Spironolactone Q&A with a dermatologist| Dr Dray 

2020: Wow! I've been taking this drug at 50 mg for 7 months for my blood pressure. I had no ideal that this is what caused my hormonal acne and facial hair to go away. I'm gonna thank my doctor on my next visit.

Spironolactone has been a miracle drug for me. I am on a high dose for acne, and while I still get some breakouts and my skin is still oily, I don't get the awful, long-lasting, painful cystic bumps along my jawline anymore. The difference it has made on my self esteem is immeasurable.

I started spironolactone a little over 3 months ago and it’s made all the difference with my hormonal acne!! I’ve been battling it for years , now finally at 28 I have a clear face and don’t feel the need to pick at it

I like that you don't "dumb things down" too much. It's interesting learning things from you. I also like the mix between fun vlogs with your mom and eating out and these types of informative vlogs.

This medication has completely eliminated my hormonal acne. Combined with your awesome skin care tips, my skin looks so beautiful for the first time in years! Its interesting because i was already on gianvi which i hear derms like for acne. But the spironalactone has changed the game. ❤️

I’ve been on and off of spiro for 10 years now and definitely notice a difference when I am off of the medication. As she mentions it does help with sebum/oil production. I went from being an oily skin type to extremely dry so keep this in mind. Luckily I haven’t experienced any negative side effects while taking 200mg/day so I plan to use this for years to come to help manage my PCOS symptoms.

Your verbalization of those huge words is impressive 👍🏻 Love watching you 😊

You’re so full of information that the everyday public can understand. Super smart and generous with your knowledge, you’re one of a kind! Thank you!

My dermatologist said this could be my miracle I’m praying so hard it is

This medication SAVED my skin I took 50 mg a day for 3 months and now 100mg a day and I haven’t had a bad breakout from hormones in a long time

This drug has been a LIFE SAVER! for me. I’m 20 years old and have dealt with painful cystic acne since i was 13. I’ve recently gotten rosacea too within the last year and I can tell this has reduced a ton of redness and the breakouts from rosacea. I NEVER thought I would get past my acne, or ever feel okay in my own skin. I’ve even been on Accutane, which didn’t work for me. I can finally see the light at the end of the tunnel for my skin. My self esteem and overall happiness has improved so much! To anyone who feels defeated - you too will get past this! You are more than your acne!

I’m on 50mg spirolactolone for my skin. Took about 5 months for a huge change and if I don’t pick at my skin- it stays *generally* clear. I do wanna point out for others new to spirolactolone that when I went from 50 to 100 mg I experienced severe nausea and projectile vomiting so I never stayed at my intended dose. 50 mg has been working totally great, aside from needing to pee in 2 huge volumes about 2-4 hours after I take it. So I do not take it at night. My potassium levels are in proper range as well.

I’ve been taking spironolactone for nearly 2 years now and I am IN LOVE! I’m now taking 200mg a day and my androgen and testosterone levels have dropped back down normal. I’m so happy!

Helpful info, Doc! I'm glad you're including the advisory against self-medicating by going through sources other than a doctor. There's a good reason you went to many years of education. I've seen/heard a lot of scary misinformation on YT & sadly many don't recognize it as misinformation. You clear the air & shine a bright light on subjects without being negative or judgemental. That is a gift & you use it wisely. Blessings! Jackie in NY state

Dr. Dray can you please do a video on Birth Control for hormonal acne?

I thank you SO much for being on youtube. You don’t know how much confidence if gives me before buying or takingb any skincare or medicine after watching your videos. In the UK, it is so hard to get a dermatologist appointment :/

I had painful cystic acne going across my chin and jawline. Spironolactone saved my skin. I still have scarring but I haven't had even a "normal" zit in forever! :)

I just wanted to say thank you for taking the time to fully discuss the topic. I was prescribed this and the dr. That I saw was very vague and quick in our appointment but watching your video provided enough information for me to realize why it was given to me and now I feel much comfortable with using it. All the best.

I have been on Spironolactone 50mg/daily for 1 month and my skin has completely changed. I’m 27 and earlier this year began developing cystic acne for the first time.

Hello Dr Dray! Last spring my 16 year old daughter developed acne over the course of a month. We really couldn’t understand it because she took such good care of her skin. When it started becoming cystic we went to our dermatologist who prescribed some topicals and ordered blood work. She had slightly elevated testosterone. So we went to a pediatric endocrinologist who put her on a birth control pill and later added in spironolactone. It was a magical combination and now several months later she is back to her normal beautiful skin. And she is using the Aveeno products with soy(and sunscreen always) to deal with the marks left behind Its amazing to me that slightly elevated testosterone could cause so much trouble!!

