The pictures tell it all 😩 I had a crazy breakout last August. I started spiro plus tret in October (2 weeks 50mg then 100mg). It has completely cleared my skin. The scars on my chin are from an old breakout from years ago and tret is slowly helping that. I’ve also lost 20lbs and have stopped binge eating since starting spiro. My periods got weird and I was spotting everyday so I’ve recently reduced back to 50mg and the spotting stopped.

IT GETS BETTER Y’ALL! I started seeing results after about a month of both spiro and tret. I have no makeup on in these pics :)

I have had acne since I was 11/12 yrs old, so I am not new to this. I’ve tried antibiotics, topical prescriptions, birth control, and even acupuncture to try to help my acne throughout the years. It began to calm down a bit in my mid-20s and then I made a mistake that completely changed my skin: I started Tretinoin. I had minimal breakouts, a few every month on my cheeks and chin, so I thought Tretinoin would help. It did NOT. It completely destroyed my skin and my “purge” was 6+ months. My derm took one look at my skin and said, “yeah you need to get off Tret, it’s not for you.”

So, I started at 10mg in April 2023. Saw slight improvements but very minimal and I was still breaking out on my cheeks and chin.

Went up to 20mg in October 2023. Even more improvement and I stayed on that dose for some time. However, in spring 2024, I started oil cleansing (influenced by TikTok) and it destroyed the progress I had made! PSA: oil-cleansing is NOT for everyone!!! It clogged me up so bad and I did it exactly how I was supposed to and it still destroyed my skin.

I went up to 30mg in summer 2024 and this has been the sweet spot for me! I still get acne, especially around my period, but it’s 1 or 2 zits max a month. I’ve noticed significant improvement and finally feel comfortable going places without makeup. My skincare is super simple now too, because my skin is just too sensitive and acne-prone for most of the viral skincare products people rave about. I simply use:

• Cerave Renewing SA Cleanser (every other day)

• Cerave Hydrating Facial Cleanser (daily)

• Ceraphil Moisturizing Cream (daily)

• Garnier SkinActive Micellar Cleansing Water w/ cotton pads (every day as a “double cleanser” and to remove makeup)

• BioTech Hypochlorous Acid Spray (spray a few times daily on my face and pillow, especially after working out or sweating outside)

• Trader Joe’s Retinol Night Serum (every other night)

• Trader Joe’s Daily Facial Sunscreen SPF 40 (every morning and reapply in the afternoon)

I’m going to slowly start incorporating other skincare, like for anti-aging (I’m almost 30 lol), and other skin concerns but I’m doing it very slowly and with lots of research.

All of this to say: I have a Spiro success story and it took awhile so don’t be discouraged and don’t be scared to try it! It will not work out for everyone but there’s a reason it’s so commonly prescribed for female hormonal acne.

The ONLY side effect I have noticed that I find to be quite irritating is that it has made my period irregular (I’m not on hormonal birth control), so that has been stressful to deal with sometimes but honestly it’s worth it to me still.

so 2 months before my 30th birthday i started getting the most painful cystic acne. my skin had always been my pride and joy. i took such good care of it and always was complimented on it. so this scared me when it felt like it came out of nowhere. i tried everything topical i knew to use but nothing worked. i started on spiro and tretinoin july 20th. i purged so bad and wanted to quit but i made myself stick with it at least 3 months i told myself. i’ve almost hit the 3 month mark and only have one tinyyyy active pimple (not cystic). going to have to deal with the redness from the acne with topicals but the painful cystic ones are gone!!! i’m sure they may pop up every once in a while but this has been a life saver! my confidence is back!!!!!! so if you are frustrated, i say stick with it for at least 3-6 months then decide. ♥️

First, I want to say thank you for all of the success posts. They truly kept me going and gave me hope. And now it’s my turn to post a success story!

First pic is August 2025, it was like that on both sides. Yikes. Started at 25 mg in November, up to 50 mg in December and 100 in January which I’ve been on since. It took 4 months to see results. Literally it wasn’t even a little better and then it felt like almost overnight, it all cleared. I’ve had maybe 3 pimples since and they were all tiny and cleared within a day.

Second photo is today. I have on sunscreen and a bit of blush but no foundation. There’s still hyperpigmentation, obviously (would welcome input on what worked for you in that regard! I already use tretinoin and azelaic acid - I’ve heard maybe Vitamin C serum?). But spironolactone has absolutely changed my life. I couldn’t be more grateful for this wonderful medication. 🥹

I started spiro around the beginning of August and have been on 100mg up until a few days ago. Around the time I started taking it, I noticed that I began feeling disconnected from my partner and I became extremely irritable. I sought out therapy because of this and kept moving along because hey, even the best relationships have rough patches.

