Spironolactone for Acne

The U.S. Food and Drug Administration has approved spironolactone for lowering high blood pressure and decreasing fluid retention. The medication is available by prescription only, and physicians normally do not prescribe it for men because it reduces levels of androgens, or male hormones. The anti-androgen effect makes spironolactone an effective treatment for some women with acne, according to eMedTV.

Hormonal Acne

Acne affects more than 75 percent of all adult women, according to the American Academy of Dermatology. Adult women are much more likely to experience acne than adult men are. Excess skin oil production is an important factor in acne, and androgens can overstimulate the oil glands. It's normal for women to have low levels of male hormones, but some have higher levels that can lead to health problems, including acne. Hormonal therapy, such as spironolactone, may help.

Hormonal Therapy

Doctors usually prescribe oral contraceptives for acne caused by high levels of male hormones in women, according to eMedTV. This helps correct hormonal imbalance and also blocks the effects of androgens in the skin. Some women cannot take oral contraceptives, however, and for others, this medication is not effective enough against acne. Spironolactone is an alternative, and can also be used in combination with oral contraceptives. Additionally, spironolactone is an effective treatment for polycystic ovarian syndrome, in which high androgen levels are associated with ovarian cysts, irregular menstruation, infertility, as well as acne.

Off-Label Use

The FDA considers spironolactone for acne treatment an off-label use, meaning the agency has not approved the medicine for that purpose. Drug manufacturers cannot advertise or promote medications for off-label use, but doctors are allowed by law to prescribe them for these uses. Doctors often are aware of promising research results for various medications although the FDA has not yet issued an approval.

Usage

Spironolactone is available in generic form, and in brands such as Aldactone and Spirotone. DermNetNZ, the website of the New Zealand Dermatological Society, recommends that women over age 30 using spironolactone for acne take 100 to 200 mg daily. Physicians usually start women with a dose of 25 mg daily and increase it gradually. It may take over six months to see improvement.

Side Effects

Some side effects are possible when taking spironolactone. As listed by DermNetNZ, they include nausea, diarrhea, dizziness, drowsiness, headache, breast pain, increased frequency of menstruation, absent menstruation and mid-cycle spotting. The drug is a diuretic, so it can cause increased urination. Spironolactone can also cause liver problems and abnormally-elevated levels of potassium in the blood, according to Drugs.com. Both of these conditions can be dangerous. However, survey results published in the November-December 2002 issue of the "Journal of Cutaneous Medicine and Surgery" did not find any cases of serious illness linked to spironolactone use over an average treatment length of 28.5 months. Side effects were common, though, with 59 percent of the users experiencing some negative reactions, and 15 percent stopping therapy due to these effects.