Treating Acne With Aldactone (Spironolactone)

An Acne Treatment for Women With Hormonal Acne

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Aldactone (spironolactone) is a medication used to treat many different disorders. This includes things like high blood pressure and fluid retention.

Aldactone is also used to treat hormonal acne in adult females.

People who break out around the time of their menstrual cycle may benefit from this drug. It can also be helpful for adult females who have acne with other problems like unwanted facial hair.

The Food and Drug Administration doesn't officially recognize Aldactone as an acne treatment. Still, it is often prescribed off-label for this purpose. It is only available by prescription.

This article discusses Aldactone as a treatment for hormonal acne. It also discusses how to take it and possible side effects.

How Aldactone Works

Aldactone is in a group of drugs called anti-androgens. Androgens are often thought of as male hormones, but both males and females have them.

Androgens like testosterone are present in the female body, but in lower levels. Still, some females produce more androgen hormones than needed.

Hormones, specifically androgens, have been linked to the development of acne. Aldactone works by blocking androgen receptors in the body. This stops cells from responding to androgen hormones.

Simply, Aldactone limits the hormonal fluctuations that can cause breakouts. It is therefore only effective against hormonal acne.

Some females get acne because of fluctuating hormones. These patients may have good results with Aldactone.

How Aldactone Is Used

Unlike most acne treatments, Aldactone isn't applied to the skin. Instead, it's taken orally. When Aldactone is used as an acne treatment, the most common dosage is between 50 and 100 milligrams (mg) daily.

Your dermatologist may start you on a lower dose. It is common to start at 25 mg daily and work up to a target dose over several weeks. Your healthcare provider will base the dosage on your personal situation.

If your breakouts only happen around the time of your menstrual cycle, you may only need Aldactone during the week before your period. This can help even out the hormone spikes that trigger acne.

Aldactone is often prescribed with oral contraceptives, or birth control pills. You will probably keep using topical acne medications while using Aldactone. It tends to work best alongside other acne treatments, rather than as the sole treatment.

Recap

Aldactone is taken orally. Most people start with a smaller dose and work up to the target dose.

You may only need to take Aldactone in the week before your period. It works best when used with other acne treatments.

Possible Side Effects of Aldactone

Possible side effects of aldactone
Verywell / Cindy Chung

Side effects of low-dose Aldactone aren't as common as with higher doses. When they do happen, they often include:

  • Irregular menstrual cycle
  • Breast tenderness

Other side effects can include:

  • Thirst or dry mouth
  • Stomach cramps, vomiting, and/or diarrhea
  • Headache
  • Dizziness
  • Increased blood potassium levels
  • Low blood pressure

Blood pressure should be checked periodically while taking this medication. For some women, blood potassium levels should also be checked. Women younger than 45 years old do not usually need to have potassium levels checked when taking Aldactone.

If Aldactone upsets your stomach, take it with a meal. Because Aldactone acts as a diuretic, it is also important to drink plenty of water.

Recap

Aldactone may cause side effects like breast tenderness and an irregular period. Some women may need to have their blood potassium levels checked regularly while using this drug.

Who Should Not Take Aldactone?

Aldactone is an acne treatment option for adult females only. It is not prescribed for males with acne or for young teens and tweens. You should not get pregnant while taking this drug.

Summary

Aldactone is sometimes prescribed to treat hormonal acne. It works by blocking androgen hormones. It is usually used alongside other acne treatments.

Aldactone is taken orally. It may have side effects like breast tenderness and irregular periods.

This drug is only for adult females. People who want to become pregnant or have a history of kidney problems or certain cancers should not take Aldactone.

A Word From Verywell

Aldactone isn't a first-line treatment for acne. Your dermatologist will probably have you try conventional acne medications first. This includes:

Your healthcare provider may prescribe Aldactone if your acne is hormonal and these medicines do not work well enough.

Try to be patient while waiting for results. It can take three to four months before you notice a big improvement in your skin. Do not give up on your treatments, and let your healthcare provider know about any side effects you may have.

Frequently Asked Questions

  • What are the side effects of spironolactone?

    Possible side effects of Aldactone (spironolactone) include an irregular menstrual cycle, breast tenderness, dry mouth, stomach cramps, vomiting and/or diarrhea, dizziness, headache, and low blood pressure. These side effects aren't as common with low doses.

  • Can spironolactone be used for weight loss?

    Spironolactone is a drug sometimes prescribed for weight loss, but it isn't considered an effective option. There are no scientific studies that have studied its effects on weight loss. It may remove some water weight from the body, but it does not directly cause fat loss.

  • How long does spironolactone take to work for acne?

    When using spironolactone, it can take three to four months before skin improvement becomes noticeable. Keep in mind that spironolactone works best when paired with other conventional acne treatments, such as topical retinoids, topical antibiotics, orbenzoyl peroxide.

  • Is spironolactone a diuretic?

    Yes, spironolactone is a diuretic. A diuretic increases the amount of urine that is produced and rids the body of salt and water faster than usual. This means that it's especially important to drink plenty of water when taking spironolactone.

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2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kim GK, Del Rosso JQ. Oral spironolactone in post-teenage female patients with acne vulgaris: practical considerations for the clinician based on current data and clinical experience. J Clin Aesthet Dermatol. 2012;5(3):37–50.

  2. Hassoun LA, Chahal DS, Sivamani RK, Larsen LN. The use of hormonal agents in the treatment of acne. Semin Cutan Med Surg. 2016;35(2):68-73. doi:10.12788/j.sder.2016.027

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