Get a topical spironolactone prescription for acne
- Board-certified dermatologists
- Prescribed through Skin Medicinals
- No expensive medication subscriptions


What is topical spironolactone?
Topical spironolactone is a localized acne treatment for men and women which was adapted from its oral form due to its anti-androgenic effects.
Androgens are hormones that can contribute to acne by increasing oil production in the skin and spironolactone helps reduce oil production but it cannot be taken by men. Topical spironolactone helps manage acne by blocking androgen effects directly in the skin, targeting problem areas without causing the same side-effects that oral spironolactone might have1.
Topical spironolactone is not FDA-approved for acne treatment, but dermatologists may prescribe it off-label based on clinical judgment and patient needs.
How to get a topical spironolactone prescription?
Do you need a prescription to buy topical spironolactone for acne?
Yes, you need a prescription to buy topical spironolactone as it is not available OTC and is not available at local pharmacies.
How to get a prescription for topical spironolactone for acne?
To get an online topical spironolactone prescription for acne, you can have a consultation with a dermatologist through Miiskin. The consultation fee starts at $39 for returning patients and $59 for new patients, and if it’s medically appropriate for you, they will write you a prescription.
Where to buy topical spironolactone?
After your get your prescription, you can buy topical spironolactone through Skin Medicinals and it will be delivered to you by a mail-order compounding pharmacy.
Why can’t I find topical spironolactone at the pharmacy?
Topical spironolactone is not an FDA-approved drug. It is sometimes compounded with other topical medications for acne as per a dermatologist’s indications.

Request acne treatment with topical spironolactone via Miiskin
- Select “Start consultation” to sign up.
- Fill out the consultation form and take photos of your skin.
- An independent dermatologist will prescribe a personalized formula with topical spironolactone to you, if medically appropriate.
- Buy topical spironolactone online from a compounding pharmacy through Skin Medicinals


Process for getting an online prescription for acne that may include topical spironolactone
You will connect with an independently practicing online dermatologist through a photo-consultation. Upon reviewing your case, the dermatologist will determine if topical spironolactone cream is safe and appropriate for you, and if it is, they will issue an ePrescription through Skin Medicinals, which is a 3rd party platform that facilitates prescriptions to some mail-order compounding pharmacies.
Topical spironolactone explained
How does topical spironolactone work?
Topical spironolactone works by reducing acne through its anti-androgen effects, which help to decrease sebum production that is often stimulated by androgens. This reduction in sebum limits conditions that can lead to acne formation, such as clogged pores and inflammation.
Unlike oral spironolactone, the topical version minimizes systemic side effects while providing localized benefits in treating mild to moderate acne.
A clinical study conducted found significant reductions in acne lesions (papules, open and closed comedones) and overall acne severity after using 5% topical spironolactone cream for 8 weeks, with no notable side effects.2

Advantages of topical spironolactone

Enhanced acne control
Spironolactone reduces oil production by blocking androgen receptors in the skin, targeting hormonal acne.

Reduced oiliness
Spironolactone’s oil-reducing effects help decrease shine and the frequency of clogged pores, making it particularly beneficial for those with oily or combination skin.

Localized treatment
Topical spironolactone is applied directly to the skin avoiding the systemic side effects associated with oral spironolactone.
Topical spironolactone warning & side-effects
Topical spironolactone cannot be used by pregnant women due to their teratogenic effects.
Side effects of topical spironolactone
- Dryness and peeling: Tretinoin increases cell turnover, which can lead to dryness, flaking, and peeling, especially in the first few weeks.
- Redness and irritation: Both spironolactone and tretinoin may cause skin redness, stinging, or irritation, particularly in people with sensitive skin.
- Potential allergic reaction: Although extremely rare, some people may experience an allergic reaction, with symptoms like itching, swelling, or severe redness.


How to use your topical spironolactone?
You should always follow the instructions of your healthcare provider, however, as a general rule, if you have never used topical spironolactone, here is a good way to start.
- Cleanse:
Wash with a gentle cleanser and dry your skin. - Moisturize:
After the medication absorbs, use a gentle moisturizer to reduce dryness. - Apply medication:
Apply a thin layer of the formula on dry skin, at nighttime avoiding sensitive areas like eyes and corners of the mouth. - Sun protection:
Apply sunscreen every morning.
It is also important to find a balance that is right for you. Your skin may not tolerate the application of topical spironolactone every day straight away. Apply topical spironolactone every other day instead of daily in the beginning if you experience irritation, once your skin is used to it, apply daily.
What ingredients can be combined with topical spironolactone?
- Sunscreen SPF 50
- Hyaluronic acid
- Non-greasy moisturizer
- Azelaic acid
- Tretinoin
- Niacinamide
- Peptides
- Ceramides
What ingredients should be used with caution with topical spironolactone?
- Benzoyl peroxide
- Alcohol-based toners
- Physical exfoliants
- Exfoliating acids (AHAs/BHAs)
Provider & Prescription Information
Miiskin connects patients with independent dermatologists who provide care through their own private practices. Miiskin does not employ dermatologists and does not sell or distribute medications. Any prescriptions issued by the dermatologists can be filled at third-party pharmacies of the patient’s choice.
References:
1https://pmc.ncbi.nlm.nih.gov/articles/PMC8247934/
2https://pmc.ncbi.nlm.nih.gov/articles/PMC8247934/
3https://pmc.ncbi.nlm.nih.gov/articles/PMC5574737/