How to Safely Stop Taking Spironolactone for Acne

If you’re prone to stubborn hormonal acne breakouts, your healthcare provider may prescribe the medication spironolactone to get rid of acne and clear your skin.

Spironolactone works by reducing the effects of hormones called androgens, which can cause your skin to become oily and prone to blackheads, whiteheads and other types of acne. It’s an effective medication that often produces real, noticeable improvements in your skin.

Although spironolactone is safe and effective for most people when used as prescribed, there are a few things that you should know before stopping treatment with this medication, both for your skin and for your general health and wellbeing.

Below, we’ve explained how to safely stop taking spironolactone for acne. We’ve also shared a few tips to help you maintain clear skin after stopping spironolactone, from other medications to consider to healthy habits to incorporate into your skincare routine. 

What is Spironolactone?

Spironolactone is a prescription medication. It’s approved by the FDA to treat congestive heart failure, hypertension (high blood pressure levels), edema (swelling caused by water retention), low potassium levels and hyperaldosteronism (high levels of the hormone aldosterone).

Spironolactone belongs to a class of drugs called ​​aldosterone receptor antagonists. It works by stimulating the release of extra water and sodium from your kidneys, while helping your body retain the essential mineral potassium.

Because of its effects as a potassium-sparing diuretic, spironolactone is sometimes referred to as a “water pill.”

At first glance, spironolactone may seem like an unusual choice of medication for treating acne in adult women. After all, what does a medication for heart failure and high blood pressure have to do with acne breakouts?

Spironolactone’s value as a treatment for acne comes from its antiandrogen effects, meaning its ability to either reduce levels of androgen hormones or limit their effects on your body. 

Androgen hormones are male sex hormones, such as testosterone. Although we usually think of testosterone as being a hormone that only men produce, the reality is that men and women both produce testosterone and rely on it for certain functions. 

Testosterone and other androgen hormones can stimulate your sebaceous glands, causing your skin to become covered in sebum — a type of natural oil. This increase in oil levels can result in oily, acne-prone skin that’s more likely to develop clogged pores and pimples. 

Our guide to the androgen hormones that cause acne goes into more detail about the effects of testosterone and other hormones on your skin. 

Enter spironolactone. Experts believe that spironolactone works by blocking dihydrotestosterone (DHT), a byproduct of testosterone, from binding to receptors in your skin and promoting sebum production.

You can think of it as working similar to an on/off switch for some of the androgen hormones that cause your skin to become prone to hormonal acne.

Because of its effects on androgens, spironolactone is also used to treat other issues caused by high levels of androgens. For example, spironolactone is widely used to treat female pattern hair loss. 

In fact, we even offer oral spironolactone as part of our range of women’s hair loss medications, following an online consultation with a healthcare provider who will determine if a prescription is appropriate.

As a prescription medication, spironolactone is generally prescribed to treat stubborn acne that doesn’t respond to over-the-counter products. Your healthcare provider may suggest using it as part of your face care routine if you have moderate or severe acne, such as cystic acne. 

Spironolactone is often prescribed alongside other acne medications, such as topical retinoids or antibiotics. This approach — of using multiple acne treatments simultaneously — can help to target acne from several angles at once. 

Can Stopping Spironolactone Cause Side Effects?

Spironolactone is generally a safe medication, although you may need to make certain changes to your habits and lifestyle while using it. 

Because of spironolactone’s effects on potassium, your healthcare provider may ask you to cut down your potassium intake during treatment by avoiding certain foods. You’ll also need to stop using products such as potassium supplements.

Make sure to inform your healthcare provider about any medications you currently use or have recently used before taking spironolactone.

If you’re prone to adverse effects from spironolactone, or if your acne improves to the point that your healthcare provider no longer thinks spironolactone is necessary, you may be able to stop using this medication.

In general, it’s rare for spironolactone to cause any problems on cessation of treatment. As for how to wean off spironolactone, your healthcare provider may suggest gradually reducing your dosage over a period of weeks, or instruct you to stop taking your medication all at once.

They may also ask you to undergo one or several blood tests while using spironolactone and/or after stopping treatment to check for issues such as high potassium levels or changes in kidney function. 

Make sure to closely follow your healthcare provider’s instructions to stop using spironolactone safely.

Stopping Spironolactone and Dealing With New Acne

One thing to be aware of is that by stopping spironolactone, you might increase the risk of your acne coming back.

