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Spironolactone for Acne Treatment

Healthcare providers may occasionally prescribe spironolactone for women who have not responded to more conventional acne treatments. Since the drug can decrease testosterone or block androgen receptors, it can help women who have acne caused by high male hormone levels. Treating acne with spironolactone is considered to be an "off-label" use of the drug.

Is Spironolactone Used for Acne Treatment?

Spironolactone (Aldactone®) is a prescription medication licensed to treat various conditions, including high blood pressure and fluid retention. It may also be used "off-label" to treat other conditions, such as severe acne in women who have not responded to more conventional acne treatments.
 

What Does "Off-Label" Mean?

When spironolactone is used to treat acne, it is considered an off-label use. Off-label is when a prescription medicine is used to treat a disease or condition for which the drug has not been approved by the U.S. Food and Drug Administration (FDA). Although the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a healthcare provider's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time. Your healthcare provider will prescribe a medicine for off-label use when he or she feels that the medicine is appropriate for your situation.
 

How Does Spironolactone Work for Acne Treatment?

In addition to being a diuretic (or "water pill"), spironolactone is also an anti-androgen, which means that it counteracts the effects of male hormones (androgens). It may decrease the level of male hormones (such as testosterone) or block androgen receptors.
 
It is normal for women to have low levels of male hormones; however, high levels can cause problems (including acne).
 
The most common way to treat acne due to high levels of male hormones is using oral contraceptives (birth control pills). This helps to correct hormone imbalance and block the effects of male hormones in the skin. However, not all women can take oral contraceptives (or they might not be effective enough). In these cases, spironolactone is sometimes used to treat acne. Spironolactone is often used in combination with oral contraceptives for this use.
 
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Spironolactone Medication

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