Spironolactone for
Hormonal Acne and PCOS

Improve hormonal acne, unwanted hair growth, and PCOS-related symptoms with physician-led, evidence-based spironolactone therapy designed for women.

Reclaim control over hormonal symptoms

Reduce acne and oil production

Support clearer skin and renewed confidence

Support reduction of unwanted facial or body hair

Help improve androgen-driven PCOS symptoms

Reduce acne and oil production

Support reduction of unwanted facial or body hair

Help improve androgen-driven PCOS symptoms

Support clearer skin and renewed confidence

What Is Spironolactone?

Spironolactone is a medication that blocks androgen receptors and reduces the effects of circulating testosterone. In women, excess androgen activity can contribute to hormonal acne, unwanted facial or body hair, scalp hair thinning, and certain PCOS-related symptoms.

Even when bloodwork appears “normal,” androgen activity at the skin or hair follicle level may still be elevated. Spironolactone works directly to reduce oil production, decrease androgen-driven inflammation, and limit testosterone stimulation of hair follicles.

At Fem Excel, spironolactone is prescribed in clinically appropriate doses as part of a personalized hormone plan that includes laboratory testing, symptom tracking, and structured follow-up care.

Spironolactone treatment options

Oral spironolactone tablets (custom dosed)
Spironolactone is taken daily in personalized doses based on your symptoms and lab results. Dosing is adjusted under provider supervision to optimize results and minimize side effects.

When appropriate, spironolactone may be combined with metabolic or progesterone support as part of a comprehensive hormone plan.

Benefits of spironolactone

Clearer skin and reduced acne

Spironolactone reduces excess oil production and androgen-driven inflammation associated with hormonal acne.

Decreased unwanted facial and body hair

By blocking androgen receptors, spironolactone reduces hormonal stimulation of terminal hair growth.

Support for androgen-driven PCOS symptoms

Reduced androgen-related scalp hair thinning

By limiting follicle miniaturization, spironolactone supports preservation of scalp hair density.

Improved confidence and emotional well-being

As visible symptoms improve, many women report feeling more confident and comfortable in their appearance.

How it works

Our in-house team specializes in hormone optimization and takes the time to understand your symptoms, goals, and history. Doctor-led hormone therapy is the key to real symptom relief, healthy aging, and results that last.

Start with your story.
Share your symptoms and health history through our online assessment.

Meet your hormone expert.
Connect online with a licensed provider to discuss your symptoms and goals. If prescribed, treatment can start right away.

Get deeper insights.
After your consult, we’ll send you a simple at-home hormone test kit to measure key biomarkers and fine-tune your care.

Personalized, ongoing support. 
Once your lab results are in, your provider will review your progress and adjust your treatment as needed. We check in every 60 days, and you’ll receive comprehensive blood tests every six months to keep your care truly personalized. 

Thousands of women are already experiencing the benefits.
Start your free assessment today.

85%

report improvement within 2 months*

96%

report improvement within 6 months*

100,000+ patients treated*

Among America’s fastest-growing companies. Voted Top Hormone Provider of 2024 and Hormone Provider of the Year 2025.

^*Data taken from 32,795 members responding to symptoms reviews with their Excel Medical providers

What our patients say

When your hormones are off, everything feels harder. But with the right care and optimized hormones, everything changes.

Women come to Fem Excel feeling tired, foggy, frustrated, and unheard. They stay because they feel energized, clear-minded, unburdened, and back in control.

These are their stories, not just of better health, but of lives transformed.

Possibly the best healthcare experience I’ve ever had

“I walked away from this appointment actually feeling satisfied with the results I received. For once I left an appointment with all my questions answered instead of having more questions than answers. The provider was very thorough, informative, and helpful. This was one of the better healthcare appointments I have ever had. Thank you Ms. Tara for the wonderful experience.”