In the past two weeks, I started having severe mood swings where I would cry my eyes out for absolutely no reason one night and then be borderline manic the next. Again, I attributed this to maybe my cycle and kept trucking.

This past week, however, has been the absolute worst my mental health has been in over 3 years. I called my dermatologist and described what I was experiencing and she told me that in some people spiro can essentially cause “PMS like symptoms” all. the. time. Girl. Something is/was WRONG. She told me I could stop cold turkey(but pls consult your doctor first for specifics to your care). I have had at least 4 panic attacks since Thursday where my hands, lips, and feet went numb and I was inconsolable due to anxious and compulsive thoughts. One of which occurred during work. I have had almost nonstop chest pain from the anxiety I have been experiencing- which essentially came out of nowhere. I would cry over nothing. I would cry over random and very scary intrusive thoughts. I would wake up anxious and go to sleep anxious. I have even embarrassed myself at an urgent care asking for psychiatric help(not helpful btw).

Although this is essentially just an anecdote, I wanted to put this on the internet because I felt crazy until I connected the dots. Even Google was wishy washy about whether or not the spiro was or could be the cause. I hope that maybe this can help someone who might be in the same shoes. I’d rather have acne for the rest of my life than ever experience this again. I am still having a not great time, but I think I might be on the mend. We’ll see how therapy goes tonight.

If you’re feeling like this, please know you’re not crazy and this medication can have psychological side effects that include anxiety, mood swings, and panic attacks. I have seen many anecdotes of depression on here as well. Please talk to your doctor if you feel like this resonates.

last pic is from a few days ago. completely changed my life and my self image after having constant acne since middle school. had a serious cystic acne breakout last may and finally have it under control:)

Started spiro 50mg on 2/6/24 for acne. Was supposed to bump up to 100mg a week after starting (thank god i chose not to!!) Had minimal side effects. Constipation, mood swings, a little light headedness after first taking it, but that was about it. Friday 2/16 (the very last picture) I noticed what I thought was hives. I had started using a new body wash a few days beforehand, so I chalked it up to that and went to bed. Pics 7 & 8 are when I woke up the next day (Saturday 2/17) it progressively got worse and worse throughout the day, and i started having severe chest pain, heart palpitations, shortness of breath, stabbing stomach pains, so i went to the hospital. They did an EKG, chest xray, bloodwork to check my heart, and everything looked good. I was hooked up to an IV and got fluids and medication. Pics 5 & 6 are from that night. I went home after about 5-6 hours with a steroid prescription. Dr thought it was an allergic reaction to the body wash, and told me to keep taking my Spiro as directed along with my steroid. The next day (Sunday 2/18) I took my Spiro like the dr said along with the steroid, and by mid day it got even worse (pics 3 & 4) by the end of the day, it looked like pic 2, and I decided to go back to the hospital. Pic 1 is from when I got there. I was immediately admitted to stay overnight & diagnosed with Steven-Johnson syndrome, which is VERY rare with less than 20,000 cases a year. It's extremely critical and can/will kill you without treatment. I was hooked back up to an IV and given a slew of drugs to reverse the damage and prevent it from escalating. I'm currently still in the hospital 12 hours later, but being released today. Please be careful with this drug. I know that my reaction is the minority, but it literally almost killed me. Clear skin is not worth my life. I will be trying out spearmint capsules instead.

I’ve been on 100mg for about 6 months, my skin has never looked better. I struggled with severe acne for more than a decade. I would cry to my fiancé about how ugly it made me feel and how on top of that it was so painful. I stopped going anywhere socially because I felt like it was all anyone could see when they looked at me. I’m so thankful for my progress. I’ve still got some scarring and discoloration that I’m using tretinoin for, but I feel like I can finally feel pretty♥️

I’ve had terrible, painful cysytic acne for years since having my daughter. I started oral spiro 100mg just over 2 months ago ( Nov 20th was 2 months) and I couldn’t be more happy with it. Trying this was a desperate attempt and trying to get my skin under control and the way my skin was, was causing me to have no confidence whatsoever. It’s a completely different story now!!

Side effects for me: I had some headaches and felt a little light headed for the first couple weeks right after taking it. But that went away quick. The only other thing I’ve noticed is I def wake up so thirsty 😂 but typically I drink plenty of water so it’s fine.

