All About Spironolactone

11 July 2024 | Spironolactone

Understanding How Oral Spironolactone Can Help with Hormonal Acne

Hormonal acne is a common issue for many women, often appearing around the chin, jawline, and lower face. It can be persistent, with flare-ups that occur around your menstrual cycle, making it particularly challenging to manage. One treatment option frequently prescribed by dermatologists for this type of acne is oral spironolactone, a medication originally used for other conditions but found to be effective in targeting hormonal causes of breakouts.

How Does Oral Spironolactone Work for Acne?

Oral spironolactone works by reducing the effects of androgens—hormones that can overstimulate oil glands in the skin, leading to clogged pores and acne. It’s particularly useful for treating hormonal acne, which tends to manifest around the lower face. In addition to hormonal acne, spironolactone has also shown effectiveness in managing other types of acne in women and is an effective alternative to oral antibiotics.

Important Considerations Before Starting Spironolactone

1. Who Can Use It?
   Oral spironolactone is not suitable for men (cis- or transgender) as its hormone-blocking effects can cause undesirable side effects.
2. Medical Conditions and Interactions
   If you have a history of kidney or heart disease, spironolactone may not be suitable, as it can affect potassium levels. It’s also important to let your healthcare provider know about any supplements or medications you’re taking, particularly potassium or magnesium supplements, or potassium-rich foods like coconut water. Based on your medical history, your prescriber may ask you to get your bloods checked to ensure your kidney function and potassium levels are normal. Routine bloods tests are not usually required for young, healthy individuals.
3. Time to See Results
   Spironolactone works gradually, so it’s important to manage expectations. Many people start to see improvements after a few months of regular use, with the best results typically observed after six months of continuous treatment.

What are the common side effects?

Oral spironolactone is usually very well tolerated in the dosages used for the treatment of acne. As a diuretic, spironolactone can lead to increased urination, so staying hydrated is important. Some women may experience mild side effects, such as breast tenderness or irregular periods, particularly at higher doses.

This is not an exhaustive list of side effects and it’s important to read your patient information leaflet prior to starting treatment.

It’s also important to note that spironolactone is not recommended during pregnancy or whilst breastfeeding, so effective contraception should be used if you are of childbearing age.

Dosage and Treatment Approach

The dosage of oral spironolactone for acne can vary depending on the individual’s specific needs and health status. Doses for acne treatment range from 50 mg to 200 mg per day. The most commonly prescribed dosage for acne is 100mg per day.

Consistency is key when using spironolactone. While initial improvements may take a few months to appear, ongoing use is necessary to maintain results and manage breakouts.

Spironolactone and PCOS

For women with polycystic ovary syndrome (PCOS), spironolactone can be particularly beneficial. PCOS is a condition where elevated androgen levels contribute to acne, irregular periods, and other symptoms. By reducing androgen activity, spironolactone helps to address the acne associated with PCOS.

While hormonal contraceptives are often the first-line treatment for PCOS, spironolactone is frequently used alongside them to provide additional support in managing acne and regulating skin health.

Is Oral Spironolactone Suitable for You?

It depends on your specific health needs. Oral spironolactone can be an effective option and an alternative to oral antibiotic tablets for managing acne in women, particularly those with hormonal imbalances contributing to their breakouts.