Best Taken:AM or PM oral medicationCaution: Check Potassium levelsBest for: Acne, hair loss, oily skin

Useful antiandrogen 

Mode of action: AntiandrogenScience Score: *****


What is the science behind spironolactone?

Spironolactone is an anti-male hormone (anti-androgen) medication. It blocks the male hormone receptor and reduces the level of the male hormones, testosterone and DHEAS. This tablet was first used as a diuretic (“fluid tablet”) effect and increases urine production. This medication lowers blood pressure and reduces fluid retention. 

Spironolactone is an oral medication & not a cream because androgens (the target for spironolactone) is found circulating in the bloodstream.

Spironolactone is a great molecule that reduces oil or sebum production, hence it’s use in treating normal acne & oily skin.

What skin conditions can be treated with spironolactone?

Hormonal acne: It’s the impact spironolactone has on the hormones that give it its acne fighting reputation.  That’s because it blocks the effect that androgens have on oil glands. This medication is an alternative to Accutane or Oratane.

Spironolactone is effective in over 85% of acne cases, including cystic acne, hormonal acne & PCOS associated acne.

Hair loss in women: Due to its impact on hormone regulation, the drug has recently been prescribed for women experiencing hair loss, also known as androgenic alopecia.

Excessive unwanted hair: On the other hand excessive hair known as hirsutism, commonly seen in PCOS can be treated with spironolactone. 

Oily skin: can also be effectively treated with this medication. Most patients only require a very small dose of between 50 to 75 mg.

To see if you are a good candidate for this medication, book in with one of the medical dermatologists @cutis_dermatology. 

*Disclaimer: I am a procedural dermatologist, I do not treat medical conditions such as hair loss, acne or other conditions that require prescriptions/tablets. 

What type of acne does spironolactone treat?

It is important to identify potential candidates for antihormonal therapy based upon the pattern of acne. Factors dermatologists consider include

  • Acne flare ups that cycle with menstruation
  • Women with adult-onset acne or persistent-recurrent acne past teenage years, even in the absence of clinical or laboratory signs of hyperandrogenism. This subset of acne is termed adult female jawline hormonal acne. 
  • Women on oral contraceptives (OCs) who exhibit moderate to severe acne, especially with a hormonal pattern clinically
  • Women not responding to conventional therapy and not wanting to use oral isotretinoin / Oratane / Accutane

Davin’s ProTip on the use of Spironolactone

This is one versalite drug that can effectively & predictably treat conditions including hormonal acne, excessive oil production, hair loss & paradoxically unwanted excessive hair (hirsutism). It is particularly useful in the management of adult female acne. Surprisingly, a low dose of between 50 to 150 +mg taken once a day is effective. Most patients experience very little, if any side effects. 

*Disclaimer: I am a procedural dermatologist & I do not prescribe spironolactone, nor any other medication unless it is pertaining to a procedure. For medical dermatology consultations please book in with one of my colleagues @cutis_dermatology

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