I wish doctors would explain what a Diuretic means. This is the third time a doctor has said this was a Diuretic. When I hear Diuretic and go to the bathroom I thought it meant I would have diarrhea or have to poop more often. It took a nurse to explain that diuretic means peeing more often. Sometimes I think doctors forget to include some explainations that seem common but what their patients don't know.

I have hidradenitis and I'm on spiro. My derm prescribed it without really explaining the drug, so thank you for this video.

Spiro was a life changer. My body was covered in cystic acne that was very painful and embarrassing. If I stop spiro it immediately comes back. I’m so happy to have it. I take 200 mg a day.

Hi Dr Dray, Please do a video on Metformin for PCOS acne sufferers. ❤️❤️❤️

Thanks for a good Q&A! I use spironolactone and it has helped greatly with acne and slowing the hair loss I experience due to thyroid issues. My endocrinologist keeps an eye on my potassium (among other things) and so far, so good! I have only experienced positive effects, not negative side effects. Good informative video!

been taking 50 mg minocycline 2x a day and 50mg spironolactone 1x with adapalene +benzoyl p topical 1x at bed for only 1 week and I already not only see but feel positive effects . so excited and grateful to be on a skin clearing journey after all these years and thank you for all the info you provide ! people like you are a blessing to people like us

Spironolactone 50mg a day, changed my life. I no longer suffer from acne. 100% remission.

Spiro has been a miracle for my hormonal acne. I reached 100% clear skin at around 6-8 months after trying so many other things. 100 mg is my magic dose. Yes there are side effects but I deal with them because of how well this med controls my acne. It also re-grew my hairline and helps me keep the water weight off. Highly recommend!! Great video.

This actually really helps bc I’ve heard of people taking spiro and birth control together and I was always confused on why they were taking both at the same time but now I understand it better

Almost a month taking sprino and i have seen the result...my acne become lesser I love it

This was incredibly helpful, thank you so much!! I appreciate how you describe the mechanisms by which medications actually work!!

This is really helpful!! I think if there was less jump cuts it would be a smoother video. You’re the expert! No need to cut up the video

I’ve been put on spiro after my acne came back a few years following accutane but I’m terrified to death of taking it. I’m finally at a good place with my period (predictable almost to the day, not heavy, and only slight cramping) and I don’t want to mess that up and go back to the pain and misery of my teenage years. I’ve taken spiro before I went on accutane and I’m just gonna say, the accutane was far kinder to my body than spiro was. Spiro made me feel crazy. I’d take Accutane any day over spiro. And I will never take hormonal birth control again. The depression while I was on that BS was way too much. I also have issues taking pills consistently. I can do a skin care routine since it feels like relaxing self care. But to get me to take a pill, you pretty much have to sit me down and shove it down my throat like you might do with a dog

Thank you for this! I am someone with PCOS and just started my journey with this medication. This helped with a lot of my questions. Anticipating what results will come in a few months!

I am a 63 year old woman that had male pattern baldness and my hair was falling out by the handfuls . I have been on 100mg of Spironolactone for 10 years prescribed by a endocrinologist by the name of Jamie Trujillo MD. He said he was the one discovered that it could be used for that. I no longer have male pattern baldness and all the hair that fell out has come back even thicker.

This med made me lose my period for 2 years. My doctors didn’t tell me that was a side effect and they did soooo many tests on me to figure out why. I just realized it a few days ago. I stopped the med 4 weeks ago and lo and behold, my period appeared yesterday.

Thank you so much for this post. You explain so much and make this option less scary.

You are a wealth of information. Though I am not "currently" affected by any of these conditions, I enjoy learning and can share this information and your videos with someone who perhaps may. Thank you for sharing and have a great weekend!

Wait, I've been taking Spiro for 3 years now. You said it's supposed to be taken at night? I was always told to take it in the morning so it didn't make you have to get up and pee in the middle of the night. What's the benefit of taking it at night vs. morning?

Be careful with Spiro if you have low blood pressure, as it lowers blood pressure. I was started 50mg, but then dropped to a very low dose of 25mg to see if I could get used to the med. I have low blood pressure. and it lowered mine so much I ended up in the ER! After trying the low dose a second time to confirm it was the meds, I started getting the same symptoms. I was told to stay off this med, and to add it to the list of medications I am "allergic" to.