Very knowledgeable & professional

“Very knowledgeable & professional. Details about the whole process and the medications that I may be taking. I was very happy to have a caring one on one with the NP. It is the help I was waiting for in the convenience of my own quiet setting.”

Caring and thorough

“I really liked ease and convenience having a virtual appointment. Kel made me feel comfortable immediately and explained everything thoroughly. She is a good listener and has an empathetic spirit about her. I feel encouraged that together we will resolve any challenges I am having.”

I had been struggling since I hit menopause…

“I had been struggling since I hit menopause a year ago. My doctors couldn’t help. It was terrible, I was struggling with no hope for any help. Then I tried Fem Excel. They HAVE CHANGED MY LIFE! I have energy, I sleep well I feel so good, it’s unbelievable and the doctors were so efficient and I just felt understood. I am so glad I got a hold of this company. Thank you so much!”

Real Reviews, Actor Portrayal shown

Related symptoms

PCOS-related acne and oily skin

Hormonal breakouts along your chin and jawline are often caused by elevated androgens. We use proven anti-androgen treatments like spironolactone and hormone balance to clear your skin from the inside out.

Excess facial or body hair (hirsutism)

Unwanted hair on your chin, chest, stomach, or back is one of the most frustrating signs of PCOS. We reduce hair growth by lowering androgens and supporting balance with spironolactone and targeted hormone therapy.

Hair thinning and hair loss in PCOS

If your hair is thinning at the crown or temples, PCOS and thyroid dysfunction may be the reason. Our approach addresses both to help stop shedding and support healthy regrowth.

PCOS-related acne and oily skin

Excess facial or body hair (hirsutism)

If you are gaining weight, especially around your middle, despite eating well and staying active, it may be due to insulin resistance. We address this using hormone therapy, thyroid support, and insulin-sensitizing treatment options.

Hair thinning and hair loss in PCOS

If your hair is thinning at the crown or temples, PCOS and thyroid dysfunction may be the reason. Our approach addresses both to help stop shedding and support healthy regrowth.

The Excel Advantage™ membership

$99/month

Get dedicated physician support, regular monitoring, and personalized adjustments so your hormone therapy evolves with you.

In-house specialists

Trained directly in the Excel Advantage™ protocol.

Integrated treatment

Hormones, metabolic support, and advanced therapies.

Symptom-driven care

Treatment guided by symptoms, not lab numbers alone.

Member access & pricing

Access to advanced treatments with preferred pricing.

Precision monitoring

Regular labs with personalized treatment adjustments.

60-day follow-ups

Provider reviews to refine and optimize treatment.

No commitment required • Cancel anytime • Medications not included

Medically Reviewed

This page was medically reviewed by Peter Fotinos, MD, Chief Medical Officer, and Lorna A. Brudie, DO, FACOG, FACS, Medical Director, Excel Medical. Dr Fotinos and Dr Brudie have nearly 50 years of combined clinical experience in hormone optimization and preventive medicine.

