Spironolactone for Acne


100 reviews

84% would repurchase

Package Quality: 4.1

Price: $$

Package Quality: 4.1

Price: $$


Age: 30-35

Skin: Combination, Other, Not Sure

Hair: Brown, Other, Other

Eyes: Green

First of all, this is a prescription drug so you need to make sure to take the advice of your doctor with this. However, I can tell you that this has worked wonders on my skin when nothing else (prescription topicals and antibiotics) would! I have not tried accutane before so I can't speak for that.

Spironolactone (the brand name is Aldactone) was actually designed to control blood pressure, but the dosage prescribed for acne typically is a lower dosage. It is a diuretic and potassium sparing. Because of this, depending on your dosage, you will need to make sure to drink plenty of water and have your blood checked to monitor potassium levels. If you are taking a high dose, you may have to monitor that you do not eat an excessive amount of foods that are high in potassium.

The great effect this medication has on acne is that it can block androgens. This is one reason that it is really a treatment for women with acne and not men. If you have hormonal acne, this can do wonders. It also really seemed to help my skin's oiliness. I have combo skin, but the oily parts of my skin were really improved by this.

I have read that it typically takes 4 months to see significant improvement, but I saw it start in a week. I also find to not get worried that your dosage isn't high enough. Give it time. A lot of people respond great on only 25mg or 50 mg (these are considered low dosages), and it would be ideal to use the lowest dosage needed. I also have found a big difference in splitting the dosage up (half in the morning/half at night) so see if your doctor says that's an option for you. I haven't had side effects on 50mg/day.

Some cons: This drug has a "black box" warning because when tested on rats---with a dose over 50 times higher than would would be prescribed to humans---it caused tumors. However, this journal entry from the US National Library of Medicine really addresses this concern: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315877/

Also, when I did go off of this medication, my acne came back in a few months. So, it is more of a management...not a cure. Definitely worth a try though.

6 out of 6 people found this review helpful.

Age: 25-29

Skin: Combination, Fair, Warm

Hair: Blond, Other, Medium

Eyes: Brown

Okay, so I'm going to write a review on this medication, finally, after having been on it since September of last year (approx. 8 months). For me, it has changed my life in a few ways besides taking care of the dreaded cystic acne.

I'm going to share something that might be TMI. I used to have a very...pungent body odor. I've been told that it wasn't necessarily bad, but it was very strong. It would linger in my clothing even after I washed them. It was embarrassing for me. I would cringe every time my boyfriend's face would go anywhere near my pit region. I was very aware of the scent and there was no deodorant in the world that could touch it (I tried them all). Then I started taking Spiro. Within a few weeks, I realized that I no longer had a lingering scent. I could wear clothing more than once, and there was no odor. My pits just smelled like...smelly good deodorant. I can't tell you how stoked I was to discover this. I would take this medication for this fact alone. It's crazy awesome.

My skin was ridiculously oily. Like, nasty, grease-slick oily. Makeup would only last 1-2 hours before sliding off and becoming patchy and disgusting. It didn't matter what makeup I was using, the result was always the same. After a few weeks (less than a month) of using Spiro at 100mg, my face was what I would consider "normal". Neither oily nor dry. My makeup looks fantastic all day, regardless of the foundation I use. Anyone who struggles with extremely oily skin AND cystic acne knows how devastating it can be. It's like you can't even cover up the horrible marks all over your face, because the makeup will slip off and look even worse that your bare skin in a few hours.

Spiro cured my cystic acne. It didn't happen over night. It didn't happen within the first few months. It was a VERY gradual process over the course of the last 8 months. And I still get zits and inflamed pores once or twice a month. But I no longer get the painful, gigantic cysts that leave indented scars in my skin.

Spiro is something you have to stick with. You have to be consistent. You have to realize that it can and will take many months for your acne to clear up to a manageable level.

Now for the bad. Because, there's always some sort of negative side effect with any medication you take. For me, it increased the amount of little visible veins in my legs. But in saying that, I will also say that it was probably because of the hormonal fluctuation. You can see an increase in leg veins if you are pregnant or take birth control, too. It's not horrendous. The only person that notices is me. But it is something to be aware of.

