Treating Acne with Spironolactone

Published June 22nd, 2021 by Chris Riley
Fact Checked by
Camille Freking
Medically Reviewed:
Erik Rivera

Acne is a common skin condition that affects adolescents to adults. But when your acne doesn’t respond to typical treatments, your dermatologist may prescribe a medication called spironolactone. Turns out spironolactone is an effective treatment for stubborn hormonal-induced acne in women. Keep reading to find out what spironolactone is, how it works to clear up acne, side effects with treatment, and where you can get it.

What is spironolactone?

Spironolactone is a well-known cardiovascular drug to treat high blood pressure, heart failure, and fluid retention. It does this by acting as a diuretic which helps remove excess water from the body, and it can lower blood pressure too. Off-label, doctors found it helped women with hormonally induced acne when other acne treatments failed.

For acne, the spironolactone is taken in pill form rather than applied to the skin like other acne-fighting products.

Spironolactone works by regulating hormones that cause inflammation so it’s helpful for women who have acne caused by hormonal fluctuations. The drug prevents excess production of oil from those glands and reduces the number of inflammatory cells in pores to help clear up acne breakouts.

Some women take spironolactone orally to treat severe cases of hirsutism, or excessive hair growth.

How does spironolactone work on acne? 

Acne is a common skin condition that affects everyone from teens to adults. There are hundreds of different treatments on the market targeting acne. Acne occurs when your hair follicles become clogged with dead skin cells or oil from the skin and manifest in the form of pimples, whiteheads, and blackheads. When typical treatments aren’t working, doctors may prescribe spironolactone to step in.

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Spironolactone works by regulating a hormone called androgen that causes glands in your skin to overproduce oil called sebum. Too much sebum can clog pores and cause acne. Spironolactone works as a synthetic anti-androgen drug, meaning it has properties in common with male hormones and blocks their effects on skin cells. The medication can slow down how fast your body produces androgen, which can slow down acne breakouts.

Your doctor may prescribe oral spironolactone for acne when you have tried other topical treatments and medications. It’s best used in combination with other topical treatments and oral contraceptives.

What are the side effects of spironolactone?

There are some common side effects that may occur when using this medication. With low-dose spironolactone, these include: 

  • Dizziness 
  • Nausea
  • Vomiting
  • Bloating 
  • Low blood pressure 
  • Headache 
  • Changes in your menstrual cycle 
  • Breast tenderness 
  • Edema (swelling) of the hands, feet, or both 

The less common side effects include:

  • Fatigue 
  • Hyponatremia (too much sodium in your body) 

Other possible adverse reactions from spironolactone are rare but can also happen with this medication. These include:

  • Anaphylaxis (significant allergic reaction)
  • Stevens-Johnson syndrome (a painful skin disorder resulting from a serious reaction to medication) 
  • Inflammation of pancreas cells which then leads to pancreatitis
  • Sexual dysfunction for males
  • Fainting spells due to low blood pressure when standing suddenly after sitting or lying down too long

These conditions may happen more often when taking spironolactone with other drugs to treat high blood pressure (antihypertensive medications), or when taken in higher doses, for a longer period of time.

Spironolactone is not recommended for women who are pregnant or breastfeeding without first consulting a medical professional due to potential harm it could do to an unborn fetus or nursing baby. There have been no reports of birth defects observed in infants whose mothers took spironolactone during pregnancy.

Adverse reactions that you may experience can diminish over time when the medication is stopped. You should talk with your physician about any symptoms you have while taking this drug so your doctor may be able to provide additional help and treatment options.

Further considerations before taking spironolactone

Doctors prescribe spironolactone as a last line of defense when other treatments have failed. First, you may want to try other topical treatments that may be more effective than spironolactone. There are other acne suppressants available such as antibiotics, retinoids (including tretinoin), and anti-androgens (including flutamide and cyproterone acetate) that are more potent than spironolactone, but they can have serious side effects.

How do I get spironolactone?

Spironolactone is most often available as the drug spironolactone (its generic form) or under the name Aldactone in 50 to 100 mg tablets. It's prescribed by a physician and is typically taken daily for the treatment of acne or other conditions that might be improved with its use, such as heart failure or high blood pressure.


Best places to buy spironolactone

Spironolactone is available in pharmacies across the United States, such as Walgreens or CVS.

Be sure to make your way over to to see if you are eligible for up to 80% off of your prescriptions, including spironolactone, at over 33,000 pharmacies in the USA today!


Spironolactone, a medication to treat cardiovascular problems, has emerged as a last line of defense to treat acne in women with a hormonal imbalance. Oftentimes, it is taken in conjunction with other topical medications to help eliminate acne. It is a powerful medication with some side effects that should only be taken under the supervision of your doctor. 


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