Using Spironolactone as an Acne Treatment
Spironolactone (also known by its brand name Aldactone), is a prescription diuretic that was first approved by the FDA in 1985. Its primary purpose is the treatment of hyperaldosteronism (elevated levels of the steroid hormone aldosterone), hypertension, edema (fluid retention resulting from various conditions), and potassium deficiency.
However, spironolactone has been noted to provide relief from hormonal acne, even in stubborn cases that have not responded well to other forms of treatment. This application is what is known as an “off-label” treatment, meaning that spironolactone has not been specifically approved for the treatment of acne. Nonetheless, many women find that spironolactone (sometimes referred to as “spiro”) yields very positive results for their skin. It does, however, come with some potential side effects and risks, so it is best to be well educated before trying this drug.
It is a good idea to consider more conventional treatments that come with a lower risk of side effects before resorting to a systemic or hormonal treatment like spironolactone. You may want to read through some acne treatment reviews on Facing Acne, so you can examine the products that are on the market and see if one of them is likely to work for you. If you haven’t experienced any luck with these, however, read on below to find out more about spironolactone.
How Spironolactone Works
First things first: spironolactone is only for women. It works primarily by blocking certain androgen hormones (those responsible for male characteristics). Heightened levels of androgen hormones are linked to excessive sebum production, which leads to acne. Men who have taken spiro have experienced bad side effects related to the suppression of androgen hormones, including gynecomastia, loss of libido, and erectile dysfunction. For this same reason, pregnant women cannot take spiro, as it can feminize a male fetus in the womb (it is also generally considered unsafe for women who are breastfeeding).
Because spiro is a hormonal treatment, it will only work for certain cases. If you have been diagnosed with hyperandrogenemia (elevated levels of androgen hormones), there is a good chance that spiro will help alleviate any acne related to that condition. Women with adult onset acne (especially acne that appears after the age of 25), persistent acne that has resisted other treatment modalities, acne that flares up around menstrual periods, or acne that is predominantly distributed around the jawline, lower face and neck may also be good candidates for spiro, since these are classic signs of hormonal acne.
Side Effects and Risks
Spironolactone comes with a mandatory black box warning about the risk of cancer. This is based on decades-old experiments where high doses of spiro (several hundred times more per body weight than would be given to a human) were found to cause tumors in rats. Follow up studies have shown no indication of an elevated cancer risk in humans taking spiro.
Nonetheless, there are some other significant known risks to taking spironolactone. As stated before, it is unsafe for men and pregnant or nursing women. It also can have the effect of raising potassium levels, so it cannot be taken in conjunction with other potassium elevating drugs or supplements containing potassium, and even high potassium foods (like bananas, potatoes, artichokes, and tomatoes, among others) must be limited. Periodic blood tests must be performed to check certain markers like potassium levels, renal function, and electrolytes.
As with any prescription drug, there are some less dangerous but nonetheless occasionally unpleasant side effects to consider as well. Some women who take spiro experience menstrual irregularities (due to the hormonal effects of the drug), diuresis, headaches, and stomach or breast pain, among others.
Spironolactone has an impressive track record in treating hormonal acne that has proven resistant to other types of treatment. Its side effects and potential health risks are probably the only things keeping it from mainstream use. Most dermatologists see it as an alternative treatment to be considered only when more traditional methods have been tried and found unsatisfactory. For a certain subset of female acne sufferers, however, Spiro provides very impressive results. The positives and negatives must be weighed, and of course, each individual case presents its own unique factors regarding health, lifestyle, and treatment history.