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Spironolactone for Acne: Efficacy, Benefits, and Potential Side Effects

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If you’ve clicked on this article, you’re probably wondering: Does spironolactone for acne actually work? In short, yes. But before I extol the benefits of spironolactone, let me share a bit of my own acne journey. 

I’ve suffered from acne from a very young age. As a pre-teen, I was among the first of my classmates to experience breakouts, which was the start of my self-consciousness surrounding my skin. My acne followed me into high school, where I covered my pimples in caked-on makeup that I now know probably made my skin even worse. 

I tried every product I could—and even gave in to those Proactiv commercials—but nothing worked. So I visited a dermatologist and was prescribed tretinoin, which showed the slightest improvement. Still, it didn’t give me the significant results I was looking for. 

Fed up with my skin, I considered trying accutane. At the time, I was 17 and needed permission from my parents, who were against me undergoing the treatment. Annoyed at their refusal, I searched for an alternative and asked to be put on birth control pills after reading online and hearing from friends that it could improve my skin. My parents said yes as a compromise so I started the pill, which gave me the best results I’d seen so far. 

But even though my breakouts lessened, I would still get big, painful cystic acne forming angry red lumps on my face, particularly around my period. I realized that I suffered from hormonal acne, which my birth control unfortunately couldn’t tame. And my acne stayed this way into my early 20s—not as severe as those teen years, but still not good skin—until I officially joined the adult acne club. According to a study conducted by the National Library of Medicine, anywhere between 12% and 22% of women ages 26 through 44 experience acne. 

Now in my late twenties, I decided to get to the root of my acne once and for all and visited board-certified dermatologist Dr. Dhaval Bhanusali, MD, at Hudson Dermatology and Laser Surgery, who immediately prescribed me spironolactone. I’d heard about the benefits of the oral medication for years—a lot of fellow beauty editors swear by it—but was skeptical. 

However, after seven months on spironolactone my acne has pretty much disappeared—cysts and all. My skin has completely transformed and looks the best it’s ever been. Everyone in my life has noticed the change, from my family and friends to strangers who compliment my clear complexion. 

I still get a pimple or zit here and there—spironolactone is not a cure-all—and I’ve come to accept that acne will always be a part of my life. But it’s been demoted from main character to a mere footnote. 

My skin after four months of taking spironolactone.

Ready to try spironolactone, but not sure where to begin? You should speak with your doctor about whether the oral medication is right for you, but we asked Bhanusali and board-certified dermatologist and creator of skin-care blog Tea with MD, Dr. Joyce Park, MD, to answer some common questions. Ahead, your guide to spironolactone for acne. 

What is spironolactone and how does it work?

Spironolactone is an oral medication that can treat a few conditions, including blood pressure, hair loss, and acne. “Spironolactone is an oral medication used to lower blood pressure and also off-label to help with hormonal acne,” Bhanusali says. “It is also used to help with hair loss and Polycystic ovary syndrome (off-label).” 

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