How Long Until Results from Spironolactone (Aldactone) Can Be Seen and when will the Skin Start to Clear Up?

As with most acne medications, patience is key.  I typically see results from spironolactone in two months, but it can take longer to get the full effect.  

Typically one can start to see improvement in their acne after being on spironolactone for 2 months with optimal results being seen around 3 to 5 months out. I usually put my spironolactone patients on an oral contraceptive (if not already on one) to avoid symptoms like irregular menses. Additionally, I will add topical treatments to the regimen as the combination of spironolactone with topicals is more effective. It is important that your potassium level is checked every 6 months while on spironolactone as it can effect the potassium levels. 

I will typically combine spironolactone with an oral contraceptive to reduce breakthrough bleeding, and I'll add topical therapy for a faster response. If only using spironolactone, then you should see some improvement by 2 months, and ideally wait 3-4 months for more optimal results. Dr. Benjamin Barankin, Toronto Dermatology Centre.