Spironolactone can be used to treat hormonal acne, in addition to facial & truncal  acne. It works by blocking androgens (hormones) that bind to the oil gland. The most common dose for acne is between 50 to 150 mg. 

It can take about 10 to 12 weeks for the drug to have a noticeable effect on acne. The first signs that this is working is a reduction in oil production. Spironolactone can also treat female pattern hair loss. In this role it may take 6 months before noticing any changes.

Skin purging is not common on spironolactone, unlike retinoid therapy. The flipside is that you won’t get outstanding results in the first few weeks. Most women should expect it to take around 12 weeks for the benefits to start showing. 

Spironolactone is not a cure-all pill and won’t rid you of acne forever. It can however act as a temporary solution for hormonal acne, until your hormones ‘normalize’. To date there are only a few predictable cures for acne. They include- 

• Isotretinoin or Oratane/Accutane: one cycle cures approximately 60% of patients.
• PDT or photo dynamic therapy: this destroys the oil glands.
• AGNES or RF destruction of the pilosebaceous units.
• Case report of microneedling RF to the depth of the oil glands.

Androgens such as testosterone are responsible for hair growth on the face, chest, and stomach that some young women with PCOS have. Androgens can also cause acne. Spironolactone may work by lowering the level of androgens, which lessens hair growth and improves acne. Other medications for PCOS include metformin, isotretinoin, finasteride & cyproterone acetate.

Disclaimer: I do not prescribe medication for skin conditions as my work is procedural. For acne, oily skin, hair loss conditions I will refer you to my colleagues in Brisbane & Sydney.

This medication is known as an antiandrogen. It modulates the signal of hormones that bind to the oil gland, thereby reducing the activity. Cyproterone acetate does the same.

Spironolactone is a potassium-sparing diuretic (water pill). It prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. Hence it is important to avoid food rich in potassium, for example bananas. Other foods that high in potassium include; 

• Leafy greens, such as spinach & kale
• Fruits, such as tomatoes, cucumbers, zucchini, eggplant and pumpkin.
• Root vegetables, such as carrots,&  potatoes 
• Tree fruits, such as avocados, apples, bananas & oranges 
• Peas & beans.
• Milk, yoghurt and meat.

Note – it does not mean you can not take the above foods, it just means that you should be mindful of potassium intake. A simple blood test will check your levels. 

Yes, this tablet is frequently combined with other medications such as minoxidil & cyproterone acetate for the management of female pattern hair loss.  Much like it’s effect in the treatment of hormonal acne, spironolactone blocks male hormones such as testosterone from binding to the hair follicle.  

Disclaimer: I do not prescribe medication for skin conditions as my work is procedural. For acne, oily skin, hair loss conditions I will refer you to my colleagues in Brisbane & Sydney.

The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). The results are modest and take at least six months to be noticeable. Depending on the severity, this can be combined with cyproterone acetate, and a cream based solution called Vaniqa.

Yes, this medication is a treatment option for hormonal acne, & hair loss. It can be safely taken long term. Your doctor may elect to perform blood pressure tests as well as potassium levels intermittently. 

If you stop taking this drug, your hormonal influx returns to normal. In the context of acne, you may get recurrence of pimples. Additionally  you may start retaining water & increase your blood pressure. Discuss cessation with your treating specialist.

Disclaimer: I do not prescribe medication for skin conditions as my work is procedural. For acne, oily skin, hair loss conditions I will refer you to my colleagues in Brisbane & Sydney.

Spironolactone is a diuretic, also known as a ‘water tablet’. It will make you go to the toilet more often to pass urine. Titrate your dose according to your side effects. If urination wake you up at night, consider taking this tablet in the morning.  

Most people do not experience side effects on this drug, however, side effects that can occur with spironolactone include- 

• Nausea and vomiting
• High potassium levels
• Leg cramps
• Headache
• Dizziness
• Drowsiness
• Irregular menstrual cycles or bleeding after menopause

* Potassium levels should be checked at baseline & after each dose escalation.

There are alternatives instead of spironolactone for the treatment of skin conditions such as acne, excessive oil production & hair loss. Cyproterone acetate is another anti hormone medication frequently used by dermatologists. Accutane is another drug that can reduce oil production, whilst finasteride can slow down hair loss. Your medical dermatologist will discuss these medications with you.

Disclaimer: I do not prescribe medication for skin conditions as my work is procedural. For acne, oily skin, hair loss conditions I will refer you to my colleagues in Brisbane & Sydney.

There are some rumors that spironolactone can cause weight gain, but there isn’t much evidence it does. The package insert for the drug doesn’t list weight gain as a side effect, in fact due to the diuretic effect of this medication, it can cause weight loss.