All my fellow PCOS girlies know that if you’ve ever searched for ways to manage PCOS acne, unwanted facial hair, or hair thinning, you’ve probably come across spironolactone. Something that is most commonly prescribed, yet people begin taking it without fully understanding what it does, why it works, or what side effects to expect.
When I was first diagnosed with PCOS, I was prescribed these special all-healing pills. At the time, I had no idea what it was; I just heard the promise of clear skin and was all in!
When dealing with my diagnosis, one thing I kept hearing was the idea that you can only treat PCOS symptom-wise and not as a whole. When receiving this, the lack of information from healthcare providers and the many struggles acne can bring you can help you understand why I was easily convinced to hop on this medication. After leaving with this prescription, I felt a huge weight lifted off my shoulders after months of begging to see a dermatologist. Spironolactone brought me the fix I was looking for: one pill twice a day, going from 50mg to 100mg. My skin finally cleared, perfect or not- it felt like I found the last piece of the puzzle. In that moment, I thought my journey with hormonal acne was finally coming to an end. Little did I know, this prescription would become just one chapter in a much bigger story about understanding my body.
For those who may not know, Spironolactone helps reduce the effects of excess androgens that are present, which is why it is deemed to work effectively for women with PCOS. It doesn’t eliminate testosterone; it just turns down that high volume, decreasing that signal to your skin and hair follicles. As a symptomatic medication, it treats hormonal acne, facial hair, excess body hair, and thinning hair on the scalp. On the other hand, it does bring side effects such as dizziness, headaches, breast tenderness, and can cause birth defects. But all in all, it does not cure PCOS or address insulin resistance, the root cause.
I finished my first bottle and went maybe 2 weeks before I got a new bottle, and I was in for a rude awakening. My acne came back!!! Worse than ever!
Hormonal acne is not an easy battle. There were days when all I wanted to do was hide. I became an expert at trying to cover it up, using makeup a certain way or even changing my facial expressions to make what felt like millions of bumps seem less noticeable. I tried product after product, each one promising clear, glowing skin. Every new formula gave me hope, only to leave me disappointed. What I didn’t realize at the time was that my skin wasn’t the problem; it was reflecting what was happening inside my body. The breakouts weren’t driven by my skincare routine (at least most of them); my hormones drove them.
For me, it definitely helped my skin. But over time, I realized it wasn’t the long-term solution I wanted for my body. I experienced side effects that made me rethink my approach, and eventually I decided to stop taking it and focus more on nutrition, stress management, sleep, and other lifestyle changes to support my hormones. My skin has its moments, but it is so much better than relying on two pill doses a day every day for the rest of my life. This isn’t me saying spironolactone is a bad medication. For many women, it’s life-changing. But my experience taught me that while medications can be powerful tools, I also wanted to understand why my body was sending these signals in the first place.
“You don’t get confident from clearing your skin. You get confident by standing up despite your insecurities and ripping through them where it hurts and scares you the most.”
— Asia Bankson
