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Treatment Options

Spironolactone

Spironolactone is employed in dermatology as a treatment for conditions like acne and hair loss in women due to its ability to block the action of the male sex hormones on the skin and hair.
| 4 min read

Spironolactone was originally developed as a diuretic (water tablet) and was subsequently found to have beneficial effects on the skin and hair. It is used "off-licence" for these indications.

What are the risks and side effects?

Spironolactone is generally safe and well tolerated and can be taken for years if needed often with minimal side effects. It is taken once a day. Common side effects include breast tenderness or enlargement, irregular menstrual periods and a drop in blood pressure (which can cause dizziness). Uncommon side effects include drowsiness, fatigue, headache, loss of libido (sex drive), confusion, rashes, abnormal blood count and high potassium levels.

It is essential not to become pregnant whilst taking spironolactone as it can cause birth defects.

A potentially serious side effect of spironolactone is high potassium levels. Do not have low-sodium salt or salt substitutes, like Lo-Salt, because they contain a lot of potassium. Using these with spironolactone can cause your potassium levels to become too high. Limit other food and drink that contain a lot of potassium, including bananas, avocados, pulses, nuts and salmon.

The British Association of Dermatologists has produced a helpful Patient Information Leaflet on Spironolactone (see link below) and it is important that you read this carefully before starting treatment. You should also read about potential side effects of spironolactone (see link below).

Blood tests

Because high potassium can be dangerous it is essential to have blood tests (FBC, U&E, LFT) performed prior to starting treatment, after 2 weeks of treatment then after a further 3 months. If these blood tests cannot be performed then it is not safe to continue the treatment. Once established on treatment blood tests can be performed every 6 months.

If you have medical insurance, your insurance provider may cover some or all of the cost of blood tests. You should check this carefully to ensure that you are not charged a fee by the hospital. The costs of these blood tests performed in private hospitals or clinics can range from £100-£200 or more.

You can also ask your GP if they would be willing to perform the blood tests for you. Many GPs are willing to do this when asked, however they are not obliged to do so for patients receiving private treatment.

How much does treatment cost?

The costs of treatment are as follows:-

  • New consultation: £250
  • Followup consultation: £220 (each time you attend - initially after 3 months then every 6 months after this)
  • Cost of medication: This is charged to you directly by the pharmacy that you take the prescription to. As this is a private prescription, you are charged the full cost of the medicine by the pharmacy.
  • Blood tests: see above

If you have medical insurance they may cover some of these costs, however you should confirm this with them in advance. Medical insurance will not cover the costs of prescription medicines. Some medical insurance policies limit cover for blood tests and follow up appointments.

What are the alternatives to spironolactone?

You can read about alternative treatment options at the following link:-

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