Manhattan Beach
Dermatology
2809 N. Sepulveda Blvd.,
Manhattan Beach, CA 90266
Phone: 310.802.8180 - FAX: 310.802.8150
Spironolactone (Aldactone) Therapy for Acne
Spironolactone is an oral treatment for adult acne in women. Spironolactone is especially
effective in post-adolescent female acne that is characterized by pimples and cysts
involving the neck, jawline, and/or chin and mouth area. This type of acne often flares
up monthly at the time of the patient’s menstrual period.
Spironolactone can be taken with other oral acne medications such as antibiotics and
birth control pills. It can also be used in conjunction with topical anti-acne treatments
such as Retin A, benzoyl peroxide, microdermabrasion, and skin peels and laser
treatments.
Spironolactone is effective in acne by blocking the body’s production of testosterone, a
male hormone that is present in small amounts in women. Adult women with acne have
an increased sensitivity to testosterone, which can cause oily skin, cysts, clogged pores,
facial hair growth, and thinning scalp hair.
The primary use of spironolactone is a diuretic (water pill) to cause the body to excrete
excess fluid and lower blood pressure. However, in the much lower doses prescribed for
acne, it is unlikely that you will experience side effects such as increased thirst or
urination that are typical with diuretics. In fact, this medication is usually very well
tolerated by patients. Rare side effects include irregular periods (this is usually not seen
if spironolactone is take with a birth control pill), breast tenderness, headache,
drowsiness, or nausea. Spironolactone should not be taken if you are pregnant or
nursing, or if you are planning on becoming pregnant soon.
While on spironolactone, you should notice decreased oiliness of your skin and decreased
acne breakouts within about a month. It may take a few months to see the full effect.
When treatment is initiated, you will be seen on a monthly basis as your dosage is
adjusted depending upon your response. Once your symptoms are under good control,
you will need to be seen once every 3 months for as long as you decide to take this
medication. If you decide to discontinue spironolactone, your acne symptoms will
usually recur within a few weeks or months as this medication is not a cure for acne.
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