Spironolactone is not primarily used as an acne medication, but it is sometimes prescribed off-label for this purpose. Taking spironolactone for acne will work for some people but not for others. Specifically, women with acne due to certain hormonal imbalances are likely to find relief by taking spironolactone. Those with acne from other sources will probably not have much luck with this drug.
Most women who take spironolactone for acne have excess levels of androgen, or male, hormones, sometimes due to an underlying disorder such as polycystic ovary syndrome (PCOS). Acne is one of the side effects in women who have an excess of androgen hormones. Spironolactone works by reducing the levels of androgen hormones and regulating the hormonal fluctuations in the body. Men are cautioned against taking this drug because of the potential side effects from reducing the levels of male hormones, including gynecomastia, or breast growth in men, along with other possible effects.
Those women with PCOS or similar problems may experience other issues besides acne that are related to hormone levels, including hirsutism, or hair growth that often resembles that of males. This may include thicker than normal body hair or even female facial hair, which is sometimes coarse and difficult to manage. Even when primarily taking spironolactone for acne, these women may find a more normal, female pattern of hair growth is slowly established after taking the medication for several months. In fact, reducing hirsutism is a second off-label use for this drug.
Many women find using spironolactone for acne to be very effective, experiencing significant skin improvements and reductions in acne breakouts. A few experience little or no improvement, but sometimes these results can be improved by altering dosage levels, dosing schedules, and using additional medications. A dosage increase should be supervised by a doctor to reduce possible side effects. Spironolactone is also often used along with birth control pills and separate acne treatments to help further manage hormone-related breakouts.
Most people can use this medication safely, but there are a few side effects. Spironolactone is also sometimes used as a diuretic and a blood pressure regulator, so people taking his medication should take care to stay hydrated and those with low blood pressure should make sure to pay attention to worsening symptoms of the condition. Additionally, pregnant women should avoid taking this drug because it may alter the hormones of the fetus and disturb normal development.