Topical and oral spironolactone for the treatment of hormonal acne
Advantages and side-effects of prescription oral and topical spironolactone. This resource contains answers to common questions about spironolactone for hormonal acne.
Table of Content:
What is Spironolactone for acne? | Topical Spironolactone, benefits, side-effects and brand names | Oral Spironolactone, benefits, side-effects and brand names | Can men use/take Spironolactone? | Can you take both oral and topical Spironolactone? | Who should not take Spironolactone? | How to get Spironolactone?
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The information presented in this article is based on scientific research and the professional advice of our Content Medical Reviewers, who are experts in the field of Dermatology. How we write our content →
What is spironolactone?
Spironolactone is a potassium-sparing diuretic used to treat hormonal acne in women; it slows down the body’s production of androgen hormones as well as blocking the effect of the androgens, which cause the skin to produce excessive oil, clog pores, and lead to acne breakouts1.
Spironolactone is available as a topical solution and in an oral form (pills).
Recent studies show that oral spironolactone are a safe and effective treatment for women with hormonal or adult acne who have not responded well to other treatments2.
What is hormonal or adult acne?
Hormonal acne, also known as adult acne, are acne breakouts related to hormone fluctuations.
Androgens (male sex hormones such as testosterone and dihydrotestosterone) play a significant role in the development of acne in both males and females.
- Increased sebum production: androgens stimulate the sebaceous glands in the skin to produce more sebum, leading to clogged pores.
- Keratinocyte proliferation: androgens can promote the growth of keratinocytes, which can lead to an abnormal shedding of skin cells, contributing to the formation of acne breakouts.
- Inflammation: androgens may also contribute to the inflammatory response in acne, which can lead to redness, swelling, and inflammation around the hair follicle and sebaceous gland3.
Although these breakouts are typically associated with hormone fluctuations during puberty, hormonal acne can affect women between the ages of 20 to 50.
Women often experience fluctuating hormones during these periods:
- Menstruation
- Pregnancy and miscarriage
- Peri-menopause and menopause
- After starting or discontinuing birth control pills4
In difficult-to-treat female hormonal acne, healthcare providers may consider treatment with birth control pills or Spironolactone which counter the effects of androgens5 6.
Request a prescription for oral spironolactone
Start your journey to better skin. Get a personal treatment plan from one of our affiliated dermatology providers. Let them know if you have a specific medicine in mind.
Other causes of adult acne
- Family history: Research suggests that some people may have a genetic predisposition for acne.
- Stress: Research shows there is a close relationship between stress and acne breakouts. However stress is not a proven cause of acne, but may worsen existing acne, and when stress intensifies, the severity of acne increases7. When a person is stressed, the body produces androgen hormones, which stimulate oil glands and hair follicles in the skin, which may lead to acne breakouts.
- Certain cosmetics and hairstyling products can cause acne: Ensure you buy oil-free, non-comedogenic products that won’t clog pores.
- Side effects of some medications: Acne is a side effect of some medicines. If you suspect that a medicine is causing your acne breakouts, talk to your healthcare provider8.
Oral vs topical spironolactone for acne
There are several differences between oral and topical spironolactone, despite the fact that they both treat hormonal acne.
Using topical spironolactone for acne
Topical spironolactone is an off-label treatment that is currently being used to treat acne and other skin conditions, primarily for its anti-androgenic properties since it helps regulate hormonal causes of acne at the skin level.
Studies show that topical spironolactone could be an effective acne treatment for both men and women, however, this drug is not yet approved by the FDA for the treatment of acne.
However, there is an alternative to topical spironolactone that works in a very similar way, and is approved by the FDA to treat acne.
An FDA-approved alternative to topical spironolactone
Clascoterone (also known as Winlevi) is a fairly new topical medication (cream) that is approved by the FDA for the treatment of hormonal acne. It works by inhibiting the effects of androgen receptors.
According to Dr. Anna Chacon, Dermatologist, androgens play a significant role in the development of comedones, so a topical medication that inhibits androgen receptors and that is approved by the FDA for acne treatment, is important for the management of hormonal acne9.
Using oral spironolactone for acne
Spironolactone is a diuretic (water pill) used to treat female acne as hormone therapy by targeting the hormonal cause of the disease.
Spironolactone slows down the body’s production of androgen hormones as well as blocks the effect of androgens, such as testosterone. Androgens can cause the skin to produce too much oil, clog pores and lead to acne10.
Spironolactone does not show results as quickly as other treatment options. The average initial effect has been reported as three months with maximal response after five months11.
