Acne is more frequent in females with PCOS (polycystic ovary syndrome) and this is because of the hormonal imbalance. In these cases, acne tends to be limited to the lower part of the face with visible spots on jaw line, under the chin, sides of the neck and lower cheeks. This particular type of acne is known as hormonal acne and affects adult females in majority.
Hormonal acne is treated in the first instance with oral combined contraceptive pill. However, it isn’t always effective. To make acne treatment more efficient in these cases, we can add Spironolactone tablets. It is a drug usually prescribed for patients with high blood pressure and heart problems. It is able to block the ‘male hormones’ (androgens: testosterone) and this is why is very efficient in acne treatment, where there is a hyperactivity of the testosterone in the sebaceous glands.
Some females with acne have high levers of testosterone. On the other hand, quite a high percentage of females with acne have normal testosterone levels, but they develop an increased sensitivity to normal levels of ‘male hormones’ and this is the reason of the acne. This means that Spironolactone is suitable for any women with acne, regardless of their blood testosterone level. Checking blood level of testosterone can be performed, but it isn’t recommended routinely.
It plays an important role in controlling excessive oiliness on face and scalp too. It is not prescribed in men. Its use is intended only for women with acne. You should not take this medication if you are pregnant or planning to conceive.
Treatment is usually started with a low dose and this is to be escalated depending on response but not earlier that 2 months, because its effect kicks in approximately 8 weeks after initiation, so you need to allow it some time to assess effectiveness. Potential side effects include breast tenderness, irregular periods (less common if you are on contraceptive pill), nausea, dizziness. Because it is a diuretic too, you might notice the urge to pee more often than usually.
It is a long-term treatment for acne and requires monitoring of blood potassium level at variable intervals. Nevertheless, increasing of potassium level in healthy and fit women under 45 years old is uncommon. Heart and kidney problems predispose more to variations of this parameter.
If you want to know if Spironolactone is adequate to treat your acne or have any other questions about this treatment and you would like to discuss with our doctor, you can book an initial online consultation, who will be happy to advise, answer your queries and initiate the treatment or any other acne treatment that is suitable for you.