Spironolactone for Female Adult Acne/Excess Facial Hair, what would be the dosage?

Question

10 months post Accutane, I have minimal scars on my cheeks, some texture, and 20+ inflamed, painful pimples on the lower half of my face. Could spironolactone treat this (hormonal?) acne? What's the usual dosage and timeframe for visible improvement? Before Accutane, I started laser therapy for lip and chin hair that began after stopping Sprintec contraceptive; could spiro treat this? At what dosage? Currently using Obagi cleansers and benzoyl peroxide for 2 weeks, some improvement. Skyla IUD.

Tracy Leong, MD · Answer

Thank you for your question! Based on your description, it sounds like you fit the profile for hormonal acne. Usually for this condition, I start patients at 50 mg daily and increase until their acne is controlled. The highest dose I will prescribe is 150 mg daily. Sometimes it will take up to 3 months to start noticing a difference. If considering this medication, I recommend scheduling a consultation with a board-certified dermatologist who can help you decide if spironoalctone is right for you.I hope this answer is helpful! Best of luck.

Matthew Elias, DO, FAAD · Answer

Margot,  Thank you for your question.  Spironolactone is a very effective treatment for female hormonal acne since it has an effect on androgens it typically will also help with hair.  Typically, the dose is started low at around 25-50mg/day and titrated upwards based on effect and monthly bloodwork.  There is no definitive timeframe for how long to be on it, as well it takes time to work.    Other options include oral contraceptives and flutamide.  Regards, Dr. Matt Elias

SPIRONOLACTONE FOR ACNE PROVIDERS NEAR YOU

Spironolactone for Female Adult Acne/Excess Facial Hair, what would be the dosage?

Answers (2)

SPIRONOLACTONE FOR ACNE PROVIDERS NEAR YOU