Spironolactone for Acne Treatment
Spironolactone is a diuretic that reduces the amount of fluid the body retains and prevents the body from absorbing too much sodium. Available as the brand name Aldactone and in generic form, spironolactone has been approved by the U.S. Food and Drug Administration (FDA) to lower high blood pressure and reduce fluid retention. Because spironolactone also has hormonal effects, it can help with acne.
Spironolactone decreases levels of male hormones (androgens) and is approved for treating hyperaldosteronism, a condition in which the adrenal gland creates too much aldosterone. Androgens stimulate oil glands, which can lead to acne. Excessive oil on the skin prevents shedding of dead skin cells, which then clog pores. Blocked pores create a suitable environment for acne-causing bacteria, and the pores also can become red and swollen.
For Women Only
Women normally have low levels of male hormones, but some have high levels that can cause acne. Physicians prescribe spironolactone to treat severe acne in women who have higher than normal levels of male hormones. Spironolactone usually is not prescribed for men because of its anti-androgen effects, which can lead to erectile dysfunction and breast enlargement. Although the FDA has not approved spironolactone for treating acne, doctors are allowed by law to prescribe legal medicines for "off-label" use.
The most common method of treating acne due to high levels of male hormones is with oral contraceptives (birth control pills) that help balance hormones. Not all women can take oral contraceptives, however, and in some women these pills are not effective at treating acne. Spironolactone can be effective when oral contraceptives are not. Spironolactone also can be prescribed in combination with an oral contraceptive. Additionally, some women with high levels of male hormones develop a condition called polycystic ovarian syndrome, which can cause acne. Spironolactone is often helpful for this condition as well.
Common side effects associated with spironolactone include blurred vision, diarrhea, nausea, dizziness, drowsiness, fatigue and headache. These effects typically dissipate after a short time. Because spironolactone affects hormones, it can result in irregular or absent menstruation and breast tenderness.
Spironolactone can raise potassium to dangerous levels, but this is unlikely except in people with kidney disease or diabetes. People with heart disease or liver dysfunction also may not be able to safely take spirolactone. Rarely, individuals experience an allergic reaction to spironolactone. Symptoms include an itchy rash or hives, dizziness, swelling and difficulty breathing.
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