The first few months, while getting acclimated to the medication, I would wake up in the middle of the night and have to pee. When I would stand up, I would get extremely dizzy. I'm assuming it's because it lowers your blood pressure. After a few months, though, this went away.

It messes with your period. My period happens anywhere between 30-45 days now. Sometimes I get random spotting. It kind of sucks, and it could probably be remedied if I took it with birth control, but birth control is what transformed my skin from normal and blemish free to a cystic mess of a grease-slick. Wasn't willing to chance that crap again, so I just deal with the irregularities of my period.

I hope this was helpful. I know that while I was waiting for the medication to work it helped to read other people's experiences with it as motivation to keep going with it. It does work, it just take a lot more time than someone struggling with cystic acne would like it to take.

10 out of 10 people found this review helpful.


Age: 44-55

Skin: Acne-prone, Other, Not Sure

Hair: Red, Other, Other

Eyes: Brown

This medication has been nothing short of a miracle for my skin. I've been acne-prone on and off throughout my 30s and early 40s. Topicals helped somewhat, but I still got hormonal cysts that would take forever to go away if I didn't get them injected with cortisone. It got to the point where I had very few clogged pores, no pustules or regular zits - just the deep, pea-sized cysts on my chin and jawline. Spironolactone began to get rid of my cysts almost immediately. I had no initial breakout - just got clearer and clearer. I have been on the medication for almost 6 months now, and have not had a single cyst in that time. I was probably getting 1-2 a month on average before I started the med, sometimes more than that. I am on a fairly low dose - 25 mg, 2x a day. No side effects to speak of, other than a slight increase in urination and thirst. I do find that higher doses tend to make me a little light-headed, so I'm glad that I am getting results with just 50 mg a day.

Definitely worth asking your derm about if you are suffering from acne that is largely cystic and hormonal.

1 out of 1 people found this review helpful.

Age: 36-43

Skin: Acne-prone, Medium, Not Sure

Hair: Black, Other, Other

Eyes: Brown

I'll be 39 this year. My teen years aside from one major pimple every now and then were acne free, as were my 20's and half of my 30's. Suddenly at 37 years old I started getting the worst "pizza face" cystic acne I ever had all around my face. I was incredibly embarrassed and wore my long hair down in hopes of covering my scarring face. I'm typically very confident but with the incredible amount of acne that never left I avoided being in the spotlight or leaving the house.

I tried retinol, face creams, scrubs etc.

Finally a dermatologist visit was in order.
Last year they claimed it was all hormonal and put me on Spiro. I was warned it would take a long time.

It did.

Six months no results. I would have given up had the doctor not told me I'd see no changes for a very long time.

Trusting him I did it with no results.

Very slowly about 9 months into it changes happened. To make a very long story short
My skin has NEVER looked better! Smooth. No acne! No embarrassment. Little makeup!

And the best part, getting noticed by very attractive younger men in their 20's.

In the past week alone four different people (guys and gals) thought I was at least 10 years younger than I am, thinking I'm 29!

Commit yourself to this for a year before giving up! You won't be disappointed if it's truly diagnosed as hormonal acne.

I feel great and my skin looks fabulous. Give it a shot. Very pleased but it was a looooooooooooong process. Well worth it.

5 out of 5 people found this review helpful.


Age: 25-29

Skin: Acne-prone, Other, Warm

Hair: Black, Straight, Medium

Eyes: Brown

I was on this stuff for 2-3 yrs and often tried to wean myself off of it even though it helped with my acne. I've always wanted to write a review for it but there's just so much I have to say about it (most of it negative) that it's overwhelming to think about.

This stuff works for acne due to the fact that it blocks your androgen receptors--accutane and birth control btw, have been shown to (permanently) lower testosterone/DHEA levels too, though obviously to a lesser degree... anyways, like other people, I was completely blind to the negative reivews and didn't understand the problems that could come with taking a medication like this when I first researched it. I had bad acne and this stuff was a desperate last ditch effort before tryng accutane.

Like everyone else I initally experienced weight loss due to the fact that it's a diuretic. However, I quickly gained that weight back--and about 7 more lbs on top of it!

I also experienced fatigue, horribly dry, irritated skin (I had never had dry skin in my life so I had no idea how to deal with it), and an almost crippling depression (which I later convinced myself was due to the accutane--even though i only went on to do 10mg of accutane for 3 months that year!).

