Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 1/19/2021
Spironolactone is a medication commonly used to treat high blood pressure. But it can also be prescribed off-label for the treatment of acne. Yup, really.
While oral spironolactone can be used for acne, there is also a topical form of it — and research suggests it’s effective at treating hormonal acne.
But, as with any mediation, before you start using it, you should have a basic understanding of topical spironolactone. Which is exactly what we’re here to help with!
When your body produces too much sebum, it can mingle with dead skin cells and bacteria to block your pores, causing acne. This production of sebum can be triggered by hormones.
Sebum is an oil-like substance that’s naturally created by your skin. Wondering why it would produce this substance? Sebum actually plays an important role in keeping your skin lubricated and protecting it from environmental factors.
Dead skin cells also play a role. Your skin naturally sheds these as part of its turnover process. But if there’s any left behind, they can mingle with sebum to contribute to blocked pores.
The biggest hormonal culprit behind acne is thought to be testosterone. Though it’s most commonly associated with men, women have it in our bodies, too. It’s an androgen hormone that, among other things, can encourage sebum production.
Both oral and topical spironolactone gel are available as an acne treatment. It’s used because there’s evidence that it has anti-androgenic effects. Essentially, it blocks androgen hormones and, in turn, is thought to decrease the activity of your sebaceous glands.
Taking oral spironolactone has been found to reduce acne by at least 50 percent in women in some studies. However, it’s not a medication used to treat acne in men.
In fact, it’s been shown to have some pretty adverse complications for men — like breast growth.
Like every prescription medication, spironolactone may cause side effects in some people. Common spironolactone side effects include vomiting, diarrhea, stomach pain, irregular periods and more.
Topical spironolactone generally has fewer side effects than oral spironolactone — and it’s been found to be effective, too.
In one study, 5% topical spironolactone was used twice a day for eight weeks to treat patients with mild to moderate acne.
By the end of the eight weeks, female participants reported significantly less breakouts. It’s worth noting that this study was quite small and included only 15 people.
Another study, which was slightly larger, found similar results. In it, 78 people with mild to moderate acne were either given 5% topical spironolactone or a placebo.
Those given the topical reported a decrease in acne.
If you are interested in a topical treatment for acne, there are a number of others you can consider.
Two of the most popular? Salicylic acid and benzoyl peroxide. Both work by removing dead skin cells while also addressing the bacteria that causes breakouts.
On top of this, salicylic acid may reduce swelling, which can help with the appearance of acne.
Tretinoin is another option. Also requiring a prescription, this topical helps your skin shed dead skin cells to prevent breakouts.
Another one to consider is clindamycin. This prescription antibiotic prevents bacteria from multiplying.
Hers offers an acne cream that requires a prescription. It contains clindamycin, tretinoin and azelaic acid — together, these things remove dead skin cells, help with bacteria and reduce inflammation.
Acne in women is not uncommon. Luckily, there are a variety of ways to approach acne treatment. One unexpected way is to use spironolactone, a medication most commonly used for high blood pressure.
Oral spironolactone is certainly available, but there is also a topical formulation. Many people like the topical option because it tends to have fewer side effects.
If you’re navigating a bad acne situation, the best thing to do is to consult with a medical professional. They will be able to determine the right course of treatment for you.