Who Can Benefit From Spironolactone Treatment
Doctors tend to consider spironolactone for women who experience moderate to severe acne and havent seen an improvement in symptoms using birth control, antibiotics, or isotretinoin. If women want to avoid isotretinoin or Retin A, this is an alternative her doctor may recommend.
Clinically, spironolactone is most beneficial for women with cyclical acne that flares premenstrual or in the luteal phase and during menses and when acne is primarily distributed along the jawline.
Cyclical acne is indicative of a hormone imbalance and can be rooted in estrogen or testosterone excess. Typically, if acne is distributed along the jawline that points towards androgen excess or excess testosterone. Testing is the best way to determine your current hormone imbalance.
As I explain in this article on acne and in Beyond the Pill, hormonal birth control can deplete acne-preventing nutrients, mess with your gut flora, AND once you stop taking it, testosterone can flare up big time, making your acne worse. This is when some women may be prescribed Spironolactone to treat their acne.
Keep reading because well be reviewing spironolactone side effects you should be aware of.
Natural Alternatives To Spironolactone For Pms
If the idea of taking spironolactone or the pill to regulate PMS sounds a bit risky to you, read on. Ive got some other options for you to consider instead.
Many times, you can attribute PMS to excess estrogen circulating in the body. Its essential that if youre experiencing PMS symptoms that you address this problem. Here are some ways you can assist your body in getting rid of excess estrogen.
Which Treatment Is The Best For Hormonal Acne
So which treatment is best for hormonal acne, spironolactone or Accutane? Well, the answer isit depends. For some women, the response to spironolactone can be very good, often leading to completely clear skin. Because of its effectiveness, many women come to rely on spironolactone to maintain their clear complexion for extended periods of time. Remember, spironolactone was originally developed as a blood pressure medication so there is precedent for taking it for a very long time. Also, since the side effect profile for spironolactone is fairly mild relative to Accutane, many women prefer to use it as their initial treatment of choice.
However, spironolactone isnt always effective for every woman who takes it. Also, the need to continue to take it in order to maintain its effects is a turn-off for many women who prefer a more definitive treatment that has a defined endpoint. For these women, Accutane is more appealing. In addition, for women who start with spironolactone and do not experience satisfactory results, they often transition to Accutane as their treatment of last resort.
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Some Important Points To Consider If You Are Thinking About Taking Spironolactone For Acne:
- Spironolactone does not work for everyone but helps at 65% of women with hormonal acne . It is not possible to predict who may benefit and who may not.
- Some women may clear completely with Spironolactone. In other women, Spironolactone may reduce the rate of acne but not clear it completely. This means you may still need other acne treatments while taking Spironolactone.
- Spironolactone can take 3 to 6 months to have its full effects. Waiting for the results can be very frustrating.
- Spironolactone only works while you are taking it. This means your acne may come back when you stop. Women may be on Spironolactone for 1 or 2 years or sometimes for several years.
- Spironolactone can cause side effects. About 1 in 20 of women may need to reduce or come off Spironolactone because of side effects .
What Is Topical Spironolactone
Now, let’s get into the topical version of the medication. While oral spironolactone works to stop hormonal acne from the inside, topical spironolactone is meant to treat the presenting hormonal acne on the outside. “Topical spironolactone is the topical formulation that is mainly used for acne that has a hormonal contribution,” Dr. Rossi says. “It has shown good results for hormonal-induced acne and doesn’t have the same effect profile as oral spironolactone in terms of blood pressure or potassium levels.”
Plus, while oral spironolactone is not typically prescribed for men because it affects testosterone , topical spironolactone does not have the same hormonal side effects and can be used by men. One study showed that the use of five percent topical spironolactone cream seemed to be an effective and safe acne treatment for both men and women patients.
Because it’s still a prescription medication, it doesn’t come without side effects. These can include skin sensitivity, which can materialize in the form of redness, peeling, stinging, or itching in the areas where the medicine has been applied. To avoid experiencing these side effects, it’s recommended that you ease into the treatment as well as cut out any other products in your skin-care routine that may be overdrying to the skin.
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Pcos Treatment And Spironolactone
In addition to being a diuretic, spironolactone is also considered an anti-androgen and reduces testosterone. For this reason, many doctors prescribe it for Polycystic Ovarian Syndrome .
But note that Metformin is used to treat pre-diabetes and diabetes and does not work the same way as Spironolactone does. So they are not interchangeable when being used for the FDA approved conditions these medications treat. Were talking strictly acne here.
Are There Dietary Concerns When Taking Spironolactone
The most important thing is to follow your prescribing medical providers instructions about diet. In general, people taking spironolactone should avoid excess potassium, which can be found in foods like:
Your Curology provider can work with you to figure out which of these medications are the best ones for you.
