The medication we’re talking about is called spironolactone, and it’s not new by any means. This medication was originally developed to help manage hypertension but has been used off-label as a hormonal acne treatment for decades—but is only cleared for use by women.

According to the recent randomized and double-blind trial published in the BMJ1, spironolactone improved acne when compared to a placebo2, with greater differences at week 24 than week 12 for women 18 or older.  

With these conclusions, researches deem spironolactone a safe and effective alternative to antibiotics for women struggling with acne. 

This echoes the findings from the American Academy of Dermatology (AAD): “In looking at the medical records of 85 women who took spironolactone, researchers found that ⅓ of the women had complete clearing and ⅓ had noticeably less acne. Only 7% saw no improvement.” (However, this wasn’t a randomized controlled study.)

Why does this matter? Well, for countless reasons, including the fact that plenty of women are put on antibiotics for months (and even years) to manage acne, which can have a negative impact on their gut and overall health. 

Rather, this medication is designed for long-term use, but that doesn’t mean it’s without its drawbacks. Most notably, the medication can cause irregular menstrual cycles in some and should only be taken when women are not pregnant or trying to get pregnant, as it can cause birth defects. 

So while it’s not for everyone, spironolactone can be helpful for women who have tried other topical remedies and lifestyle changes without luck. Of course, you should always consult a dermatologist if you have any lingering concerns or are interested in trying out the treatment.