But how could a medication like this--a diuretic acne-fighting super star--cause weight gain and depression? BECAUSE IT LOWERS YOUR TESTOSTERONE and DHEA LEVELS. You're probably thinking well duh, isn't that the whole point?

Unfortunately, these hormones (like all hormones) are responsible for a multitude of functions: our sense of well being and even our metabolism (to a certain extent) being some of them. For example: no testosterone= no lean muscle mass= slower metabolism and higher body fat percentage.

This is why we've got some women complaining of cellulite and body fat in weird places (this stuff can change your body composition and make you estrogen dominate). If you don't work out or don't have much lean muscle in the first place it won't be as noticeable.

It also has the ability to lower your sex drive but then again, so does birth control (in fact studies show that birth control can do all these things--some of them permanently).

I can say from personal experience that the weight I gained while on this stuff, WOULD NOT BUDGE despite the fact that I exercised for over 90 minutes a day (embarrassing to admit). It drove me crazy so over the years, I'd just keep lowering my dosage more and more which resulted in horrible acne (though no worse than before) and oily skin (definitely worse than before but I think some of it was due to having to take wellbutrin for the depression).

Eventually I had to do accutane, but even on accutane I was too afraid to go lower than 25mgs of spiro, which I would split in half to take am and pm (sidenote: super important to take this stuff 2x a day am and pm!). I had stayed on that dose about a year and a half until I got sick of devoting all my free time to exercise and diet (even such a small dose made it really hard to maintain my weight).

There's really no telling whether you will experience these side effects to this degree as I suspect it's up to your own individual biology. I've seen many women claiming to have very high androgen levels complaining of this same stuff while others have nothing negative to say about spiro, so who knows (also if you're on certain bc pills you might already be experiencing these symptoms). I also feel like some of it developed slowly over time for me (the 1st year it didn't seem as hard to maintain my weight), which fits with how this med works.

All I know is, I am officially off of this crap and for once, I feel great and am not experiencing the horrible acne or ugliness (I believe the drop in estrogen causes some of the ugliness people are complaining of when they get off this stuff). I also seem to have lost those 7lbs within like WEEKS, so I suspect a lot of it was water. It's amazing but I was only able to do this through balancing out my hormones naturally with supplements and probiotics.

7 out of 8 people found this review helpful.


Age: 19-24

Skin: Acne-prone, Fair-Medium, Warm

Hair: Blond, Straight, Fine

Eyes: Brown

I'm 20 years old. I've always had acne prone skin but it was never really horrible. During high school it was just like everyone else's hormonal acne. A few pimples here and there, sometimes it would be for a couple months at a time. It was nothing I needed any oral medication for. I just used pink drying potion and was prescribed Benzaclin. After being really stressed out and depressed for a couple months when I was 18 my skin got horrible. I had really deep cystic acne and it was all over my jawline and my chin. I thought it would go away and so I didn't go to the dermatologist. After it breaking out for about 2 months, I got really bad scars on the sides of my cheeks. My skin went back to normal for about a year. Then, around the same time when I was 19 I broke out really bad again. This time I went to the dermatologist right away. I got on Doxy and Acanya. It worked for about 3 months and then I started breaking out again. My doctor then put me on Spiro, Doxy and Acanya. I was on 50 mg a day and it work RIGHT AWAY. My skin was flawless and it improved the scars, the texture and I had a glow to my skin. I didn't really have any side effects on it at all at first. About 2 months into it I noticed my cheeks were bigger looking and my thighs were HUGE. I'm 5'2 and I weighed 118 before I got on Spiro. Right after I quit I weighed 135. I looked at pictures from the beach and the back of my legs had cellulite all over them. Noone in my family has cellulite and I never did before Spiro. I didn't eat more, didn't change my diet. I know for a fact it was the Spiro that made me gain weight. Right when I noticed I had, I went to the gym and I couldn't loose the weight. I couldn't get my legs to tone and get rid of the cellulite. My skin looked good but I would rather have a couple pimples and find another product than gain 15+ pounds in 2 months. I read that once you get off Spiro your skin is HORRIBLE. I tried to let my body off it slowly, so I went to 25 mg and then to half a 25 mg pill and eventually off. I've been off it about 6 months now and I still have HUGE thighs and cellulite. It's gotten a lot better but my body isn't shaking it. Once I noticed I had gained weight I knew it was Spiro and searched to see if anyone had the same symptoms. I found a website with about 200+ girls who all had weight gain in their face, thighs and produced cellulite. It makes your skin look great so if you don't care about gaining weight, you should do it but I will never take it again. No matter how bad my skin gets, it's not worth gaining that much weight to me. I would rather do Accutane.

