I have a rash after starting Spironolactone. Should I continue? (Photo)

Question

Acne increasing slowly since Mirena (6th year on it). Started Clindamycin Phosphate gel April (no change in acne), doctor added Differin Gel 0.1% August (some clearing, no new breakouts), then added 50mg Spiro on November 1st. In 2nd week, slight itchy rash around mouth & nasolabial folds. Rash continues to worsen and spread slightly. Itchy, red, clear fluid from bumps in rash. Have avoided putting Differin gel on rash in case it would make it worse. Should I continue Spiro? What's going on?

John Louis Ratz, MD · Answer

A localized rash like you describe is probably not allergic in nature. If you would be allergic to the topical medicine, you should have the rash in all areas where the medication is being applied. An allergy to oral medicine would also have more widespread effect. Based on the location of this rash, it might be seborrheic dermatitis which can be treated with one of a number of topical medications. Your description of "clear fluid" suggests scratching or picking on the rash. I suggest seeing a good dermatologist for face to face evaluation and treatment.                                  jlr

Adrian M. Guevara, MD · Answer

Google perioral dermatitis.  Dermnetnz is a great resource.  That's an incredibly common problem.  Oral doxy or minocycline is you best option.  Spirono is not reliable nor are the usual acne topicals.  Go for the standard therapy.  Good luck.

I have a rash after starting Spironolactone. Should I continue? (Photo)

Answers (2)