I totally recommend it. It has redeemed my self esteem, but I'm unsure what the long term effects are. I do have occasional cramps and my periods are sometimes irregular, and I drink a ton of water, but my skin looks amazing. (I also use Rodan & Fields unblemish line, which helped me reduce to 50mg, with Oil of Olay Regenerist, as well as a prescription retinoid). I also think it might aggravate depression in some people, particularly with alcohol. So I would recommend reducing or remove alcohol altogether. In conclusion, I would say try everything else-with regards to foods, sugar intake, etc. before starting this, especially if you are hoping to become pregnant. But if that isn't a desire for you, I would try this incredible medicine. And if you do, be patient. It will work. But continue to listen to your body. *~~*~~*
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December 7, 2017
TRUST ME AND READ THE WHOLE THING
I'm a 21 year old female that is caucasian and has fair skin that is extremely sensitive. Although my skin is sensitive, I struggle with oily acne prone skin. A couple of years ago I was given Bactrim at a pretty high dose to try and combat my acne. It worked! almost a week in, the acne was gone and the scars were disappearing. It was seriously an acne miracle. Although, every time I went off of the medication my acne returned with a fight. My derm didnt want me to be on bactrim forever since it is a pretty intense drug and isnt meant for forever use. Finally, I asked my dermatologist for me to try spironolactone. I have PCOS and knew my acne must be related to hormones. It was deep and cystic and never was a simple pimple or two. The first week (50 mg) my acne was the same. The second week (50 mg) my acne got worse. During this time I was still taking a pretty high dose of bactrim to get me through the initial breakout phase. After a month the initial breakout started to end and my skin returned back to its normal self (cystic acne like normal) I then upped my dose to 100 mg. My skin then had another initial breakout but wasn't nearly as bad as before. At about 2 months is when I saw some improvement in my skin. Anytime before that my skin was the same if not worse. My skin at this time was softer and my pores were smaller. I started to decrease my bactrim dose and to my surprise I wasnt breaking out as much as I would have before if I had lowered my bactrim dose. Before, my skin would breakout if I went even a day without taking my bactrim medication. At three months my skin improved even more. It was softer and i wasnt getting deep cystic acne but moreso regular pimples like anyone else. At four months my skin was getting softer, firmer, and less oily while having no cystic breakouts and no antibiotic medication. The first couple of months were rough but trust me, you just have to wait! It gets better. My skin is NOT perfect. but its 90 percent better than before.
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August 15, 2017
Spiro Week Three 100 MG
I know it's too early to review, but I'm 19, I took Accutane in 2014 and stayed clear till 2017. I tried stopping my birth control for two months which was the big culprit. I started again in July. I'm taking 100 MG a day of Spiro and have been since July 21st. It's been about 3 weeks. It's pretty moderate and has gotten much worse on my cheeks and jaw line I since I started. My forehead acne is basically gone by using clindamyacin gel. I am feeling very insecure because it seems worse than when I started. My cheeks have so many deep bumps and scars and redness. I feel like I need to cake on foundation which I haven't had to for a couple years. I feel very sad about this. I could use some positive motivation. When will it start to get better? I know it takes time but it's so depressing to deal with it again. Update- Just Finished Month 2- 60 Days In- My face still looks bad. :( I have tons of small bumps on my forehead and like 3 big pimples on both cheeks. I am so discouraged. I am so impatient. Anyone else experience this? Any tips? I started Ortho Tri Cyclen to hopefully speed up the process because this birth control pill helps acne compared to my previous one. I am still on 100 MG. I am tired of seeing so much acne everytime I look in the wrong lighting. :/ --MissNotSoOptimistic
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Michigan88
August 16, 2017
I understand the frustration. But I would encourage you to continue as long as you aren't experiencing any significant side effects. It took 6 months of taking 100mg for me to see results. At 4-5 months I remember feeling defeated, convinced there was no hope of positive results. Stick with it!!
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TRDMeister18
September 6, 2017
It has also been 3 weeks since I've been on Spiro and I FEEL YOUR PAIN. I feel like my acne has gotten worse on my chin and jaw line as well. Thankfully the acne goes away after a few days but leaves me ugly scars. I am also taking 100MG a day taking (2) 50MG pills in the morning and one in the evening. Haven't experienced any side effects so I will just stick with it! Posts like the one posted by Michigan88 is what keeps my hopes up LOL. I am willing to wait 6 months as long as the results are great!
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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