Spironolactone for Acne Treatment

Spironolactone (Aldactone) is widely used to treat acne in women, particularly when acne are caused by hormonal imbalance. Hormonal-pattern acne are usually inflammatory papules, many deep-seated and tender, that are located predominantly on the lower half of the face and anterior-lateral neck region.

Spironolactone is especially helpful for women with hormonal disorders (over-production of androgens), with acne not responding to conventional treatments, or late-onset acne (past the teenage years).

How does Spironolactone work?

Spironolactone is a steroidal anti-androgen that lowers levels of the hormone androgen, which stimulates the skin’s oil glands. It reduces sebum production and comedone formation by decreasing the activity of sebaceous gland2.

Dosage range for acne is 25 to 200 mg daily. After a desired result has been achieved, maintenance dose typically ranges from 25 to 50 mg daily.

There are sufficient data1 to suggest that the long-term treatment of acne with spironolactone in women is safe and effective.

How long does it take for Spironolactone to help acne?

Decrease in skin oiliness and acne can be noted after 1 to 2 months. It usually takes about 4 months to see full results.

Spironolactone not only improves facial acne, but improves truncal acne as well.

Spironolactone with Birth Control Pills

Spironolactone can be used in combination with oral contraceptives to enhance therapeutic benefit for acne and to decrease menstrual-related side effects. Also, this synergistic combination may in some cases allow women with acne to be on a lower daily dose of spironolactone without a sacrifice in efficacy.

Caution should be taken when spironolactone is combined with drospirenone-containing pills, such as Yaz® or Yasmin®. Drospirenone is a 17-alpha spironolactone derivative with anti-mineralocorticoid activity, and a potassium-sparing diuretic effect. A 3 mg of drospirenone is equivalent to 25 mg of spironolactone.

In 2008 study3 the combination of spironolactone with Yasmin cleared severe papular or nodulocystic facial acne in 85% of women.

See also


  • 1. Shaw JC, White LE. Long-term safety of spironolactone in acne: results of an 8-year followup study. J Cutan Med Surg. 2002 Nov-Dec;6(6):541-5. PubMed
  • 2. Kim GK, Del Rosso JQ. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris: J Clin Aesthet Dermatol. 2012 Mar;5(3):37-50.
  • 3. Krunic A, Ciurea A, Scheman A. Efficacy and tolerance of acne treatment using both spironolactone and a combined contraceptive containing drospirenone. J Am Acad Dermatol. 2008 Jan;58(1):60-2.

Author: OriginalDrugs Team
Last reviewed: February, 2015

  • Adult acne is NOT the same as teenage acne, and does not usually respond to teen acne treatments.