Spironolactone is most commonly prescribed off-label to treat hormonal and adult acne in women — especially deep, tender breakouts along the jawline, chin, and neck that flare with the menstrual cycle. It can also help reduce excess facial oil.

Spironolactone is an anti-androgen. It blocks androgen (hormone) receptors in the skin, lowering the hormone-driven oil production that fuels hormonal acne. Less oil means fewer clogged pores and breakouts over time.

It is a strong option for women with persistent hormonal or adult acne that has not cleared with topicals or antibiotics, or who want to avoid long-term antibiotics. Because of its anti-androgen effect, it is generally not prescribed to men for acne. Your provider will review your history to confirm it is right for you.

Most people tolerate spironolactone well. Possible side effects include increased urination (it is a mild diuretic), lightheadedness, breast tenderness, and menstrual spotting or irregular periods. Taking it with food and staying hydrated can help.

No. Spironolactone should not be used during pregnancy, as its anti-androgen effect can affect a developing fetus. Reliable contraception is recommended while taking it, and you should stop if you are trying to conceive or become pregnant. Tell your provider if there is any chance you could be pregnant.

For healthy young women, routine potassium monitoring is often not required. Your provider may order labs (such as a potassium level) if you are older, have kidney or heart conditions, or take certain medications. Avoid potassium supplements and high-potassium salt substitutes unless advised otherwise.

Spironolactone works gradually. Most people start to notice improvement around 3 months, with continued improvement after that. It is often combined with a topical routine for the best results.

Your prescription is sent to the pharmacy of your choice, and the cost of the medication is separate from your visit and may be covered by insurance. See spironolactone in our shop →