Hormonal acne can be highly stubborn, and research suggests that it takes around five months for spironolactone to have its strongest effects against acne in women. If you have severe acne and stop taking spironolactone too soon, you may not fully get your breakouts under control. 

Because of this, your healthcare provider may suggest waiting for a few months after your acne clears to stop using spironolactone completely, or to use other medications for the treatment of acne after you remove spironolactone from your daily routine. 

Common medications for female acne include:

• Benzoyl peroxide. Benzoyl peroxide is commonly used in over-the-counter cleansers for female acne. It works by preventing the growth of bacteria that can cause inflamed acne lesions to develop on your skin. 

• Salicylic acid. Salicylic acid is another popular ingredient in over-the-counter acne treatments, salicylic acid works by unclogging blocked pores that can cause adult-onset acne. It also helps to reduce the swelling that can accompany acne breakouts.

• Tretinoin. Tretinoin is a prescription medication, it works by peeling away dead skin cells, a major component of acne breakouts. It’s a highly effective medication that’s included as an active ingredient in our customized Acne Cream. 

• Clindamycin. Clindamycin is a prescription antibiotic that works by slowing down or preventing bacteria that cause acne from growing on your skin and inside your pores. Like tretinoin, it’s an active ingredient in our customized Acne Cream. 

• Hormonal birth control. Several birth control pills can prevent acne by controlling your body’s production of hormones that stimulate your oil glands. Your healthcare provider may suggest taking an oral contraceptive while you’re using spironolactone.

Our full guide to the best treatment options for women with acne goes into greater detail about how these medications work, their biggest benefits, potential side effects and more.  

If you notice your acne coming back after stopping spironolactone, it’s best to reach out to your healthcare provider as soon as you can. 

Other Tips for Preventing Acne From Coming Back

In addition to using any other medications your healthcare provider prescribes, it’s important to maintain good skin care and general health habits to prevent breakouts from coming back after you stop using spironolactone. Make sure to:

• Wash your face two times a day, as well as after exercising. It’s best to clean your skin as soon as possible after anything that makes you sweat. Try to wash your face twice a day, as well as after workouts or other exercise.
  
  

• Avoid scrubbing your skin aggressively. Scrubbing can cause irritation, which may make acne breakouts worse. Apply acne treatments and other skin care products with your fingertips to avoid causing irritation.
  
  

• Use a gentle, non-abrasive cleanser. Certain cleansers and other topical treatments for acne contain ingredients that can irritate your skin. If you have sensitive skin, pick a gentle, alcohol-free cleanser to use as part of your morning and evening face wash.
  Our Clear Waters Facial Cleanser is formulated to match your skin’s natural pH levels, allowing it to clean away dirt and grime without irritating your skin.
  
  

• Be careful with makeup products. Many cosmetics can clog your pores and trigger acne breakouts, even after using spironolactone. Look for products labeled “oil-free,” “won’t clog pores” or “non-comedogenic,” as these typically contain fewer oils.
  
  

• Limit your exposure to bright sunlight. Not only can sun exposure accelerate aging, but it can also damage your skin. Make sure to limit your sun exposure and avoid any devices that emit UV light, such as tanning beds.
  It’s especially important to use sunscreen and limit your sun exposure if you use tretinoin, as this and other acne medications may increase your risk of developing sunburn.
  
  

• Check in with your healthcare provider if breakouts return. If your acne breakouts start to come back, let your healthcare provider know as soon as possible. You should get the best results by restarting your treatment before your acne intensifies.

Our full list of ways to reduce acne shares more actionable tips that you can use to prevent your breakouts from making a comeback after you stop using spironolactone. 

Learn More About Spironolactone

Spironolactone is a versatile and effective drug that’s used as everything from a blood pressure medication to acne treatment. If you have stubborn acne that’s caused by a hormonal issue, it’s one of several medications that your healthcare provider may recommend for you.

Most of the time, stopping spironolactone won’t cause any issues. However, it’s still important to closely follow your healthcare provider’s instructions and keep them informed if you develop any adverse side effects or concerns. 

Interested in learning more about spironolactone? Our guide to spironolactone discusses how it works, as well as its benefits and side effects, while our list of uses for spironolactone goes into more detail about how it’s used to treat acne, female pattern hair loss and other conditions. 

Worried about acne? Our range of evidence-based acne products for women covers all of your bases, with customized acne treatments made to match your skin type, prevent breakouts and keep your skin looking its best year-round.