Topical spironolactone: Benefits, side effects, and usage
Learn more about the benefits and side-effects of topical spironolactone and get answers to common questions about using topical spironolactone for hormonal acne.
Table of Content:
What is topical spironolactone? | Is it used for acne? | Do you need a prescription? | How to get it? | Benefits | Side-effects | Oral vs topical spironolactone | FAQ
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What is topical spironolactone?
Topical spironolactone is a localized treatment option derived from oral spironolactone due to its anti-androgenic properties. Androgens are hormones that play a role in conditions such as acne and hair loss1.
By using topical spironolactone it is possible to target specific areas to mitigate the effects of androgens in the skin without the systemic effects often associated with taking spironolactone orally.
Is topical spironolactone used for acne?
Topical spironolactone and oral spironolactone are off-label treatments 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.
Some 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 2 3 .
Do you need a doctor’s prescription to buy topical spironolactone?
Yes, spironolactone cream needs a doctor’s prescription as you cannot purchase it over the counter.
How to get a prescription for topical spironolactone?
You can request a customized formula via Miiskin with a board-certified dermatologist that includes topical spironolactone + tretinoin or topical spironolactone + niacinamide. The price for the consultation is $59 and price for a medication refill consultation is $39.
How to get topical spironolactone?
Once your online dermatologist has sent your prescription, you can buy your customized topical spironolactone formula via Skin Medicinals.
Benefits of topical spironolactone
Reduced sebum production
Spironolactone can help decrease the production of sebum (skin oil), which is a contributing factor to the development of acne. By reducing sebum, it can help prevent clogged pores and the formation of acne lesions4.
Anti-inflammatory effects
In addition to its impact on sebum production, spironolactone has anti-inflammatory properties. This can help decrease redness, swelling, and overall inflammation associated with acne lesions5.
Targeted treatment
Topical spironolactone is applied directly to affected skin areas, allowing for localized treatment only where acne is problematic.
Mild side effects
Topical spironolactone has usually very mild side effects6 compared to oral spironolactone.
Very effective as acne treatment when used as combination therapy
It can be used in combination with other acne treatments, such as topical retinoids or benzoyl peroxide, to enhance overall acne management.
Topical spironolactone side effects
The most common side effects of topical spironolactone are very mild and often include:
- Redness
- Itching
- Swelling
- Irritation
- Burning
- Scaling7
Topical spironolactone vs oral spironolactone
There are several differences between topical spironolactone and oral spironolactone for acne despite the fact that they both treat hormonal acne.
FAQ about topical spironolactone
Does topical spironolactone cause purging?
Although it is rare for topical spironolactone to trigger an initial outbreak of acne, an acne flare-up may affect very few patients when they first start using spironolactone.
Acne-Prone Skin Care
How long does topical spironolactone take to work?
With topical spironolactone 5%, studies show that you should start seeing improvements after 4 to 8 weeks10.
How effective is topical spironolactone?
Research shows that both male and female patients appear to respond well to the topical 5% spironolactone cream as an acne vulgaris treatment 11 12 .
It is important to consult with a dermatologist to initiate the acne treatment that best suits your skin, as well as evaluating therapeutic response during follow-up and adjusting the treatment.
Can spironolactone be used orally and topically at the same time?
Research suggests that taking oral spironolactone alongside topical treatment is beneficial for women with persistent acne and can reduce oral antibiotic prescribing13.
Who cannot use topical spironolactone for acne?
Topical spironolactone is antiandrogenic and these medications are not recommended for use during pregnancy or breastfeeding as it is not safe for the baby.
What is hormonal 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 gland14.
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 pills15
In difficult-to-treat female hormonal acne, healthcare providers may consider treatment with birth control pills or Spironolactone which counter the effects of androgens16 17.
Other contributors to hormonal 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 increases. 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.
Stress can trigger the release of hormones like cortisol. These hormones can stimulate the sebaceous glands in the skin to produce more oil, which can clog the pores and contribute to the development of acne.
- 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 provider18.
Article References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763909/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483163/
https://pubmed.ncbi.nlm.nih.gov/36412248/#
https://www.ncbi.nlm.nih.gov/books/NBK554421/
https://www.sciencedirect.com/science/article/pii/S1110116416300333
https://www.dovepress.com/the-efficacy-and-safety-of-oral-and-topical-spironolactone-in-androgen-peer-reviewed-fulltext-article-CCID
https://pubmed.ncbi.nlm.nih.gov/34250269/
https://www.bmj.com/content/381/bmj.p1114#
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