Should You be Taking Spironolactone for Your Acne?

Will spiro be the trick to clearing up your acne?

Will spiro be the trick to clearing up your acne?

If you have problem skin, it’s important to understand that everyone’s skin is different and that there are many types of acne. Everything from your diet to your hormones and genetics will influence your skin. It stands to reason then, that there are a wide variety of medicines and solutions that can help you on your path to becoming acne free. Sometimes old remedies experience a surge in popularity. While dermatologists prescribing spironolactone for acne is nothing new, recently spironolactone prescriptions have been on the rise… again (even if it is prescribed off-label).

What is it?

Spironolactone, or as it is commonly called “spiro”, is a prescription diuretic. It prevents your body from absorbing too much salt and also ensures that your potassium levels don’t drop too low. In common terms, it’s basically a water pill that helps your body stay hydrated. It’s commonly used to treat high blood pressure and heart failure. Spironolactone is on the list of the world health organizations most important medicines and has been in wide use clinically since 1959. But now it’s becoming known for its use as an acne treatment.

Today, adult women make up a substantial portion of those seeking treatment for acne. Non-hormonal treatments are often not effective for adult acne and even more so for women. Even powerful, well-known treatments like oral isotretinoin fail to be as reliable in post-adolescent acne cases and antibiotic medications and treatments are becoming less effective. Because of its anti-androgen effects, it’s becoming a more commonly prescribed treatment to clear and help control, especially for acne suspected to be hormonal in nature. Plus it doesn’t add to the potential antibiotic resistance.

Is Spironolactone for Me?

Well if you are a women suffering from hormonal cyclical acne breakouts and have had trouble controlling your breakouts, then “spiro” may be for you. That’s right, spiro is only prescribed to women. That is because spiro is an androgen blocker. Androgens are responsible for a lot of masculine traits, including sebum production and body hair growth. Since spiro is an antiandrogen, it blocks these masculine traits. In fact, it is often used in hormone therapy for people trying to control their testosterone.

For women, there is an increased androgen production around a certain time of the month. When this happens, oil glands go into overactive state and produce too much oil. This overproduction of oil tends to cause breakouts, particularly around the jaw and chin line. This kind of cyclical acne can be especially painful and frustrating to deal with. Spironolactone has antiandrogenic effects that can help.

Spiro works to decrease your level of testosterone, which in turn decreases breakouts. While Spiro has been something of a miracle drug for many women who have struggled to get rid of cyclical hormone based acne, it’s by no means a miracle drug or recommended for everybody.

Using the Right Amount

While it may take more time than you'd like, spironolactone has been shown to completely clear skin in many cases.

While it may take more time than you’d like, spironolactone has been shown to completely clear skin in many cases.

Doses of spironolactone may range anywhere from 25 to 200mg daily when used for treating adult acne in women. Your doctor may also use it in combination with another form of treatment. In many cases, 50mg is plenty to be effective. Using 50 to 100mg daily can decrease sebum production by half, resulting in clearer skin. Studies show that the number of blemishes can also be cut in half or even completely cleared within three months. While these studies usually used a higher dosage of 100 to 200mg per day, they also note that many times, 50mg is enough to get results.

In one 10-month  study, 85 women participants used 50 to 100 mg per day. One third of them became completely acne free, while others seen partial and dramatic improvement. Most had no side effects.

Why Spironolactone May Not be for You

As stated earlier, Spironolactone is a hormone blocker and can have many of the same negatives for women who are sensitive to the pill. Another downside is it doesn’t exactly work quickly. In fact, it usually takes about three months to see any effect. Also Spiro is not for you if you love bananas or coconut water. It increases your potassium levels, at times drastically, so it’s important to not consume too much potassium in your diet. It’s also important to get your potassium levels checked regularly.

Note: The FDA requires the labeling of spironolactone to include a black-box warning on the label saying it shouldn’t be used if not completely necessary. It basically warns of tumors and cancer. However, the evidence for this warning came from early studies that used extremely high doses of spironolactone, up to 500 times higher than what you would ever find prescribed in any normal circumstance. Newer case-controlled studies and research has not been able to provide proof that there’s a direct link between spironolactone and cancer.

Other side effects include breast sensitivity and enlargement of your breasts. Also common is frequent urination, and in very rare cases dizziness with a drop in blood pressure. So take all of these factors into consideration when deciding if spiro is right for you. If not, there are still many other topical options to consider like Proactive or Exposed Skin Care.

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