Will I Receive an Initial Breakout from Sprinolactone?

Will I receive an initial breakout when I start Spriolactone for my hormonal acne? I have slightly elevated testosterone. My derm said no I won't. But I've read a ton of reviews and a bunch of women say they had a horrible breakout for 2 months! Why would it cause a breakout if it block androgens? I'm starting on 25mg twice a day.

Doctor Answers 1

Very unlikely

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You are very unlikely to see an initial breakout from initiation of spironolactone therapy.  Realize that with hormonal acne, you are dealing with a disease that has cyclical fluctuations, so there is certainly a possibility that you could have a cyclical flare before the spironolactone begins to benefit you, but the medication itself is not generally associated with a "worse before it gets better" phenomenon.

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