Spironolactone for Acne: Uses, Safety Tips, and Effectiveness Explained

By: Dr. Mariano Busso


For those unfamiliar, spironolactone is a versatile medication used in various medical fields, including treating acne, excess hair growth, and hormonal imbalances affecting women.

This medication has been available since 1959, primarily used initially for high blood pressure and heart failure. Its efficacy in treating acne emerged later in its timeline.

How does spironolactone work in the body for acne treatment? 

It targets testosterone receptors in sebaceous glands, blocking the stimulation caused by testosterone, which can contribute to acne. 

Before considering spironolactone, here are essential points to consider: 

  1. Apart from its primary use for blood pressure, spironolactone offers added benefits, reducing stroke and heart attack risks. However, it can slow heart rate, so monitoring for symptoms like lightheadedness is crucial. 
  2. High-potassium foods like avocados or bananas should be avoided due to the risk of elevated potassium levels leading to heart issues. 
  3. Spironolactone can induce drowsiness, so refraining from driving while taking it is advisable.  
  4. Maintaining hydration is essential as spironolactone works as a diuretic, eliminating fluids from the body. 

Regarding its effectiveness for acne treatment, results may vary, usually noticeable within six months with consistent use. 

Dosage-wise, 25 mg or 50 mg is within recommended guidelines, although some prefer starting at 100 mg. However, personalized dosing advice from a healthcare provider is essential. 

Ceasing spironolactone should be supervised by a healthcare provider, and if a dose is missed, avoid doubling it the next time. 

Concerning alcohol consumption while on spironolactone, it’s generally considered safe, but consulting a physician is recommend due to potential interactions. 

In acne treatment, spironolactone can be used alone or combined with birth control pills, enhancing their effectiveness when used together. 

Spironolactone remains a safe option but should be approached under professional guidance. Consulting a healthcare provider before starting or stopping any medication is crucial for personalized advice. 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.