There are no currently FDA/EMEA-approved dermatologic indications for spironolactone and its off-label uses are, among others, female acne, female pattern hair loss, hidradenitis suppurativa or hirsutism. Spironolactone seems to affect androgen receptors in the sebaceous glands causing reduced sebum production and thereby causing an improvement in acne symptoms. The dermatology nurse must be aware of the attached black box warning, the potential for teratogenicity, and the need to monitor for fluid and electrolyte imbalances and side effects. They should be advised of the risks for hypovolemia and orthostasis and encouraged to maintain a consistent fluid intake. Oral spironolactone therapy for female patients with acne, hirsutism and androgenic alopecia. If you think you may have a medical emergency, immediately call your doctor or dial 911. Spironolactone, sold under the brand name Aldactone among others, is a medication that is primarily used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It is available generically and presents an attractive and inexpensive alternative to expensive proprietary medications because of its high efficacy and tolerability for use in select female patients. Low-dose adjunctive spironolactone in the treatment of acne in women: A retrospective analysis of 85 consecutively treated patients. Other common reactions patients may experience include rash, nausea, diarrhea, somnolence, and headache. The effects of circulating androgens on the skin and hair are well known and studied (When used for the treatment of acne and hirsutism, the mechanism of action of spironolactone is not completely understood. Spironolactone reduces male hormone levels, thus decreasing skin oil production and ultimately decreasing acne symptoms. The average dose used by the dermatologits is 50-100 mg daily. Patients should plan to start the medication at a time and place when urinary frequency can be accommodated. Some of the brands for spironolactone might be better known than spironolactone itself.

2013 Oct;64(10):752-6. doi: 10.1007/s00105-013-2594-1.Hautarzt. Choudhry R., Hodgins M. B., Van der Kwast T. H., Brinkmann A. O., Boersma W. J. 1. ), hypertension, and hypokalemia (Aldactone is made by Pfizer (New York, NY).

It's not FDA-approved for acne, but can be especially helpful for women who have acne … Springer Spironolactone (Aldactone)can block the action hormones on your skin’s oil glands. For those who choose not to use oral contraceptives, barrier or other methods of contraception should be encouraged.Blood pressure, symptoms of orthostasis, changes in menstrual patterns, and symptoms of breast tenderness should be monitored routinely at office visits during therapy. Journal of Endocrinology, 133 (3), 467-475. MECHANISM OF ACTION. Androgen metabolism in sebaceous glands from subjects with and without acne. November/December 2011, Volume :3 Number 6 , page 374 - 376 Spironolactone is a potassium-sparing diuretic and selective aldosterone blocker used off-label in dermatology for treatment of acne and hirsutism in women.Spironolactone received initial approval by the Food and Drug Administration (FDA) in 1960s. – It should only be considered for the treatment of acne or hirsutism in select women when androgen sensitivity is suspected to be contributory or for women in which other acne treatments have been ineffective or insufficient. The rationale behind these relays on the mechanism of action of spironolactone which interferes with the hormone-controlled sebum and sweat gland secretion and with androgen stimulated hair growth. Bottom Line. Spironolactone (Aldactone)can block the action hormones on your skin’s oil glands. Fertility and Sterility, 68 (6), 1000-1003. Oral spironolactone use improves acne vulgaris and reduces sebum excretion. Spironolactone tablets are indicated for treatment of NYHA Class III-IV heart failure and reduced ejection fraction to increase survival, manage edema, and reduce the need for hospitalization for heart failure.Spironolactone tablets are usually administered in conjunction with other heart failure therapies. 2013 Oct;64(10):727. doi: 10.1007/s00105-013-2589-y.Hautarzt.

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