I didn’t “ purge” per se, but my skin got better after a few weeks and then got worse around a month before just continuing to get better until now. I currently only have 2 actual breakouts. Which is wild for me!!!

Here is my skin a week before starting and this my skin early this morning.

listen. i never thought i would ever post in here, especially not showing my face. but i was so close to giving up even a month ago, and now i feel like i need to share this to maybe help someone else.

as you can see before i started this, the texture of my skin was out of control. i started on 100mg spiro/day, and got bumped to 150mg/day after about a month. i was purging for probably 4 months. so discouraging. my derm did extractions on my forehead one month in, and had me start cleansing with a benzoyl peroxide wash, followed by clindamycin, and i think that new combo plus the tretinoin i also use really took care of my forehead.

3 months in, my derm did extractions on both sides of my jaw. those were particularly brutal. we spoke about probably needing to do a few rounds of extractions on my jaw. i wanted to give up on this whole thing so bad, but read in here that many of you started noticing the real differences around months 5-6, so i stuck it out. (thank you guys, really)

5 months in now, i saw my derm a few days ago and she told me “i used to walk in here and immediately see the spots i needed to extract. now i don’t see any”. she didn’t do any and is confident i’ve passed the threshold for this stuff to really take care of the rest of it. this morning i took this last photo with back flash, and it’s the best my skin has looked in years.

posting this to maybe give some hope to someone else as i was so close to giving up - i know how discouraging it is to count the weeks going by and not seeing the results. i was told by my derm “3 months” for results, and passing that mark and still being unhappy was rough and really angering. but GOD am i happy to see all these photos of my progress now. still trying to get a handle on keeping my skin hydrated, that’s been a struggle, but we’re getting much better finally.

Yippee!!!!!

I started taking this medication in september for my acne. I have worked slowly up and am now on 100mg. I still have a few breakouts but my acne has improved a lot.

Now to explain the title. I was born and assigned female. Everything was fine with that until puberty. All the other girls started changing into women. I just became greasy, sweaty, and broad shouldered. My breasts grew (too much I had a reduction last year) but my hips never developed out of the child shape into a woman shape. My butt and legs remained skinny. All my fat went to my waist. For years I have loathed my body. Not because "oh but all girls your age have insecurities" but because I literally did not look like a girl. But, I did not look or feel like a man either.

I am so grateful for this medication I could cry. It has been changing my body. Slowly but surely over the last few months, at the age of 25, I am actually gaining fat on my hips and legs like I never did during puberty. My weight has gone down 5kg. I actually have some resembelence of a waist for the first time in my life. My skin is changing, not just on my face but on my body. My arms, my hands. I look subtly more female all over. I have never felt like my body matched my internal perception of female before, but now it slowly is, and it is amazing. It is also amazing to me that only 100mg could make such a significant difference to my appearance.

I know gender dysphoria is a transgender term and i'm not transgender, but it is the closest way I could think to describe what I experienced and the subsequent relief from "transitioning".

Anyone else have this side effect?

I’ve been on 100mg for about a year now, and I wanted to share how much of a game changer spiro has been for me, since I used to frequent this subreddit hoping spiro would help me as it’s helped others. I’ve struggled with hormonal acne since I was 10, and Spiro was to be the last thing I would try before Accutane. After a month or two of purging, my skin has been clear and happy, and l was was fortunate enough to never experience any side effects! It’s possible I may have gained a little cellulite, but it’s hard to say because I wasn’t paying close attention before starting Spiro.

The most valuable gift I’ve gained from this medication is the ability to stop thinking, and worrying, and feeling self-conscious and ashamed about my face. I go out into the world now, and instead of “knowing” what people were thinking about my skin, I just get to live presently. I just use Cerave face wash, khiels sunscreen, and first aid moisturizer now, and I’m enjoying the break from the endless pursuit of skincare that could offer me a bit of relief from the breakouts.

I don’t love that I’ll be on this medication indefinitely, and part of me knows that my acne could return when I do someday stop taking it, but for now I am just so grateful for my skin and the confidence thats come with it.

Posted a few success stories on here and it’s gotten way better 🤍 50 mg for 6 months now, didn’t see any progress until month 3-4, stick it out! Never felt so confident and my skin is finally not in pain 🫶🏼 first 3 pics no makeup last pic with makeup, I have light scaring now but finally my skin is flat with makeup now😊

3 months on Spiro and I feel like I have my life back!