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How Long Do Most Patients Take Hormonal Treatments
When hormonal therapy helps to clear acne, a patient may stay on it for a long time. You will often stop other acne treatments such as an antibiotic and medication that you apply to your skin. Hormonal therapy can be used alone to prevent new breakouts.
Taking hormonal therapy long term appears to be safe.
Studies show that taking spironolactone at the same time every day can give you the best results.
How Does Spironolactone Fit Into A Routine
While Spironolactone is amazing, it is just one piece of the acne puzzle. No medication was ever meant to be used as monotherapy, explains Dr. Marchbein. She, along with Dr. Karp, recommends taking Spiro in conjunction with a birth control billits the most effective way to target hormonal acne. If you also experience whiteheads and blackheads, chances are your doctor will recommend incorporating a benzoyl peroxide, retinoid, salicylic acid, or prescription topical into your routine.
The medication doesnt need to be taken with food and, depending how much youre on, it will either be taken in the evening, or the mornings and the evenings. Just remember not to skip a day. This is a pill that has to be taken every day or it does not work, emphasizes Dr. Marchbein. I have many, many patients who will skip a day by accident and they get a cyst. It is temporarily suppressing your hormones, it’s not accumulating or building up in your system. So if you do not take it for a day or two, it doesn’t work and you’re probably going to break out.
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Side Effects From Spironolactone Include:
- There may be a flare in acne which occurs in about 5% of people.
- Passing urine more frequently for the first few weeks 29%. This settles within a month.
- Menstrual irregularities either heavy menstrual cycles, irregularity in cycles, spotting, discomfort or amenorrhoea 22%. Sometimes it is necessary to add the combined oral contraceptive pill to help these side effects.
- Breast tenderness 17%
- Elevated potassium levels in the blood 0.75%-2% for those under 45 years of age. The rate may be as high as 16% for women who are over 46 years of age.
- Reduced kidney function
- Reduced sodium levels in the blood
- Feminisation of a male baby it is important to avoid pregnancy while on Spironolactone as it can cause a male baby to become feminised by blocking androgens
- Theoretical risk of cancers with very long term use At the doses used for medicinal reasons, Spironolactone has not been associated with cancer. Animal studies in which 150 times the dose used in humans found that there were increased benign and malignant tumours. This does not appear to be relevant for the doses used for acne.
What Are Potential Side Effects To Taking Spironolactone
There are a few side effects to keep in mind when taking spironolactone, which is why everyone should consult with their doctor first. Spironolactone is a diuretic, so patients may experienced increased urination,” says Park. “It can also cause irregularities with your period, spotting, breast tenderness, and headaches. Spironolactone can also cause higher potassium levels, which is why you need to let your doctor know if you have heart or kidney problems to start. Lastly, spironolactone can cause birth defects in babies, so you must be on some form of birth control.
It can also effect your blood pressure. Given that it is used as a blood pressure medication, patients who tend to run low need to be careful,” Bhanusali says. “Dizziness and light headedness can occur and we always encourage adequate hydration, since the medication increases urination. There is a black box warning, previously shown to cause tumors in rats, but has been shown safe in humans and is used in pretty much every dermatology office in the country.”
As I’ve used spironolactone, I’ve experienced increased urination, breast tenderness, an irregular period, and nausea.
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S To Eliminate Hormonal Acne Naturally At Home
In this section, were going to look at how to use your diet, lifestyle and skin care routine to start clearing up your skin quickly.
If your acne is really severe, its best to follow all of these steps.
However, you can start with whichever ones make the most sense for you and add on others as time goes by.
Spironolactone Is Hormonal Therapy
First, it is important to know that spironolactone falls into the hormonal therapy category and is mainly used to treat hormonal acne. It works like this: your body contains sex hormones called androgens. Androgens bind to androgen receptors, such as oil glands, which then secrete hormones, according to SingleCare. Spironolactone blocks androgens from making that connection, thus reducing and preventing oil production, an excess of which can lead to acne.
Spironolactone is not advised as a treatment option for males because it decreases testosterone levels, per GoodRx, and because males have too many androgens for the medication to block successfully . However, it can be used as part of gender-affirming hormone therapy for trans women.
For those who use a hormonal IUD as birth control, keep in mind that androgens love progestin, which is synthetic progesterone released by the IUD and could be contributing to your acne . Alternatively, many birth control pills contain a mixture of estrogen and progestin hormones, which can combat acne by reducing testosterone levels.