5 out of 7 people found this review helpful.


Age: 36-43

Skin: Combination, Olive, Not Sure

Hair: Brown, Straight, Medium

Eyes: Hazel

Where to start? In my early 20's (I am now 43) I was diagnosed with PCOS. After fighting with a few doctors for help, at age 28 I finally got bumped over to endocrinologists who prescribed spiro, 200 mg a day. I have been on spiro for 15 years straight. (usually 200 mg, sometimes I'd bump lower it a bit to 150mg). I have had all kinds of side effects over the years, constant thirst, low blood pressure, getting up to pee every 2-3 hours (which never gets better btw), unfortunate breast enlargement (to a 34G from a 32D), large bags and dark circles under my eyes, redness to my skin, I always look like I have a sunburn, and dry eye syndrome, just bizarre type stuff. Some of this might not be spiro, but I think most of it is, after 15 years it's a bit hard to tell. I never stopped taking it beacuse my PCOS symptoms are so severe.

Recently it became apparent that spiro has screwed up my electrolyte balance to the point where I couldn't keep enough sodium in my body, I have been sick for the past year, passing out from low blood pressure. So I decided to stop taking it. I tapered down to 100mg but was still so sick that 6 weeks ago I had to stop entirely.

Now that it is fully out of my system I am shocked at;

A. How much better I feel, so much energy and focus, I didn't realize how tired I had become, and
B. How horrible I look, downright haggard and so aged that it breaks my heart

First I swelled up quite big but now that the swelling has passed all of my skin has sagged terribly. I suddenly (I mean within the past 6 weeks) have developed turkey neck and jowls. My cheeks sag and my eyes droop. It looks as if all the muscle tone has just left my face. I look 20 years older, it's horrific. My skin is yellowed (not my liver, I checked), and somehow looks darker. Doing further research I realize that basically I have been taking a steroid for 15 years and having stopped I suddenly look like an old woman.

I am a typical, yet thin PCOS'er. I have high androgens, my LH to FSH ratio is off, pearled ovaries, as well as insulin resistance, even when thin. I can grow a mean goatee and had some serious acne and male pattern thinning of my hair before starting spiro. I am now trying to treat my PCOS with a paleo autoimmune diet and drinking spearmint tea for the facial hair. It's too soon to tell how well this will work, but running back to the spironolactone is no longer an option as it makes me too ill.

If I had it to do all over again, would I? As bad as it sounds,i t's really hard to say. On one hand, I got 15 good, if not sickly, years out of this drug. I looked great, no side effects that a little makeup wouldn't cover, no acne, and minimal facial hair. Being a thin PCOS'er weight was never too much of an issue.
On the other hand, I am only 43 and my looks are now ruined. I will do my best to try to combat this, I am by no means throwing in the towel, but I look so much older then my age now. The other day someone thought my mother and I were sisters. I almost started crying on the spot. I try to tell myself that if I was going to look good, why not my "younger years"? It's the best positive spin I can put on this but it's really tough to stay upbeat when everytime I look in the mirror at my suddenly aged self, I am shocked all over again.

I'm not sure what my review says except to the user beware. If you need it now for PCOS, you will need it later. It's not a cure, it's a maintenence drug and can wreak a lot of havok over many years of use.

Also, I was sad & amazed by Christine2004's review, her case sounds just like mine, the aging that this drug has done to her. I knew I couldn't be the only one, but I was sorry to hear that someone else has to deal with this.

I will update if I find a way to reverse or reduce this terrible aged look I have suddenly developed. Maybe with time my face and body will recover.

13 out of 13 people found this review helpful.