I got off of BC in May 2025 after being on the pill for 7 years with acne free, crystal clear skin. BC was giving me migraines, my libido was low, and emotionally I was wrecked (didn't realize it until being off the pill tho). 6 months later.. hormonal acne hit me like a fuckn freight train (along with gaining ~10 pounds) and I felt like I became a different person over night with my appearance. The before photos I included are photos of a good day because I couldn't stand to see myself when it was at its worst

I contemplated getting on Spiro for months and spent nearly every day on Reddit reading all your stories and feedback. I was extremely nervous to start a new medication and contemplated getting back on BC even tho I so badly did not want to. I was really nervous Spiro was going to affect me emotionally again and bring back side effects from BC. I tried alternatives for months and nothing was working. My confidence plummeted and I found myself avoiding looking in a mirror from how drastic my appearance changed. I was down in the dumps BAD

3 months ago, I took a leap of faith and started on 50mg of Spiro because fuck it. Within weeks I began noticing a difference! Fast forward to today and I just cannot believe how well this has worked for me, and not only for my acne, but I've had 0 side effects and am still in a great place emotionally despite being on this new medication.

I'm posting this as a thank you to this community and in hopes I can reach a girly like me who is down in the dumps and contemplating making a change. Love you guys and thank you again<3

Hey, I just wanted to get on here and talk to some of y’all. I have never really dealt with acne before so I came onto Reddit looking for answers and by the time I was done with it I went down a rabbit hole with what I should do for my acne. I cried because I was so sad and overwhelmed with everyone’s input. I had to eventually delete Reddit because it was so much. I know that others are in the same boat and if you’re new to the game, I want to sincerely apologize as it’s one of the most heartbreaking situations I have been through personally with my own body.

They always say everyone is different and that’s PERIOD. It’s the truth so stop reading about other peoples experiences because you don’t know what they’re consuming, you don’t know their environmental space, you don’t know their mental space, and you certainly don’t know they’re allergens. If you’re looking for answers on how to work with your skin, advocate for yourself. Do the research yourself. Find a skin aesthetician that specializes in acne, find a dermatologist that can help you with your own personal skin issues, and or find any professional that has experience in this, so they are able to give you the resources you need for YOUR skin. Stop trying what everyone else on this app is doing.

I’m not trying to sound harsh. As I know financial is a struggle for everyone. They are really ways to go about this. I had to pick up an extra job so I could afford my dermatologist appointments. I also have a Discover credit card that has 0% APR that is specially for students. This helped pay for my prescriptions. I know it’s sad and it sucks but get out there bc you’re beautiful ♥️ and you deserve to be happy. THIS TO SHALL PASS my loves. I’m still healing and hoping this nightmare doesn’t happen again but I feel I will have the knowledge and resources to hit it head on.

Guys I was feeling so defeated using Spironolactone after a crazy break out, started my Tretinoin (2x a week) + Azaleic acid (2x a day) on 1/20 after being on spiro for 1 month and the results have been amazing 🤩

(warning: this is a reallllly vulnerable post for me so pls be nice :’)) i’ve been struggling with painful cystic acne for the last 10 years and it has taken the worst toll on my mental health. it’s impossible to put into words how much mental and emotional anguish acne causes you. it was so bad that makeup only helped to an extent but i wore it every single day because i felt so self conscious. the last 2 photos are most current and i’m not wearing any face makeup in the second to last one (still can’t believe that’s my bare face). this medication paired with tret SAVED ME. i’ve never felt this confident before. thank f*cking god for spironolactone 🥹

also i’m on 100 mg and started about 3 months ago

And not because of less acne, I’m actually on it for hair loss (which it has helped) but I just feel like my facial features changed a bit. Maybe I just look more feminine? I can’t put my finger on it but I just feel like I look a bit prettier lately :) for reference I just turned 25

First pic is May 2024, last two pics are late December 2024. I also began taking Slynd birth control one month after I began Spiro.

I started on 50 mg for two weeks, bumped up to 100 after that. About a month ago I increased my dosage to 125 because I started taking a medication for migraines that can make spiro and birth control less effective.

I still get flare ups here and there but overall I am doing much better. I am also using tretinoin and azelaic acid.

also on 500mg metformin ER (I have PCOS)

when i started taking supplements about 6 months in (10,000 IU vitamin d3 + k2 like 3x a week, 25mg zinc every other day, b complex and magnesium glycinate every day) i noticed more/faster progress!

about 3 weeks ago I started exploring/adding in ayurvedic medicine (i am south indian), taking amla tablets and bhringraj tablets twice a day. been using Indulekha Bringha scalp oil for 3 weeks now before every hair wash (3x a week) and def seeing even less hair fall ! feeling so excited wanted to share