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Spironolactone Not Working for Acne? Here Are 5 Possible Reasons

Acne can be a frustrating condition to deal with. While numerous treatments are available, spironolactone has become a popular medication for hormonal acne, particularly in women.

However, not everyone taking this medication experiences the clear skin they hoped for. This blog aims to delve into the five possible reasons why spironolactone might not be the ultimate acne solution for you.

Also read: How to choose the best acne treatment

Biggest Take-Aways:

  • Spironolactone may not work for everyone due to reasons like incorrect dosing, short-term use, or hormonal imbalances.
  • Interactions with other medications, such as birth control pills or antibiotics, can also affect spironolactone's effectiveness.
  • For those not seeing results with spironolactone, exploring alternative treatments that may be more effective, such as Accutane or hormonal birth control pills, is possible.
  • Exposed Skin Care offers a comprehensive range of products that can serve as an effective alternative or complementary treatment for various types of acne.

Close up of hand holding Spironolactone pill

Understanding What Spironolactone Is

Before we delve into why spironolactone might not work for your acne, it’s essential to understand this medication. Spironolactone was originally a diuretic medication used to treat high blood pressure. 

However, it is often prescribed off-label for treating hormonal imbalances in women, manifesting as stubborn jawline or cystic acne.

How Spironolactone Works in Treating Acne

Spironolactone helps in acne treatment by blocking the action of androgen hormones, particularly testosterone. These hormones are usually responsible for excess oil production, which leads to clogged pores and breakouts. By blocking these receptors, spironolactone prevents acne caused by hormonal imbalance.

Why is Spironolactone Not Working for Acne?

Understanding why spironolactone is not working for your acne is crucial in deciding the next steps for your skincare regimen. Here are some factors to consider:

Inadequate Dose

The dose of spironolactone prescribed for acne treatment varies from person to person. You may be on a low dose, typically starting at around 25 mg to 50 mg, gradually increasing to 100 mg based on how your body reacts. An inadequate dose might be one reason spironolactone is not delivering the desired results.

  • Low Dose: Starting with a low dose is common but may be insufficient to see significant improvements.
  • High Dose: Sometimes, an increased dose of up to 100 mg is required to treat stubborn acne like cystic acne effectively.

Large dose of Spironolactone

Not Enough Time

Like many acne treatments, spironolactone does not yield instant results. It often takes up to 3 months for any noticeable changes. If you've been taking spironolactone for only a few weeks, it may give the medication more time to work.

  • First Few Weeks: Minimal changes are often observed during this period.
  • 3 Months: This is generally when significant improvements should be noticed.
  • Long-Term Use: Some may require long-term use for continued results.

Hormonal Imbalance in Women

While spironolactone is effective in treating hormonal acne, it may not address all types of hormonal imbalances in women. If your acne persists despite treatment, you might need to explore other hormonal therapies or contraceptive options that can regulate your hormones more effectively.

  • Birth Control: Some women find relief from acne by taking birth control pills.
  • Testosterone Blockers: Besides spironolactone, other medications that block male sex hormones can be considered.

Interaction with Other Medications

Spironolactone shouldn't be taken with certain medications, as they may negate its effects. For example, pairing spironolactone with antibiotics commonly prescribed for acne, like tetracycline, may impact its effectiveness.

  • Topical Medications: Some topical acne treatments like benzoyl peroxide or tretinoin may not work well with spironolactone.
  • Blood Pressure Medication: Since spironolactone is also used to treat high blood pressure, taking it with other medications can cause dizziness or irregular blood pressure.

Incompatible Skincare Routine

Sometimes, your skincare regimen could be affecting how well spironolactone works for your acne. Incorporating skincare products like salicylic acid or benzoyl peroxide alongside spironolactone may either amplify or negate the medication's effects.

  • Salicylic Acid: This ingredient is a potent acne-fighting agent but can cause dryness when used with spironolactone.
  • Retinoid: Topical retinoids are often prescribed for acne but can lead to extreme dryness when combined with spironolactone.

Woman applying cream to her hands

Side Effects of Spironolactone

While we focus on why spironolactone may not be working for you, it is equally essential to understand its side effects. Spironolactone can cause various issues that may deter some individuals from continuing its use.

Common Side Effects

The common side effects of spironolactone include dizziness, irregular menstrual cycles in women, and elevated levels of potassium in the blood.

