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Spironolactone For Acne – Is Spironolactone a Safe Acne Treatment?

by Christine GlasgowNovember 22, 2016

Spironolactone as an Acne Treatment – What’s It All About?

Acne is never something anyone wants to deal with even occasionally if they can avoid it. Even just a few pimples can be both unpleasant to look at (although it does tend to look much worse to those suffering from it than it does to others) and self-confidence sapping.

Severe, persistent acne can be even worse though. Where the odd pimple or to can usually be handled with one of the many natural or over the counter acne treatment products out there severe recurring acne often has a deeper cause – sometimes very much hormonal – and therefore does not respond very well to standard treatments. It is in these cases that many people seek out some formal medical advice.


Acne as a Bona Fide Medical Problem 

People who are lucky enough to have made it through life with little more than the occasional blemish often find it hard to see why severe acne can be so distressing to deal with. Often their attitude to an acquaintance’s acne woes is to suggest they stop being quite so vain, go buy a good concealer and suck it up, there are a lot worse things that can happen in life.

While acne sufferers do know that yes, a lot worse could happen to them that does not make dealing with severe acne any easier. The mental toll can be worse than the physical one. Yes, the pimples go away eventually but more pop up in their place. Make up can only serve as a mask – and often a not very convincing one anyway –  and so a dip in self-confidence, and often a big one, can be almost inevitable.

Medical science does consider acne to be a bona fide medical disorder though and therefore allows for prescription medications to be advised in cases where acne really is becoming a big problem. Therefore, a visit to a dermatologist really isn’t vanity, it’s as sensible in most cases seeing your general practitioner for the flu.


Acne and Medications:  A Brief History 

The idea of using medications to treat acne is not new. It hasn’t always been that safe – for example, in the 1920s small doses of arsenic were prescribed for persistent pimples – but these days things are a lot better, although certainly not controversy free.

For decades now one common medication prescribed to treat hormonal acne – which is most common in younger women – has been the birth control pill. There is also a well-known acne med called Accutane that has been in common use for a number of years now too.

However, both solutions come along with problems. Birth control pills have now had some hormone levels reduced due to fears over pulmonary embolisms and while they are still ‘strong’ enough to prevent pregnancy their effectiveness against acne has diminished.

Accutane – scientifically known as isotretinoin- is even more controversial, having been linked to severe birth defects when used by pregnant women, the development of the serious bowel disorder Crohn’s Disease and the onset of depression.

So many complaints were received that the FDA issued a ‘black box warning’ on the drug in 2009, leading to the original manufacturer, Roche, discontinuing the drug. Generic versions are still available but it is the rare doctor who will take the risk of prescribing it these days.


Spironolactone as an Acne Treatment — Is it Safe?

Despite the problems with acne medications people still seek them, they still want a solution to what can be a very distressing disorder. So, medical science and medical practitioners still look for one. One of the newest acne solutions has been to take an older medication – spironolactone – and prescribe it to those suffering from severe acne, especially women suffering from adult acne.


What is Spironolactone?

Spironolactone, which has been around for over 50 years, is a medication that was originally designed to treat high blood pressure, congestive heart failure and other conditions that cause the body to retain fluid to dangerous levels. It is basically a strong diuretic and many people rely on it to help keep them healthy in a chronic disease situation.

The use of spironolactone to treat acne is what is known as an ‘off label’ use. This means that the FDA – who govern the use of all drugs in the US – and its counterparts elsewhere in the world have not formally acknowledged that a drug should be used for a certain purpose for which it was not designed but there is enough medical evidence to suggest it could be fairly safely.

Off label drug use is not illegal and it is far from uncommon. Accutane, for example, was originally created as an anti-nausea drug for chemotherapy patients. Because the governing drug bodies have not formally approved the use it is considered to be risky, however many drugs are used for off label purposes successfully all the time.


Why Does Medical Science Think Spironolactone Can Treat Acne?

We should begin here by saying no one has ever suggested that Spironolactone can or should be used as a general acne remedy. It is only believed to be effective in cases of adult onset acne in women that have a hormonal element that means acne is not responding to more conservative and conventional topical acne treatments.

Spironolactone is an anti-androgen. Androgens stimulate the production of oil from the oil glands and sometimes even alter the hair follicles in women especially. It is therefore assumed that by limiting androgen production overactive oil glands can be ‘slowed down’ and the instance of hormonal acne in adult women reduced.


Spironolactone Acne Treatment Success Rates 

An increasing number of peer reviewed studies have suggested that using spironolactone to treat acne in the situations we have described have been promising, especially in women in their twenties and thirties.


Spironolactone Side Effects

It is very rare that you find a prescription medication that does not come along without any side effects at all and that is true of spironolactone. The most common include:

  • Lowered blood pressure
  • Potassium deficiency
  • Drowsiness
  • Dizziness
  • Lightheadedness
  • Diarrhea
  • Increased urination
  • Dehydration
  • Nausea
  • Vomiting
  • Headache

Because none of these side effects are very pleasant, and some, like lowered blood pressure and potassium deficiency, can become serious health problems, the use of the drug needs to be very carefully monitored by the prescribing doctor and patients need to be diligent enough to report it right away if they do begin to suffer from these ill effects.


Should You Consider Spironolactone for Acne?

This really is a question that only your doctor can answer. As we have outlined Spironolactone has only shown to be useful in certain situations and it will take careful consideration before your doctor even suggests the idea at all in most cases.

However, even if your doctor does mention the idea it is still one that you should give some very careful consideration. Prescription medications of any kind are no joke and as you can see, the side effects on this one, if they were to affect you, might be harder to deal with than the original problem – the acne – itself. Once your doctor has suggested the drug might help it is a personal decision from there.

Now we’d like to hear from you. Have you tried spironolactone for acne? Would you consider it? How do you feel about taking prescription medications for acne in general? Get in touch, we’d love to hear your opinion.

Christine Glasgow
Canadian girl addicted to beauty and fashion. I'm a Blogger, Entrepreneur and web influencer 👑 I mostly talk about anything related to skin care and beauty. I created this site to share science-based information on skin conditions, treatments and skin care.

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