Is 25mg spironolactone effective for hormonal acne?

Question

I take 50 mg and have had incredible results with my skin however I am tired and as a runner, notice I lack the endurance I had before. Wondering if anyone has experience with 25mg and whether it may have any effect on the fatigue and still work for the acne.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about Spironolactone. The lowest recommended does for Spironolactone to treat hormonal acne is 50mg.  I would encourage you to speak to your healthcare provider to see if 25mg would be appropriate and have less side effects for you.One safe and easy treatment we recommend to all of our patients are our Koji Pads.  Kojic acid along with Arbutase work well for brightening the skin and preventing blemishes.
To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

Melissa Chiang, MD, FAAD · Answer

If you are doing well on 50 mg, you can halve your dose to 25 mg and see if your acne remains under control.  This is a question that can only be answered by "trial and error."

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  The dose that works for each patient varies, and I think you should go ahead and try reducing the dose to 25mg daily.  Some of my patients take 25mg daily as maintenance, and increase the dose to 50 or even 100mg daily if flaring, then go back to their "maintenance" dose.  It should be fine to change the dose now and then as long as you don't overdo it.  I hope this helps with your energy and keeps your acne at bay!

Is 25mg spironolactone effective for hormonal acne?

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