Get a topical spironolactone prescription for your acne

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bottle of topical spironolactone for acne

Medically reviewed by:
Dr. Eric Howell
Dermatologist

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.

How to get topical spironolactone for acne?

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.

How to get an online 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 for acne?

After your get your prescription, you can buy it via Skin Medicinals and it will be delivered to you.

Why can’t I find topical spironolactone at the pharmacy?

Topical spironolactone is only available at specialty pharmacies that prepare it based on a dermatologist’s prescription.

It topical topical spironolactone always compounded?

Yes, topical spironolactone for acne is usually compounded with tretinoin and niacinamide to treat acne because this combination is extremely effective at targeting acne with hormonal causes.

Request a topical spironolactone + tretinoin prescription 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 Skin Medicinals

Process for getting an online prescription for topical spironolactone for acne
You will connect with an 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 a prescription to Skin Medicinals, a platform that transmits topical spironolactone prescriptions to an online compounding pharmacy.

Topical spironolactone + tretinoin 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

How does tretinoin work?

Tretinoin accelerates cell turnover in the epidermis, helping to renew the outer skin layer, reduce pigmentation, and repair sun-damaged cells.

In the dermis, tretinoin boosts collagen and elastin production, which thickens the skin’s deeper layer and enhances firmness and volume.

Research supports tretinoin creams and gels as a safe, effective long-term treatment for acne and signs of photoaging³.

Benefits of topical spironolactone + tretinoin compounded together

Enhanced acne control

Spironolactone reduces oil production by blocking androgen receptors in the skin, targeting hormonal acne, while tretinoin unclogs pores and prevents new acne from forming.

Improved skin texture and tone

Tretinoin unclogs pores, smoothes skin texture, and fade dark spots. Topical spironolactone reduces inflammation.

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.

Minimized irritation

Compounding the two can allow for more precise dosing, potentially reducing irritation associated with tretinoin alone.

What patients say about Miiskin

Very happy with this service. Quick and easy. With someone with not the greatest insurance and super busy. This was perfect. Got my prescription next day and great advice for my condition.

Marcus Liniarski,
Patient Review →

I had a great experience with Miiskin – I was able to get my prescription very quickly and their app is easy to use. It was very convenient and their team is very responsive. I highly recommend them and will likely use them in the future for other skin issues.

Susie Tse,
Patient Review →

What a technology! I was very impressed by the speed of communication with a doctor using the Miiskin app. Losing my hair has been my biggest concern, but I didn’t have the courage to reveal my bald spot to a doctor in person. Miiskin solved all my issues instantly. I just took a photo in my own room, uploaded it, and wrote about my concerns. That’s it. The best part is that without insurance, the consultation fee was much lower than any health insurance. I submitted my photo at midnight and received a prescription the very next morning. The doctor at Miiskin was very professional and empathetic, which really helped ease my emotional distress. Although I’m just at the beginning stage of my treatment and haven’t seen significant results yet, I feel reassured and supported. I will definitely upload my progress in 3 to 4 months to show my appreciation for the prescription from Miiskin.

Jiyeon Kang,
Patient Review →

My dermatologist was extremely quick, reviewed my consultation request within 2hrs and I had my Rx the next day! The Miiskin team also responds within minutes and are very polite and communicated concisely. I’ll never make a in person appointment again after experiencing this outstanding and affordable telehealth service!

Dion H,
Patient Review →

Quick response from the dermatologist — I wanted a fast turnaround for a skin concern that would be more immediate than going through health insurance, making an appointment, traveling to the doctor.

Timothy C.
Patient Review →

Warning, Side-effects and purging

Topical spironolactone and tretinoin cannot be used by pregnant women due to their teratogenic effects.

Side effects of spironolactone and tretinoin

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.
Increased sun sensitivity: Tretinoin makes the skin more susceptible to sunburn, so daily sunscreen use is essential.
Purging: Tretinoin can lead to an initial “purging” phase where existing clogged pores are brought to the surface, causing a temporary increase in breakouts.
Potential allergic reaction: Although rare, some people may experience an allergic reaction, with symptoms like itching, swelling, or severe redness.

How to use your customized formula of topical spironolactone + tretinoin?

You should always follow the instructions of your healthcare provider, however, as a general rule, if you have never used a formula of tretinoin + topical spironolactone, here is a good way to start. Start every other night to build tolerance, avoid other strong active ingredients, and be patient as results may take 8–12 weeks.

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, as tretinoin increases sun sensitivity.

It is also important to find a balance that is right for you. Your skin may not tolerate the application of tretinoin + topical spironolactone every day even after weeks of use and you may notice that your skin improves by applying topical spironolactone every other day instead of daily.

What ingredients can be combined with topical spironolactone + tretinoin?

Sunscreen SPF 50
Hyaluronic acid
Non-greasy moisturizer
Azelaic acid

Niacinamide
Peptides
Trifarotene
Ceramides

What ingredients should not be combined with topical spironolactone + tretinoin?

Other retinoids
Alcohol-based toners
Benzoyl peroxide

Physical exfoliants
Exfoliating acids (AHAs/BHAs)

*Remember that whenever skin irritating products are combined, it is better to do so under medical supervision.

Request a topical spironolactone + tretinoin prescription 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 Skin Medicinals

Got more questions about getting a topical spironolactone prescription for acne?

Can men use topical spironolactone for acne?

Yes, men can use topical spironolactone for acne. Since it is applied directly to the skin, it generally has minimal systemic absorption and therefore does not significantly impact hormone levels throughout the body. Topical spironolactone can be effective for treating acne by reducing local oil production, and it is an option for men who want to avoid potential side effects associated with oral spironolactone.

Can spironolactone be applied topically?

Yes, spironolactone can be formulated as a topical treatment. It is often used in this form to help reduce oil production and treat hormonal acne, especially in individuals who cannot or prefer not to take it orally.

Does topical spironolactone work as well as oral for acne?

Topical spironolactone can be effective for mild to moderate acne, but it typically does not work as strongly as oral spironolactone, which affects hormone levels systemically and thus can have a more pronounced effect on severe hormonal acne.

Can I buy topical spironolactone for acne?

Topical spironolactone is not typically available over the counter and usually requires a prescription. Some compounding pharmacies can create it if prescribed by a dermatologist.

Can dermatologists prescribe topical spironolactone for acne?

Yes, dermatologists can prescribe topical spironolactone. They will send a prescription for your customized formula to a compounding pharmacy so you can get it.

Does topical spironolactone cause facial hair growth?

No, topical spironolactone does not cause facial hair growth; in fact, spironolactone can help reduce unwanted hair growth by blocking androgen receptors, which is sometimes a reason for its prescription in certain cases of hirsutism.

How long does it take to see results from topical spironolactone for acne?

Results from topical spironolactone can typically take about 8 to 12 weeks, similar to many other acne treatments, as it gradually reduces oil production and inflammation in the skin.

Does topical spironolactone mess with hormones?

Topical spironolactone has minimal effects on hormone levels because it acts locally rather than systemically. It primarily blocks androgen receptors in the skin without significantly altering hormonal balance in the body.

What is Miiskin?

Miiskin is platform that connects patients with independent providers for convenient quality medical care for skin health issues.

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/