Blood Pressure Medication Has A Little-Known Effect On Your Skin

There are a few different medications to treat high blood pressure and each of them works differently. For example, some medications, like potassium-sparing diuretics, relieve pressure on your blood vessels by promoting water and sodium loss in your body. There are other medications that help relax your blood vessels in an attempt to reduce blood pressure, and there are still more that work by making your heart beat slower.

A drug that belongs to the first category, diuretics, called spironolactone, also has an unexpected effect on your skin: It can clear up hormonal acne. According to a 2023 randomized control study published in the British Medical Journal, this blood pressure medication was found to be a good alternative to oral antibiotics when it came to treating acne in women. The participants included 410 women with an average age of 29 who had acne for a period of more than half a year. The women were divided in half — one group receiving spironolactone and the other a placebo. After 24 weeks of consuming the blood pressure medication, the women saw significant improvement in their skin condition, when compared with the placebo group.

"Spironolactone lowers blood pressure by acting on specific hormones in the body. These hormones just so happen to play a role in hormonal acne. Dermatologists have used spironolactone for many years as a well-studied and effective treatment option for hormonal acne," explained dermatology resident, Dr. Claudia Ricotti (via Cleveland Clinic). Understanding how spironolactone works first involves understanding what happens to your body when you take blood pressure medication.

Excess sebum caused by an increased amount of testosterone, which belongs to "male hormones," also known as androgens, is one of the reasons for hormonal acne. When you have more of the oily substance in your skin glands, your pores can become clogged. 

Spironolactone, as a blood pressure medication, is thought to block a hormone called aldosterone, an adrenal cortex hormone. Aldosterone, along with another hormone called vasopressin or antidiuretic hormone, helps your kidneys retain sodium. When spironolactone blocks aldosterone, it is essentially thwarting this sodium-retaining function, leading to a flushing out of salt and water from your system (hence, the reduction in blood pressure). 

What spironolactone also unexpectedly does when blocking aldosterone is mess with the release of another adrenal cortex hormone – androgens. For women with hormonal acne, this can mean a welcomed relief from hormonal acne, which typically "presents on the jawline, neck, and chest," according to clinical director of the Mohs and Dermatologic Surgery Center at Brigham and Women's Hospital, Dr. Abigail Waldman (via Everyday Health). Spironolactone, however, is not recommended as an effective treatment for acne in men. This is mainly due some of its side effects, including breast enlargement. Speaking of side effects, let's take a look at them more closely. 

Bleeding gums, bloody urine, blurred vision, cough, constipation, diarrhea, dizziness, drowsiness, headache, heartburn, hives, nausea, loss of appetite, vomiting, and weight gain are some of the blood pressure medication's side effects. You could also experience scaling of the nipple, dimpling in your breast skin, inverted nipples, painful and irregular periods, tender breasts, and breast enlargement. High potassium levels are another side effect of spironolactone, so this is something someone with kidney issues should be mindful of. 

Even so, this unexpected acne medication has seen an uptick in use in the recent years, according to an Epic Research report conducted on behalf of NBC News. Experts attribute this increase to a combination of factors. The American Academy of Dermatology's push for antibiotic stewardship could be one reason, per dermatologist and epidemiologist at Brigham and Women's Hospital in Boston, Dr. John Barbieri (via NBC News). Overuse of antibiotics can be difficult on your gut. Antibiotic resistance and immune system damage are other concerns. There has also been a shift in women who take birth control pills to manage hormonal acne/prevent pregnancy. With people opting for IUDs and other forms of contraception, spironolactone, could be an effective way of bringing acne under control, added Dr. Barbieri.

If you're wondering about spironolactone and whether or not it would work for your hormonal acne, your best options would be to discuss the possibility of trying it with your dermatologist. On a similar note, antidepressants have an unexpected effect on your skin too. Perhaps, you'd like to find out more.