I would like to point out that I also experienced the same symptoms that more than a few have commented here on spironolactone. Increased abdominal cramps as if I was back in middle school, fatigue, night panic (really bad, never experienced this ..only on spiro), dark thoughts, and insane dizziness! It was just too intense. What a mess; never again. Yes my mustache was gone and no pimples but not worth it ;lol I will leave my hormones (and frida kahlo weekdays) alone. :)

I just started a low dose spironolactone 2x daily 3 weeks ago for my acne. It has helped clear my skin. However, horribly worsened my anxiety, PTSD, and depression. I am now unable to stop uncontrollably crying when I’m overwhelmed-even at work. I get so sulcldal and angry worse than before. I’d rather have the acne than lose my job and have anxiety attacks at every little thing or rude comment. Don’t recommend

Is there an advised length of treatment or would one have to be on it for life?

I've been taking this for over a year and I still get breakouts during my cycle but other than that my breakouts have ceased. Considering I used to break out every day, I'm pleasantly surprised with this treatment.

Hello Dr Dray, thank you for all the helpful info. I've learned more from you than some of the doctors I've been to. What dosage do you recommend for spironolactone?

My face is so clear from this medication. I used to be on an anti biotic and thought there wasn’t anything else besides Accutane that would help, but wow did Spiro helped me.. so I’m more than blessed that I tried this and didn’t give up

I have been on this for hormonal cystic acne for 6 months. I would say around the 3 month mark I noticed my skin was getting clear 🙌🏻I was very excited and things just kept getting better until around 6 months when I kept getting my period every other week. I have since stopped and I think I will start again on a lower dosage 25mg vs the 100mg I have been on and see if it still keeps my skin clear. How long are people normally on this?

the wombo combo treatment for hormonal acne: differin gel + spironolactone + birth control.

Spiro worked amazingly for my skin but holy crap It messed with the rest of my body even in the lowest possible dose. I was dizzy a lot to the point I had a panic attack, had to go to the bathroom constantly like could make it through an hour lecture constant, my pms symptoms increased a lot, and my periods became so irregular I literally didn't know when it would start or end. I'm so angry nothing was explained to me because I was told essentially it might make me have to go the bathroom more but that even that really wouldn't happen on the lowest dose. Well guess what buddy it did a number on me

Thanks for this! It's the first time I hear that dermatologic problems mentionned here are actual diseases and not just a cosmetic thing that we should just accept. It's incredible how much this society is encouraging to take care of our appearance but refuse to see that it make us suffer in silence/alone when we unfortunately encounter those kind of issues which are not fully covered by insurances btw. In same time, maybe if appearance was not as valued for women, it'd be easier to let it go. And in same time we have the right to feel ok in our own skin, look, features and this is not making us shallow. if I don't know. Feeling so hopeless for years but I was just prescribed spiro 75mg for 3 months combined with supplement & topical solution and now I want to have some hope to help to find a vague normalcy after AAG has crushed my beautiful curly thick middle easterne hair since my beg 20's til now almost 10 years later. There's little chance I found back what I lost but will try to accept and do my best in terms of diet, medication, haircare, workout, relaxing routine..to improve the situation. Hope it works.

After so many years spent looking to help my hormonal acne, my Derm. Prescribed Spiro ❤️ my goodness it's a dream come true. Been on it for a year. I'm on 75 mg twice a day. Side effect is continuous bleeding. Last month I bled for 4 weeks in a row and my Derm. Explained there's nothing we can do so I decreased the dosage to 50 mg twice a day and it resolved however the acne came back. Needless to say, I'm back at my perfect dosage and bleeding/cramping again 😭

Thank you Dr. Dray. Your a very intelligent woman and I enjoy learning fro your channel, thank you for

Thanks for the info. I've heard birth control pills could clear up acne but didn't understand why. I noticed you are almost at 30,000!

I’ve been on spironolactone for 7 weeks today and I feel like it’s slowly..... getting better now but at first it got really bad! Just doing some more research,thanks for the information!

