It wasn’t until her 30s that Jessica Line began to develop acne.
The radiologist had always had perfect skin – even through her teens. But suddenly she found herself experiencing painful flare-ups of angry bumps across her jaw and lower cheek.
‘It was a humbling experience,’ says Jessica, from Surrey. ‘I didn’t want to leave my house when my skin was breaking out – I would cancel plans and stay home. It really affected my social life.’
Keen to sort it out quickly – and finding over-the-counter creams and serums ineffective – Jessica decided to try Accutane, a powerful medication used to treat severe, persistent acne.
At first the drug seemed to work – with the acne gradually clearing up over the nine months she was on it. But a year after the course of pills ended, the spots returned.
Not willing to do another round of Accutane, which left her with incredibly dry skin and unable to be out in the sun for too long, Jessica was at the end of her tether.
So when her GP suggested taking the blood pressure medication spironolactone off-label – a drug prescribed for an unapproved purpose – she agreed to try it.
Jessica Line says: ‘I didn’t want to leave my house when my skin was breaking out – I would cancel plans and stay home’
She gave Accutane a go, but stopped after it left her with incredibly dry skin and unable to be in the sun for too long
Within five months her skin was crystal clear, and remained so even after coming off the medication four months later. ‘I was amazed,’ she says. ‘My skin had never looked so good.’
Spironolactone is not a new drug. Developed as early as the 1960s to lower blood pressure, doctors soon noticed it had positive side effects in female patients.
It left them with significantly less oily skin and fewer breakouts, while others reported their hair getting thicker or even growing back after patches of hair loss.
Researchers later discovered that spironolactone was blocking the effect of male sex hormones such as testosterone.
Increased levels can cause sebaceous glands in the skin to produce more sebum than the skin needs – causing oiliness and blocked pores. By stopping the effect of testosterone, spironolactone was reducing acne and thickening the hair of female users.
Because of its effects on male sex hormones, the drug is not suitable for men as it can cause side effects such as breast growth and erectile dysfunction.
But a growing number of women have taken to social media in recent months to express their amazement at what some have dubbed the ‘magical life-changing pill’. In videos posted on social media platform TikTok, young women with glowing skin make gushing statements such as ‘I owe my life to spironolactone’.
And it’s not just credited with improving skin.
In one viral TikTok video, viewed more than 2.5 million times, a young woman dances happily with text on the screen reading: ‘Spironolactone made my acne completely go away, made my boobs grow and also made me lose weight.’
A growing number of women, including Jessica, have taken to social media in recent months to express their amazement at what some have dubbed the ‘magical, life-changing pill’
‘I’ve prescribed it for many patients and haven’t really seen any severe side effects,’ says consultant dermatologist Dr Magnus Lynch
While experts say spironolactone has been prescribed off-label to treat hormonal acne for decades now, they’re now seeing more and more women coming in requesting it explicitly.
But how much of it is merely social media hype? And what’s the truth on claims about its effect on weight and breast size?
According to consultant dermatologist Dr Magnus Lynch, it is a very effective and safe drug. ‘I’ve prescribed it for many patients and haven’t really seen any severe side effects,’ he says. ‘Most people get on quite well on it.’
According to health service guidelines, spironolactone is suitable for women over 18 with moderate to severe acne that has failed to respond to both topical treatments and antibiotics.
‘The most common side effects are irregular periods, occasional dizziness from the blood pressure-lowering effect, and more frequent urination,’ says Dr Aleksander Godic, consultant dermatologist at Clapham Park Dermatology in London.
Spironolactone can also cause breast tenderness and swelling, explains Dr Godic, which may lead some women to think their breasts have grown. ‘But it’s not a side effect that happens to everyone,’ he adds.
However, spironolactone is not without its downsides, says Dr Lynch. It’s not suitable for pregnant women and will be most effective for hormonal acne sufferers, who tend to see painful, under-the-skin spots form on the bottom half of the face, rather than those struggling with blackheads and whiteheads.
‘The main disadvantage is that it’s not as effective as Accutane, which usually requires just one six- to nine-month course of treatment,’ he says. ‘Spironolactone only works while you’re taking it, though it can be taken for several years.’
For Jessica, minor side effects were well worth the relief she now feels. ‘I recommend spironolactone to everyone,’ she says. ‘There’s no shame in taking the help that’s available. And it worked wonders for me.’
