Dr. Aouthmany, MD, FAAD
Board Certified Dermatologist


  • Spironolactone is a diuretic (water pill) that is used to treat acne due to its antiandrogen (antitestosterone) effects.
  • Spironolactone is not approved by the FDA for treatment of acne, although it is commonly used in women for this purpose.
  • Spironolactone works most effectively when it is taken every day as prescribed. Everyone misses a dose occasionally, but missing many doses, or starting and stopping the medication, will reduce its chance of working.
  • Spironolactone often takes several months to work; try to be patient.
  • Spironolactone usually does not cause stomach upset, but if it does, it can be taken with food.
  • Spironolactone should not be taken if you are pregnant or planning to get pregnant. It can affect the development of a male fetus’s genitalia. Spironolactone should also not be taken if you are breastfeeding. 
Side effects: Spironolactone is usually well tolerated, but just like with any medication, side effects are possible. More common side effects include irregular menses, midcycle spotting, breast tenderness, and headaches. Very rarely, Spironolactone can cause a rash, liver, kidney or blood problems. Questions have been raised about whether this drug can cause breast cancer or thyroid cancer; to date, no link has been shown.
  • It is known that the drug can stimulate breast tissue, and can cause gynecomastia in men; because of this it is not recommended in women with an immediate family history of breast cancer. 
  • Increase in urination.
  • Increase the level of potassium in your bloodstream. This is generally only an issue for people with kidney disease, but some people suggest avoiding salt substitutes that contain potassium while taking Spironolactone.  Do not overeat produce like avacado.
Stop taking Spironolactone and call the office if any of the following occur: a sudden severe rash, severe or daily headaches, vomiting, severe abdominal pain, visual changes, unusual bleeding or bruising, or jaundice (yellowing of eyes and skin).