Is Spironolactone a Safe Acne Treatment?

I am a 20 yo female who has been dealing with mild-moderate acne for about 7 mnths now. Before this year, I never struggled with skin problems. Differin has cleared the closed comedones on my forehead, but I am still getting wkly inflamed, cystic bumps (typically) around my mouth and along my jawline. I also use Aczone on my chin, and have been off and on Yaz for the past 3.5 yrs. I've been taking Spiro for 3 weeks now, 25 mg the 1st 2 wks and 50 mg this past wk. I have also stopped eating dairy.

Doctor Answers 8

Yes, but don't eat too many bananas...why? Read more....

Yes, spironolactone is a super safe, and effective drug to treat female hormonal acne. It is especially useful in the 'adult female jawline acne' setting. 

Things you need to know about this treatment-

1. Only used in women
2. Best for hormonal acne
3. Works as an anti-androgen or hormone blocker
4. May take up to 3 months to work
5. May experience dizziness as drops blood pressure (v rare)
6. May urinate a litte more as it is a diuretic 
7. Dont eat too many bananas as it can increase potassium levels- get this checked frequently. 

One of my favourite treatments for acne!


Dr Davin Lim 
Laser and cosmetic dermatologist

Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Spironolactone safety in the treatment of adult female acne

Spironolactone can be an excellent choice in the treatment of acne in women.  As it blocks male hormone receptors, it is not used in men.  It is generally a safe choice when prescribed under the care of a knowledgeable professional.  That being said, all medications, including spironolactone, can have potential side effects.  Firstly, don't get pregnant while on this medication as it can cause feminization of a male baby.  It is a diuretic, meaning it make one urinate, so frequent urination, dehydration and dizziness may result.  This can be managed.  Although studies do not support an association with breast cancer, as it affects sex hormones, like the birth control pill, we stay mindful of the family history.  Spironolactone was originally used as a blood pressure medication and one of the reported side effects is retention of potassium in the body.  This is thought to have been more of an issue in the older people who used to take it for this problem rather than the younger, healthier people who take it for acne.  That being said, it is advised to not take excessive amounts of potassium while on this medication.  Sometimes potassium is monitored.

Dina D. Strachan, MD
New York Dermatologist
3.3 out of 5 stars 10 reviews

Spironolactone for acne

Spironolactone is a great treatment option for females with adult hormonal acne. It does take 3 months for it to work. You have to be careful not to eat too much bananas or coconut water. Sometimes, I add a Doxyccline as well. Aczone is also a good compliment to Spironolactone. Overall, it is very safe. 

Ben Behnam, MD
Santa Monica Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Safety of Spironolactone

Hi! I love Spironolactone in women with adult acne. I think that it is a very effective and safe medication. As you are probably already aware, some common side effects include irregular menses, breast tenderness/enlargement and it may increase your potassium levels. We normally check a baseline potassium level with a repeat in 2-4 weeks just to make sure that everything is fine. Many people start worrying excessively about their potassium intake but I say to continue eating what you normally do on a daily basis. We watch you carefully when on this med. A few foods to not over consume are bananas, avocados, pistachios and other nuts, and beans. You need to be patient with the medication as it takes roughly 6-8 weeks before you start to see some improvement. Stick with it and you'll do great!

Stacy Chimento, MD
Miami Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Spironolactone is a safe and effective treatment for acne

Hi - Yes, Spironolactone is a safe and effective treatment for hormonally influenced acne, when taken under the care of a dermatologist.  Spironolactone works by blocking the androgen receptor, so that androgen (male hormone) cannot bind to the receptor and cause hormonal breakouts.  It is important to use contraception while taking Spironolactone, as it can cause birth defects if taken while pregnant.  Spironolactone generally takes 1-3 months to have a dramatic effect on hormonal acne, but can produce a great improvement of hormonal acne (often presenting as cysts on the lower face and chin) once it kicks in.


Eric Schweiger, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 13 reviews

Acne Treatment Regimen

Many females with what we call “hormonal” acne can benefit from taking spironolactone, if under the care of a board-certified dermatologist. When used like you are using, with appropriate topical agents, this can be an effective therapy. The biggest problem is ittakes several months, on average, for it to work well; therefore for many of us, this hampers our regular use of spironolactone. I would find an appropriate oral antibiotic if needed to use on a regular basis and then as needed.

I am also a big fan of a light source called Isolaz – this is a pulsed light treatment with an associated vacuum apparatus – and Isolaz is also an incredibly effective device to use in these situations.

But for you, this treatment regimen may be just fine.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Spironolactone is Safe And Effective for Certain Types of Acne

As spironolactone works by blocking the androgen receptor preventing androgen (hormone) from binding to its receptor and causing breakouts, it is very effective for the hormonal type of acne (typically lower third of the face).  It typically takes a few months to show its benefits so you need to keep with it. When prescribed by a dermatologist, and when monitored under the care of a dermatologist, spironolactone is safe.  

Channing R. Barnett, MD
New York Dermatologist
4.1 out of 5 stars 8 reviews

Spironolactone - safe and effective in young, healthy women

Spironolactone is a treatment of choice for hormonal acne (deeper acne of the jawline that worsens around the time of menses).  It can take a couple months to work, but you will notice your pimples are less frequent, more superficial, and shorter in duration.  

Spironolactone can increase your potassium, but it doesn't have this effect in young, healthy women.  I only get concerned if my patient goes not have normal kidney function (and the kidneys aren't clearing the potassium properly) or if my patient is taking other potassium-sparing medications (these are usually high blood pressure meds).

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.