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Spironolactone for Hormonal Acne: Is It Right For Me?

Those of you battling hormonal acne have probably heard of spironolactone. Either it has been recommended to you by a doctor, or you've heard about someone who was on it for their hormonal imbalance.

Although it is not generally considered a primary option in the management of acne in females, a spotlight has recently been placed on the use of this agent for acne treatment.

First developed in 1957, spironolactone is an aldosterone antagonist that was used initially as a potassium-sparing diuretic in the treatment of hypertension and congestive heart failure. The antiandrogenic effects of spironolactone were first discovered when it was being used to treat hypertension in women with concurrent polycystic ovary syndrome (PCOS) and hirsutism.

It has now been used for women with hormonal-pattern acne, defined as primarily inflammatory papules, usually deep-seated and tender, that are located predominantly on the lower half of the face and anterior-lateral neck region. Currently, dermatologists prescribe spironolactone for off-label use, with acne being a non-United States Food and Drug Administration (FDA)-approved indication.