10 Things You Need to Know About Spironolactone Before You Take It for Hormonal Acne

This little pill really works on hormonal acne, but it does have an impact on your daily life.
Publish date:
July 28, 2016

We’ve talked about spironolactone on xoVain a lot. It’s a pill intended for high blood pressure that is often prescribed to those with hormonal acne, and for those of us who deal with big, honking zits on our chins and jawlines during Period Time — one of the things spiro does is help block male hormones, which is why it’s only prescribed to women — it’s a godsend.

Since I’m decidedly not a dermatologist, I reached out to Dr. Elizabeth Tanzi, Assistant Clinical Professor for the Department of Dermatology at the George Washington University Medical Center, for more info on spiro.

“Spironolactone is particularly effective for women over 25 who struggle with hormone-driven cysts on the lower face and neck,” she said. “Although it is not a birth control pill, it works by blocking the effects of certain hormones on the skin.”

I actually take spiro for both my hormonal acne and my heart issues, but that’s a whole ‘nother story. I came to it last year around this time when my skin was really, really bad, and I was so frustrated by the state of my face. Later, my doctor changed my dosage to address my heart issues. Now, spiro and I are very happy together, and I recommend that any woman who’s been having skin issues she just can’t beat should ask her doctor about it.

We’ve talked about spiro before, but we haven’t talked about what happens when you’re on it for a long time, and what its impact might be on your day-to-day life. That's where I come in!

1. You will probably pee A LOT. Spiro is a diuretic, which means that it’s constantly flushing out your body so you don’t retain fluids. I pee about 15 times a day, if not more.

2. It helps with bloating. Added perk.

3. It takes about three months to see results. The first time I tried spiro, I got frustrated because I wasn’t seeing results immediately, and I quit. When I started it again, I stuck with it; after three months, my skin basically transformed. Stick with it!

4. You’ll get cozy with your doctor. When you’re on spiro, you do need to visit the doctor to have your blood tested to make sure your potassium levels are OK. It’s not as bad as Accutane, where you have to go in all the time; it’s more like every four to six months.

5. Your body hair might get thinner. Since spiro works to cancel out male hormones, you might notice a decrease in your body hair’s thickness or coarseness overall.

6. It may have an effect on your boobs. One of spiro’s side effects is breast tenderness, which I totally experience. I also think it made my boobs bigger, but don’t quote me on that scientifically.

7. You shouldn’t take it if you’re trying to get pregnant. Dr. Tanzi says, “Spironolactone cannot be taken if you are thinking about becoming pregnant, if you're pregnant, or if you're breast-feeding because birth defects have been associated with its use.” So, um, if I decide it’s time to get knocked up, I’ll have to take a break from my spiro. Eek.

8. Your skin won't be 100% clear 100% of the time. I know, I know. But it's not a miracle! It's just a pill. I still get a zit or two around my period, but it's nothing like the huge ones that used to blossom all over my chin.

9. You need to watch your potassium and salt intake. Spiro is what they call a "potassium-sparing" diuretic, which means when you take it, your body tries to save all the potassium it can. If you eat too many bananas, for example, it could have an affect on your heart. That's why you have to go to the doctor and have your levels checked. If you've got low blood pressure, you probably shouldn't take spiro because it's used to treat hypertension.

10. Spiro doesn't always play nice with the sun. I'm a devoted beachgoer, and I've noticed an increase in sun sensitivity since going on spiro. Don't forget your sunscreen! (Seriously, my previous SPF 8 doesn't cut it, and I've upped it to 30.)

  • Do you take spironolactone? Do you pee as much as I do?
  • Have you had success with acne medication?
  • What the hell is the deal with hormonal acne? Like, do we not suffer enough?