Spironolactone for Acne Treatment

Spironolactone is an anti-hypertensive (high blood pressure) prescription drug that may be prescribed as an off-label, non-FDA approved treatment for females with acne.

Spironolactone for Acne Treatment

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The Skinny


Average Recovery

0 days

Permanence

Temporary

Application

Pill

Surgical

No

Cost

$6 - $25

The Specifics


What is spironolactone?

Spironolactone is a prescription medication used off-label to treat acne vulgaris in females. Spironolactone, or brand name aldactone, is a potassium sparing diuretic typically used in the treatment of high blood pressure, those with heart failure, or other cardiac or fluid retention conditions due to its aldosterone antagonist effects, and water pill like fluid volume reduction in the body.

Off-label dermatologists may prescribe Spironolactone to reduce the appearance of acne vulgaris in women due to its anti-androgen properties, which combat the formation of acne. Spironolactone is not used in men due to its disruption of testosterone production and risk of adverse side effects like gynecomastia. Spironolactone should be stopped if a woman plans to conceive, and should not be used with potassium supplements due to risk of adverse effects.

What cosmetic concerns does Spironolactone treat?

  1. Acne: Spironolactone is a receptor blocker that binds to androgen receptors in the body decreasing the production of androgens that are shown to correlate to acne development.

Who is the ideal candidate for Spironolactone?

The ideal candidate for Spironolactone is a post-adolescent female with acne vulgaris (clinically defined as inflammatory deep seated and tender lesions mostly located on the lower half of the face and neck).

Types of Acne

Types of Acne Illustration Comedonal Inflammatory Cystic Dark Skin

Spironolactone is not recommended for males due to its anti-androgen properties, pregnant women, women who are breastfeeding, or trying to conceive, or those with certain heart disease, kidney disease, or liver disease.

What is the average recovery associated with Spironolactone?

There is no recovery associated with Spironolactone use. Patients will need to inform their other providers of this therapy to avoid possible drug interactions with other prescription drugs, and to monitor blood tests for serum potassium levels.

What are the potential side effects of Spironolactone?

Possible side effects of Spironolactone therapy include menstrual irregularities, breast tenderness, hypokalemia, hyperkalemia (high potassium levels), fatigue, muscle weakness, dizziness, lethargy, headache, gynecomastia, frequent urination (due to water pill diuretic effects), and lightheadedness. Spironolactone should be used with caution when taking non steroidal anti-inflammatory drugs like ibuprofen, naproxen, or indomethacin.

What can someone expect from the results of Spironolactone?

Spironolactone results develop within four to eight weeks of daily use. Therapy may be continued indefinitely depending on patient response and regular consultations with their provider. Women who wish to become pregnant should stop therapy. Some individuals experience complete resolution of acne or a lessening of severity of breakouts. Some candidates may not respond to therapy at all.

What is the average cost of Spironolactone?

The average cost of Spironolactone is $5 to $25, but may be dependent on insurance. The actual cost of the Spironolactone will vary by location, healthcare provider, and individual candidate needs.

Pros

hormonal acne treatmenthigh blood pressure treatmentexcess hair growth treatmentfemale pattern hair loss treatment

Cons

menstrual irregularitiestirednessbreast tenderness

Invasiveness Score

mildmoderatesevere
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Invasiveness is graded based on factors such as anesthesia practices, incisions, and recovery notes common to this procedure.

What to Expect


For women experiencing acne flare ups caused by hormonal changes, Spironolactone may be prescribed to treat unwanted blemishes. While acne treatment is an off-label use, many women have seen improvements in their complexions when using this medication. Here is a quick guide for what to expect before, during, and after treatment with Spironolactone.

The Takeaway


Spironolactone is a potassium sparing diuretic with anti androgen properties used in the treatment of acne vulgaris in females. Spironolactone (brand name aldactone) is FDA approved as an antihypertensive for high blood pressure and congestive heart failure, however, it is commonly used off label for acne. Candidates should speak with their providers about common side effects of this medication such as abnormal potassium levels or drug interactions.

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Source List

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AEDIT uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Yanhan Wang, Tissa R. Hata Yun, Larry Tong, Christos C. Zouboulis, Richard L. Gallo, Chun-Ming Huang The Anti-Inflammatory Activities of Propionibacterium acnes CAMP Factor-Targeted Acne Vaccines ; 2018-11-11
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