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Are There Any Common Side Effects From Taking Spironolactone
Side effects will vary from patient to patient. However, overall, the side effects of Spironolactone are mild. Spironolactone is a diuretic and may increase urination urge and frequency.
Some patients may experience mild dizziness, lightheadedness, breast tenderness, and irregular menstruation. “Whenever prescribing Spironolactone to a patient, I typically start with a low dose and moderately increase their dose through if needed,” mentions Dr. Villacorta. “Some patients may respond to the medication best with simultaneous use of birth control pills. It is also important to note that you should not take Spironolactone while pregnant or trying to become pregnant. Sexually active patients may benefit from pairing birth control with the drug.
Spironolactone is an effective short-term solution for women experiencing moderate-severe hormonal acne. This is especially true if you have had trouble finding or sticking to a targeted skincare routine. As always, it is best to consult with your dermatologist , to understand if using Spironolactone is right for you.
Have you been considering Spironolactone for your hormonal acne? Contact Galt Dermatology to schedule your New Patient Appointment with Dr. Villacorta – one of Fort Lauderdale’s most-sought, trusted, and highest-reviewed Board-Certified dermatologists. For Patient Testimonials, please click the link provided here.
Here’s Everything You Need To Know About Spironolactone
Medically reviewed by Aimee Paik, MD
When it comes to battling hormonal acne, believe me when I say Ive been there. Ive shot out of bed in the morning, headed straight to the mirror, and inspected my chin to see if any of my painful, cystic pimples have gone down . Ive taken my foundation everywhere I go, in case I need to touch up a caking spot on my face midday. Ive gone down the path of vitamin supplements and acne-fighting foods in an attempt to heal my hormones naturally. Ive been there, and I know how debilitating hormonal acne can be in your everyday life.
If you feel like youve tried every acne-fighting topical to try and treat those painful, inflamed pimples, it might be time to talk to your doctor about trying an oral medication called spironolactone. Previously used as a blood pressure medication, spironolactone is the latest treatment being used to balance hormones and calm inflammation without too many side effects.
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How Effective Is Spironolactone For Hormonal Acne
Women may see an improvement in their acne and less oily skin in a few weeks since spironolactone blocks testosterone receptors and inhibits your body from making androgens.
That said, there is limited research evidence to support spironolactone for acne. A systematic review in 2017 found that there is not enough high-quality evidence of the potential effectiveness of spironolactone at present. More research with larger sample sizes and double-blind procedures are recommended.
Given the limited research support, its essential to consult your doctor or dermatologist to determine if spironolactone is the right treatment approach for you. As with many acne treatments, results tend to vary from person to person.
Spironolactone Pcos Side Effects
While spironolactone can be a great relief for some women, others are unable to handle the side effects like headaches or increased anxiety that accompany the use of the medication.
Spironolactone side effects in women with PCOS may include:
- Heart palpitations
- Low electrolytes
Plus, since most doctors require that patients take hormonal birth control while on spironolactone, this can be a potentially dangerous situation for women with PCOS. With spironolactone and oral contraceptives treating some symptoms, the inflammation and insulin resistance that are at the heart of this condition can continue to develop putting you at further risk of developing heart disease and diabetes.
Furthermore, spironolactone can increase blood sugar levels in some patients.
For this reason, I recommend that patients consider a more natural, root-cause focused approach to managing PCOS.
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You May Feel More Tired Than Usual
When my body was adjusted to spironolactone, I was so exhausted I could have easily fallen asleep standing up while in line at Whole Foods even though I was taking a very small dose of the medicine. Since then, my energy levels are back to what they used to be before taking the pill. “Spironolactone blocks the hormone aldosterone, which can lead to fatigue,” Dr. Shah explains. “In addition, it can lower the blood pressure, and if this drop is sudden, you may feel tired.”
How Long Does It Take To Work
Using Spironolactone can lead to clear skin in as early as one month but sometimes can take two or three months to show good results. Patience is key when setting your expectations for efficacy.
Remember, everyones body is different, and so your response to Spironolactone may be different than others.
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Does Spironolactone Help Acne
Spironolactone has been used as a treatment for acne, specifically acne vulgaris the kind associated with hormonal imbalance. The typical dose, which is an off-label use, for women struggling with acne is 50 to 200 mg daily. However, it is recommended to begin with a lower dose as this may be effective for resolving acne with a reduced risk of side effects.
Theres not a ton of reliable data to determine its efficacy when used in this way. Although there are some studies that show dramatic improvement, others have reviewed the data and found a high likelihood of bias in these studies.
As with most treatments, results vary from woman to woman. Plenty of women claim its the holy grail of acne healing and others dont experience much improvement. Some develop headaches or other side effects that make using the medication unbearable.