To anyone that wants to read. I just feel so stuck. 37 years old. Have never had acne all of my life. Last summer, I began suffering with GI issues (severe bloat, etc) and ACNE. Since then I’ve been using topical clindamycyn, retin-a and have been on 100mg daily of doxycycline for 5 months. All of this with little to no improvements. My derm just seems “annoyed” by me when I come in and appears to be annoyed that I do so much acne research on my own. I asked yesterday about spironolactone and she just said “yeah we can do that”. I want to get off of doxycycline because being on an antiobiotic for so long worries me but she didn’t mention that being on an oral birth control would help the spironolactone to work better. I cannot do this because it could flare up old melasma. My acne is not even that bad compared to some poor soles, but to me, someone who has never had it before...it is devastating. Embarrassing and really effects my life and confidence. I don’t know what the best treatment is for me and it doesn’t seem like my derm does either or that they really care all that much. I have an apt for a second opinion at another place but they can’t get me in till DECEMBER! Does spironolactone have a chance to be effective on me if I do not take birth control? Is there a link to gut health and skin health? All of this started the same time. I posed that question to the derm and they said yes and just blew me off. Why do doctors not want to help me? In the meantime, my skin is scarring and residual red spots are being left behind and are marking up the entire lower half of my face. It’s just all so frustrating. Spironolactone may be the only other option for me but...I am scared to make the switch from doxycycline.

As an anti-androgen, does Spiro impact muscle building for women?

This medication definitely works! But the side effects are to severe for me to continue using it. Dizziness, especially after working out. Sleepiness , mild anxiety attacks , headaches.

You’re in Houston! I would love to have you as my dermatologist, since mine doesn’t seem to care about my problem with body hair. She thinks it’s no big deal.

Thank you so much for that information! My dermatologist recently prescribed me that medication and it's nice to know more information about it

Great videos. Very informative. You confidently know your stuff! We appreciate your work! ❤️

Hi dr dre! I’ve been on spirno for several months now and have been on 75 milligrams per day now my urine is starting to smell odd and I’m kinda worried, any thoughts?

Thank you so much for your feedback. I was just increased to 100mg spironolactone about 2 months ago. My hormonal acne is diminishing, but I still get these annoying tiny little bumps around my chin area. I hope these go away

I was on Spironolactone for many years for PCOS. My doctor decided I didn't need it any longer. I began losing hair after stopping the med. Can Spironolactone help regrowth of hair that has been lost? Is there any danger of taking it over long periods of time?

I laughed so hard at the pore joke😅😂

Thank you Dr. Dray! Do you have to take Spironolactone forever for continued benefits? Does unwanted facial hair growth and hormonal acne return if you stop taking it? Also does this affect fertility if you’re trying to get pregnant while taking it? 💜💜

Hello Dr. Dray! Thank you for such informative video. I was wondering if spironolactone permanently treats the acne or will acne return back after I stop taking the pill. Also how long is the treatment with spironolactone recommended for? Is it safe for long term use?

I am so glad you posted this video, I have been taking spirnolactone for 2 years and it literally saved my skin. I developed insane acne at 40 that I never had before and these pills completely transformed my skin! I do have a question- will I be on them forever and what are the long term side effects, if any? Thanks so much! ❤️

I love how you explain everything thank you so much

It didn't work for my acne, I couldn't make it to the 100mg dose due to severe leg cramping. But it definitely helped with my heavy monthly periods. I'm now on accutane, I also suffer from hair thinning & hair loss. Dr. Can you be on both Spironolactone & accutane at the same time? Thank you. Hope I hear back.

Should I be worried about my potassium intake?

I just started it a couple months ago it works wonders !

Dr. Dray you're extremely informative, thank you! Just talked to my doctor today after watching your video. I hope this medication can help me.

I have been taking spironolactone for several years - it has changed my life. I know I cannot take it if I am pregnant (thinking of starting a family soon). Do you recommend any other medications or treatments for hormonal acne during pregnancy?

Dr Dray, thank you for this video. I was wondering if the long-term use of Spironolactone increases the risk of cancer (breast, ovarian) in premenopausal women? Thank you

I recently got on it because I have hs.

I just got prescribed 100mg and I’m worried about the possibility of weight gain. I workout 5x a week / mostly strength training. I’m a pretty active person, and I’ve worked really hard to lose & keep off 40lbs. I know if I were to gain weight from this it would be detrimental to my mental health. 😕

I am 50 and have been taking spiro for several years now to treat acne 50mg/day. It works so well - second to none - including birth control pills. Now that I have entered menopause I have unsuccessfully tried to wean off of it. I am not a fan of resultant sun sensitivity and reduced libido. My regular blood tests (inc potassium and liver enzymes)have been fine but I am still worried about long term effects on my liver. Thoughts ?

Hi Dr. Dray - today I was prescribed spirolactone 50 mg for hormonal acne. My derm cautioned about not eating too much potassium on the drug and gave me a list of foods to limit intake of. Unfortunately, it's almost my entire diet! Green veggies, avocados, spinach, artichokes, bananas, legumes, beans, greek yogurt...Do you know the reccommended intake of potassium in mg's for an adult female (115 lbs) on this drug? Is it a problem for your patients to comply?

