Women with adult acne usually have normal hormone levels. However, their oil glands can become sensitive to normal hormone fluctuations, causing the body to overreact and leading to the development of acne.

Spironolactone has been safely used for almost fifty years to treat high blood pressure and fluid retention. The diuretic effects are more evident at higher doses (around 200mg). At lower doses, spironolactone works by preventing hormones from binding to the oil glands, thus helping to blunt unwanted acne breakouts. Hormone levels in the body remain the same, which usually avoids hormone-associated side effects. Most patients must take spironolactone regularly for several months to see a beneficial effect.

Possible side effects of spironolactone

• Elevated serum potassium levels – Avoid abnormally large amounts of potassium-rich foods, such as bananas or chickpeas (the main ingredient in hummus).
• Breast tenderness or enlargement
• Dizziness when standing up quickly (due to reduced blood pressure) Staying hydrated helps to avoid this side effect.
• Irregular or frequent menstrual periods

Who should not take spironolactone?

Women who are pregnant, breastfeeding, or actively trying to conceive as well as anyone with a history of elevated potassium levels should avoid taking spironolactone.