Treating Acne With Aldactone (Spironolactone)

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.

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.

Possible Side Effects of Aldactone

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.

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:

• Topical retinoids
• Topical antibiotics
• Benzoyl peroxide
• A combination of these medications

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.