I tried it for about 2 years. It made migraines worse and actually gave me acne ( I have combination skin but never before full blown acne) among other side effects . My doctor dismissed my symptoms but I decided to not continue taking it as I only manifested side effects but marginal results ( hair loss was not progressing but did not improve)

I would love to be prescribed this by my doctor but i'm wondering how one goes about asking for a medication as i imagine doctors like to reach their own conclusion as to medication rather than prescribing what the patient wants.

Hey Dr! Please please comment on: Spironolactone 25 mg(Acne, PCOS, hair loss) daily & Ashwagandha 250mg daily(For stress). Is this advisable?

Finally!!! you are so beautiful! does spirano cause hair loss ? I got worried when I read a post about causing hair loss. Is that normal ? maybe shedding phase ?

Interesting thankyou, I take Spironolactone for high BP, and in a short period of time noticed skin drying and rapid ageing. Skin was fine previously, normal for my age. I have asked my GP several times whether it was my health condition causing the issue and associated dry/sore patches of skin, or the medication - my questions albeit asked regularly have never been answered.

Forgive me but as a long term user of Spironolactone in the U.K., I can say with authority that it’s a diuretic. I have an auto immune disease and use this medication daily, for water retention. The diuretic aspect is not a side effect, but it’s main function.

Dr Dray! Thank you! for the vid, question, how long should spiro be taken max?

Hi Dr. Dray! Is the ok to take spironolactone only a week before the acne starts to flare up around my period? Instead of the daily dose

I just started this Rx today Fingers crossed Thanks for this info

Hi Doctor! Three questions: - Is Spironolactone a kind of antibiotic or does it contain antibiotics? I am trying to avoid antibiotics but I am also trying to get rid of my hormonal acne. - how long does it take for Spironolactone to leave your system? When is it safe to get pregnant after taking this medicine? - I've heard that this medicine will make my acne worse before making it better. Is it true? Thank you for your help! :)

Excellent video! Thank you for sharing your knowledge. How long can you be on Spironolactone? Years? What about long-term side effects? Thanks so much.

hi Dr. Dray! I love your videos. I was wondering if spironolactane will effect implant birth control such as nexplanon?

Informative video Dr. Dray. Love the mix of this content and VLOGs. I think VLOGs are my favorite ;) Thank you for the frequent posts.

I had severe acne and spiro was a lifesaver for me but i started getting kidney stones, this is something i've never suffered with before. Have you heard of this? My acne is coming back and i really need to go back on it but my derm is reluctant. Any advice would be great.

Dr Dray- I recently started Spironolactone for pcos and this was so helpful to see, thank you! I have horrible scarring from the hirsutism (plucking the hair destroyed my skin it seems like). What would you recommend for scar treatment for this?

Anyone else experience deepening of the voice on spironolactone? Also is this ok for me to take if my mom had estrogen sensitive breast cancer? Thx

Can spironolactone worsen existing eczema / dry skin on the face?

How long can you use spironolactone for hormonal acne ????

Hmm as a trans woman I'm taking both spiro and finasteride to obliterate my testosterone. Hopefully it works for me! I've been on spiro for 7 months now with pretty great results for my skin but the finasteride has only been a part of my regimen for a month so I'm excited to see what kind of hair growth changes develop.

Dr Dray: CAN you enumerate and expand on the possible disease processes you mentioned that may be causing hirsuitism?? I am 56, and have had excessive facial hair growth since I was 22. The daily plucking I initially started with, at 22, has become daily--- or twice daily-- shaving of both face and neck. And the hair has changed from dense blond hairs, to coarse, rigid dark brown/ grey hairs covering my face from the cheekbones all the way to the base of my neck. I would welcome Any sort of relief from this, as I am very self conscious of said hair growth! Thank you!

New to this channel and immediately subscribed after this. I'm headed to the gyno this morning and needed some info because I've been asking for my hormones to be tested last year due to some facial hair development. They said quote, "well the range is huge so you'd test normal anyway." Fast forward to today: I have cystic acne and facial hair. I'm demanding spironolactone. I'm allergic to synthetic hormones (like body hives and swollen lips) so birth control is out of the question. I also have high blood pressure. This sounds like a home run for me.

Because of the diuretic properties of Spironolactone, will discontinuance result in rebound water retention? I went a few days without taking it and noticed that I felt like a marshmallow, as if I was holding onto much more water. Thank you! I've learned so much from your channel.