Age: 19-24

Skin: Acne-prone, Fair, Not Sure

Hair: Red, Other, Other

Eyes: Blue

Lord have mercy, this medicine is great! I thought all was lost when I developed acne. It began when I started taking my birth control pills off routine and my hormones became unbalanced. I was desperate to find something to cure the whiteheads and cysts. My dermatologist prescribed multiple antibiotics which did not work. I heard my friend that spironolactone cleared her cystic acne. Next appointment, I asked about this. He prescribed it to me. I was on the lowest dose, then bumped me up to 75 mg (2x in the morning, 1x at night). It took six months to really notice a complete difference, but the difference was intense and extraordinary. This is a medication that take awhile to get in your system to work. What it does is change the androgen receptors which cause unwanted facial hair and acne (even weight gain). It basically balances hormones. Within a week of this medicine, I dropped weight. I'm not fat, I'll be honest, but I'm not the skinniest chick alive. Spironolactone is a diuretic so it eliminates water from the body. The only cautions I suggest are checking your potassium levels regularly, because it messes with potassium levels. This medicine made me tired and faint at first, but the side effects go away. Once again, I recommend this product to anyone suffering from acne. It will change your life.

3 out of 3 people found this review helpful.


Age: 36-43

Skin: Dry, Medium, Neutral

Hair: Brown, Curly, Fine

Eyes: Brown

This was so interesting to see this pop up on my home page reviews, because I've been taking 50 mg per day for over 2 years because my hair was falling out in droves. It was to the point that I had to clean the hair out from my shower drain every time I washed my hair because so much would come out!
I finally went to my doctor & after ruling out any thyroid issues, he put me on spironolactone. He also said I might even grow my hair back if the follicle wasn't damaged.
After 2 weeks, my hair wasn't falling out beyond what is normal, and after a month, I could see some new growth around my hairline. Not all of my hair grew back though. My hair is so much thinner than it was before this all happened. And I can't grow it as long. It seems to "get stuck" at about 2" past my shoulders. I wish I had gone to the doctor sooner.
I tried to go off this after I had been on it for a year, & within a few weeks my hair started falling out more, so I went back on it. I will always be taking this, unless I want to be bald, which I don't. This has not made my body hair grow more, thankfully.
I hope this review helps someone that is in the situation I was in.

3 out of 4 people found this review helpful.


Age: 19-24

Skin: Acne-prone, Fair, Not Sure

Hair: Blond, Other, Other

Eyes: Green

I'm almost nervous writing a post to say I've gotten my acne under control with Spiro because I feel like I'll jinx all of my progress! Hopefully not.

I've had acne since age 13 but it was never very serious. Then, out of the blue when I was 22 it turned from mild to severe. I was finally at the stage when I should be growing out of acne and it was worse than ever. I even got a few severe cysts on my cheek that scarred. I was actually depressed, had no self confidence and was truly in a bad place.

Then, I saw an endocrinologist (which I REALLY recommend, especially for women). She was able to diagnose me with PCOS, which explained the severe hormonal acne. I went on Yaz, which was able to stop the horrible acne and it went back to mild.

But I was still frustrated, I would constantly have at least 2 or 3 spots at any given time and I wasn't confident without makeup. I went on Spironolactone 2 months ago and was led to believe by my dermatologist and endocrinologist would finally sort me out.

The most important thing: BE PATIENT. I waited for results for the first 6 weeks and saw no change. Some weeks, things actually seemed to be getting worse. Now, at around week 8, I'm beginning to see a change. Almost no new spots and no severe cysts.

From other reviews, I hope I can expect consistent progress in the coming months and see full effects in the next 6 months. I highly recommend Spiro: it has few side effects and is a mild treatment compared to Accutane, oral and topical antibiotics, and even a lot of topical treatments like Benzoyl Peroxide, which can rapidly age skin.

In general, I encourage people treating active acne to look towards internal treatments for long term success. Topical skincare- washing, moisturizing etc- is important, but it won't change the underlying cause of your acne.

These days, I'm working with a combination of birth control pills, diet (and lots of water!), vitamins, and of course, Spironolactone, to change my body from the inside out and correct the hormonal irregularities that cause my acne.

Try spironolactone, be patient, and good luck!

3 out of 3 people found this review helpful.

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