Advantages of using oral spironolactone for acne
Traditional acne prescription medication such as antibiotics and isotretinoin are usually recommended for approximately three to six months, respectively. The long-term use of antibiotics can cause bacterial resistance and the long-term use of isotretinoin may cause unwanted side effects. Oral spironolactone has the advantage that it may be used for more than six months12.
Potential side effects of oral spironolactone
- Increased in urination
- Headaches
- Frequent bowel movements
- Menstrual disorders
- Breast tenderness
- Fatigue
- Dizziness
- Low blood pressure
- Elevated blood-potassium
- Decreased sex drive13
Brand names of oral spironolactone
- Aldactone
- CaroSpir
Acne-Prone Skin Care
Answered: questions about spironolactone for acne
Get the answers to these questions:
- Can Men Take/Use Spironolactone for Acne?
- How to Get Topical and Oral Spironolactone?
- Does Spironolactone Cause Purging?
- How Long Does It Take for Spironolactone to Work?
- How Effective Is Topical Spironolactone Compared to Oral Spironolactone?
- Can Spironolactone Be Used Orally and Topically at the Same Time?
- How Well Does Spironolactone Therapy Work, and Is It Safe?
- Who Cannot Use Spironolactone?
Can men take/use spironolactone for acne?
Oral Spironolactone is not advisable to treat acne in men because it may cause unwanted side effects14.
However, men can use topical Spironolactone as it does not have the same systemic effects when applied topically.
Does spironolactone cause purging?
Although it is rare for spironolactone to trigger an initial outbreak of acne, an acne flare-up may affect very few patients when they first start using spironolactone.
How long does it take for spironolactone to work?
Depending on your skin, you should see improvements after starting spironolactone therapy within three to four months.
How effective is topical spironolactone compared to oral spironolactone?
When used orally, spironolactone treats acne’s hormonal issues from the inside out. Higher oral spironolactone dosages are thought to be more efficient than its topical equivalent.
Applied at the skin’s level, it can take some time for topical spironolactone to start working, making it less efficient than greater dosages of oral spironolactone.
Can spironolactone be used orally and topically at the same time?
During the last few years, in the US, topical Spironolactone has been mentioned on popular online dermatology providers’ webpages as a possible supplement to oral Spironolactone which may reduce the oral medication required. However, no studies have been conducted to confirm this as of yet.
How well does spironolactone therapy work, and is it safe?
In general, oral spironolactone causes more side effects than topical spironolactone. Because of its negative effects, oral spironolactone is not recommended for the treatment of acne in men. For healthy women, spironolactone is found to be safe15 .
Oral spironolactone is not recommended for pregnant women as it is not safe for the fetus 16 17.
Research shows that both male and female patients appear to respond well to the topical 5% spironolactone cream as an acne vulgaris treatment18.
Who cannot use spironolactone for acne?
Spironolactone is not recommended for pregnant women as it is not safe for the fetus.
How to get spironolactone and clascoterone?
Oral spironolactone and clascoterone can only be purchased with a prescription from a licensed healthcare provider. You can get a prescription by clicking on the “start a consultation” button below.
Request a prescription for oral spironolactone or clascoterone
Start your journey to better skin. Get a personal treatment plan from one of our affiliated dermatology providers. Let them know if you have a specific medicine in mind.
Article References:
1 https://pubmed.ncbi.nlm.nih.gov/26897386
2 https://pubmed.ncbi.nlm.nih.gov/32078195/
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/
4 https://www.aad.org/public/diseases/acne/really-acne/adult-acne
5 https://pubmed.ncbi.nlm.nih.gov/26897386/
6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419026/
7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360964/
8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903830/
9 https://www.ajmc.com/view/first-in-class-topical-treatment-clascoterone-launches-in-us-to-treat-acne-vulgaris
10 https://pubmed.ncbi.nlm.nih.gov/26897386
11 https://pubmed.Ncbi.Nlm.Nih.Gov/32078195/
12 https://pubmed.ncbi.nlm.nih.gov/26897386
13 https://www. Ncbi. Nlm.Nih.Gov/pmc/articles/pmc3315877/
14 https://www. Ncbi. Nlm.Nih.Gov/pmc/articles/pmc3315877/
15 https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy#
16 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360964/
17 https://pubmed.ncbi.nlm.nih.gov/26897386/
18 https://pubmed.ncbi.nlm.nih.gov/34250269/
Ask a provider if oral spironolactone is right for you.
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