Does spironolactone taken with birth control cause the birth control not to work?

Spironolactone does NOT effect the efficacy of your birth control.  It does make your skin less sensitive to the hormones that cause hormonal acne. 

Both medications work well together to help control acne.  The spironolactone does not affect the ovaries or ovulation, and can't be used alone as a birth control method.  It is more specific to helping the oil glands be less sensitive to our natural testosterone and helps with excessive hair on the lower face in women, and hormonal acne.  The oral birth control pills do not really see or interact with the spironolactone, so you are not at higher risk of pregnancy by taking both.  We do recommend always using birth control while on spironolactone if you are of childbearing potential.
Please discuss them with your dermatologist who is an expert.
Thanks for your question!

Unlike antibiotics, there are no interactions between the pill and spironolactone. All safe. If you are planning pregnancy, talk to your dermatologist about coming off the spiro and onto a pregnancy safe acne prevention regime. All the best, Dr Davin Lim