Last reviewed: October 2025

References

Citations

Santer M, Lawrence M, Renz S, et al. Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double-blind, randomized controlled trial. BMJ. 2023;381:e074349. doi:10.1136/bmj-2022-074349
DOI: https://doi.org/10.1136/bmj-2022-074349
PubMed: https://pubmed.ncbi.nlm.nih.gov/37192767/
Pyne S, Sach TH, Lawrence M, et al. Cost-effectiveness of spironolactone for adult female acne (SAFA): economic evaluation alongside a randomized controlled trial. BMJ Open. 2023;13(12):e073245. doi:10.1136/bmjopen-2023-073245
DOI: https://doi.org/10.1136/bmjopen-2023-073245 
PubMed: https://pubmed.ncbi.nlm.nih.gov/38081673/
Plovanich M, Weng QY, Mostaghimi A. Low usefulness of potassium monitoring among healthy young women taking spironolactone for acne. JAMA Dermatol. 2015;151(9):981–984. doi:10.1001/jamadermatol.2015.1638 
DOI: https://jamanetwork.com/journals/jamadermatology/fullarticle/2194951 
PubMed: https://pubmed.ncbi.nlm.nih.gov/25796182/
Shaw JC. Antiandrogen and hormonal treatment of acne. Dermatol Clin. 1996;14(4):803–811. doi:10.1016/S0733-8635(05)70405-8 
DOI: https://doi.org/10.1016/S0733-8635(05)70405-8 
PubMed: https://pubmed.ncbi.nlm.nih.gov/9238337/
Carmina E, Azziz R, Bergfeld W, et al. Female adult acne and androgen excess: AE-PCOS Society recommendations. J Endocr Soc. 2022;6(3):bvac003. doi:10.1210/jendso/bvac003 
DOI: https://doi.org/10.1210/jendso/bvac003 
PubMed: https://pubmed.ncbi.nlm.nih.gov/35155970/
Somani N, Turvy D. Hirsutism: an evidence-based treatment update. Am J Clin Dermatol. 2014;15(3):247–266. doi:10.1007/s40257-014-0078-4 
DOI: https://doi.org/10.1007/s40257-014-0078-4 
PubMed: https://pubmed.ncbi.nlm.nih.gov/24889738/
Mihailidis J, Dermesropian R, Grant-Kels JM, et al. Endocrine evaluation of hirsutism. Int J Womens Dermatol. 2017;3(2):56–62. 
PMCID: PMC5419053 https://www.sciencedirect.com/science/article/pii/S2352647517300175?via%3Dihub 
PubMed: https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/
Trivedi MK, Shinkai K, Murase JE. A review of hormone-based therapies to treat adult acne vulgaris in women. Int J Womens Dermatol. 2017;3(1):44–52. doi:10.1016/j.ijwd.2017.02.018 
DOI: https://doi.org/10.1016/j.ijwd.2017.02.018 
PubMed: https://pubmed.ncbi.nlm.nih.gov/28492054/

Frequently asked questions

What is spironolactone used for in women?

Spironolactone is commonly used to treat symptoms driven by excess androgen activity, including hormonal acne, unwanted facial or body hair (hirsutism), androgen-related scalp hair thinning, and certain symptoms associated with PCOS. It works by blocking androgen receptors and reducing the effects of testosterone at the tissue level, helping restore hormonal balance when androgens are contributing to persistent skin or hair concerns.

Is spironolactone safe long term?

When prescribed at appropriate doses and monitored by a medical provider, spironolactone is generally well tolerated and has been used safely in women for decades. Most side effects are mild and dose-related. Baseline and periodic lab monitoring are standard to ensure safety. At Fem Excel, dosing and follow-up are carefully managed to support both effectiveness and safety.

How soon will I see results?

Most women begin noticing improvement in acne within 8-12 weeks, with more significant improvement often seen around 4-6 months. Hair-related symptoms, such as unwanted facial hair or scalp thinning, may take longer to improve because hair cycles change gradually. Consistency and appropriate dose adjustments are key to achieving optimal results.

Can spironolactone help with PCOS?

Yes. Spironolactone can help reduce androgen-related symptoms of PCOS, including acne, unwanted hair growth, and scalp hair thinning. However, PCOS often involves metabolic and hormonal factors beyond androgens alone. At Fem Excel, spironolactone is used as part of a broader, personalized plan that may also address insulin resistance, cycle regulation, and other symptoms of hormone imbalances.

Do I need labs before starting?

Yes. Baseline lab testing helps ensure spironolactone is appropriate for you and allows your provider to personalize dosing safely. Ongoing labs are also important to monitor electrolytes and overall hormonal balance as treatment progresses. Regular monitoring is part of our physician-led care model to keep your therapy both safe and effective.

Spironolactone for
Hormonal Acne and PCOS

Reclaim control over hormonal symptoms

What Is Spironolactone?

Spironolactone treatment options