  • Potassium Levels: Since spironolactone is a diuretic, it can increase potassium levels, requiring regular monitoring.
  • Dizziness: This is often experienced in the first few weeks of starting the medication.

Woman experiencing dizziness as side effect

When to Stop Using Spironolactone

Certain conditions or life stages, like trying to become pregnant, may necessitate stopping spironolactone treatment. Women taking spironolactone who wish to become pregnant should discontinue its use due to potential medical conditions it may cause in developing fetuses.

  • Pregnancy: Spironolactone is generally not recommended for pregnant women or trying to get pregnant.
  • Medical Conditions: Discontinuation might be advised if you experience severe side effects.

Alternatives to Consider If Spironolactone Isn’t Working

When spironolactone is not working for acne, it is natural to consider alternatives. Several other treatments are available that you might find more effective for your specific condition.

Topical Treatments

Topical acne treatments like salicylic acid, benzoyl peroxide, and tretinoin may work well for mild to moderate acne. These can be used as a stand-alone treatment or in combination with systemic therapies.

  • Benzoyl Peroxide: Effective for treating whiteheads and blackheads.

Woman showing Benzoyl Peroxide dropper

  • Tretinoin: A derivative of vitamin A that promotes skin renewal.

Oral Contraceptives

Birth control pills containing estrogen and progestin can regulate hormones that trigger acne. However, it’s crucial to note that not all contraceptives will have this effect; some may even worsen acne.

  • Estrogen-Progestin Combo: Pills like Ortho Tri-Cyclen have been approved for treating acne.
  • Hormone Regulation: Birth control pills can help regulate fluctuating hormone levels, thereby controlling acne.

Accutane (Isotretinoin)

For severe cases of cystic acne where other treatments have failed, Accutane is often prescribed. This medication comes with its own set of stringent guidelines and potential side effects but is effective in treating severe acne.

  • Severe Acne: Accutane is mainly used for treating stubborn cystic acne.
  • Stringent Guidelines: Accutane is often a last resort treatment option due to its severe side effects.

Consider Exposed Skin Care as an Effective Alternative

If you've been taking spironolactone for acne and haven't seen the results you desire, you may want to consider Exposed Skin Care products as an alternative or complementary treatment. It offers a range of products formulated to target various types of acne.

Exposed Skin Care Ultimate Kit

Here are some benefits of Exposed Skin Care:

  • Comprehensive Kit: From facial cleansers to treatment serums, Exposed offers everything you need to know about a full-fledged acne treatment regimen.
  • Natural and Scientific Ingredients: Unlike spironolactone, a hormone blocker, Exposed Skin Care employs a perfect blend of scientific ingredients and natural extracts for acne fighting.
  • Safe for Various Skin Types: Whether you have cystic acne or are dealing with acne on the breast and other body parts, Exposed has a solution.
  • No Need for Prescription: Exposed Skin Care is over-the-counter and can be availed by anyone.

If you're looking for an effective, well-rounded treatment for acne, Exposed Skin Care is the comprehensive skincare routine for you.


As we've explored, spironolactone is used primarily for its anti-androgenic properties, and it may not work for everyone due to various factors such as incorrect dosing, hormonal imbalances, or interactions with other medications.

Everything you need to know about spironolactone should ideally come from an in-depth consultation with healthcare professionals. 

For those who find spironolactone as ineffective, it may be time to consider alternative options. Exploring a more holistic approach that addresses the root causes of acne might be more effective in the long run.

Avoid using a one-size-fits-all approach to acne treatment. Each individual's skin has unique needs and sensitivities, which may not necessarily align with commonly prescribed treatments. Diversifying your skincare regimen might be the key to finally achieving the clear skin you've yearned for.


Q: How long does it typically take for spironolactone to show results?

A: It usually takes around 3 months to see noticeable changes.

Q: Can spironolactone cause hormonal imbalances in women?

A: Yes, spironolactone can alter hormone levels and may result in imbalances.

Q: What are some common side effects of spironolactone?

A: Common side effects include dizziness, irregular periods, and high potassium levels.

Q: Can I use Exposed Skin Care products along with spironolactone?

A: Yes, Exposed Skin Care products can be used as a complementary treatment to spironolactone.

Q: What types of acne does Exposed Skin Care treat?

A: Exposed Skin Care treats various types of acne, including cystic and adult acne.