SPIRONOLACTONE FOR ACNE
Spironolactone is a medication that is used primarily for the treatment of high blood pressure. However, for many years it has been used to treat acne and excess hair growth in women because of its ability to block the effects of certain hormones (testosterone). By blocking the effect of these hormones, spironolactone reduces oil gland secretion, which helps prevent acne, and reduces hair growth on the face. This medication can only be used in women and is recommended for women whose acne is largely hormonally controlled.
The optimal dose of spironolactone varies in different individuals and may require some adjustment. The beneficial effects can usually be seen within two or three months, but frequently within one month. With over 25 years of use, this drug has been quite safe. Serious side effects are extremely rare, but there are some nuisance side effects that you should be aware of: the most common side effect is irregularity of menstrual cycles, which, if you are taking birth control pills, should be minimal. Mid-cycle spotting, early periods, or longer periods can be seen.
Since spironolactone has diuretic properties, there may be a “water-pill” effect during the first week. This is what causes a slight lowering of the blood pressure. It is important to prevent dehydration if you are active in sports and exercises. Adequate fluid intake should prevent light-headedness.
Some people have experienced fatigue, breast tenderness, nausea, and decreased sex drive, but these occur infrequently. Hormonal treatment of acne can be associated with darker pigmentation on the face, which is accentuated by sun exposure.
You must not get pregnant while on spironolactone. If you accidentally do, you must stop your medication immediately and notify our office and your gynecologist.
Spironolactone causes your potassium level to increase; it is important to avoid excessive eating of bananas and citrus fruits, orange juice, etc. However, these foods do not have to be eliminated. It is recommended to check your blood potassium level after one or two months of therapy, depending on your dose.
CONCLUSION: Spironolactone can be quite effective in the treatment of acne in women and is generally well tolerated. If side effects develop, the dose can be adjusted to a more tolerable dose. Whether spironolactone is helpful or not can usually be determined within two or three months of therapy.
