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Spironolactone or Aldactone is the medication used as the treatment of various medical conditions. It is usually prescribed for hypertension and retention of fluids, but it can be also used as the treatment for severe cases of acne that didn’t respond to any other treatment. This drug has not been approved for adult acne treatment by the FDA (Food and Drug Administration) and this use of spironolactone is therefore considered “off-label”. People experiencing hirsuitism (excessive hair growth) or androgenetic alopecia may also be prescribed spironolactone.

Acne is a skin condition common in women, because of their monthly hormonal fluctuations. Most people think about acne as the condition associated with teenagers, but many adult people, in their 20s and 30s or even later in the life also have problems with acne. Increased production of oil, blocked pores, pimples and black and whiteheads are just some of the unpleasant companions of acne.

How Spironolactone Works

Spironolactone acts against the effects of male hormones in the body, decreasing the amount of these hormones (also called androgens) and limiting the fluctuations in hormonal levels that caused acne in the first place. Women experiencing severe acne are often found to have an increased level of male hormones, and that’s why spironolactone or oral contraceptives have been used as the treatments for acne. Spironolactone can be used with birth control pill to manage serious acne, or just on its own when oral contraceptives don’t work or can’t be used because of some medical reason.

Potential Health Risks

Spironolactone usage can cause some adverse effects, and some of them are considered to be dangerous. Low doses of spironolactone used for the acne treatment usually don’t cause any side effects but higher doses can cause some problems. The most problematic issue is effect to hormones in the body, since spironolactone may lead to menstrual problems, irregularities and absent menstruations and breast tenderness. Patients have reported swelling of the neck and face, dry mouth, thirst, stomach cramps, diarrhea and vomiting. There were also reports about allergic reactions, breathing difficulties, hypotension (low blood pressure), arrhythmias and increased level of potassium in the blood, headaches and dizziness.

Pregnant women or breastfeeding moms should avoid spironolactone.

Patients suffering from kidney problems or experiencing abnormal menstrual bleeding should also stay away from this medication. People who have family history of uterus, ovarian or breast cancers should also avoid spironolactone. There is also recommendation for people currently using ACE (angiotensin converting enzyme) inhibitors – doctors agree that these patients should not use spironolactone.

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