Aside from Isotretinoin, Spironolactone was discovered to have a potential ability in treating acne. The drug was approved as a diuretic and antihypertensive agent but is also prescribed to utilize its anti-acne off-label use. The treatment provides perfect cure for the acne that is caused by the fluctuations of hormones.

According to Fashionista, Dermatologist Dr. Doris Day stated that spironolactone is one of the dermatologist's options for treating adult acne. Unlike in the case of high blood pressure that needs a high dose, the recommended dose of the drug in treating acne is 25mg. One benefit in using spironolactone is its lower cost compared to topical preparations such as benzoyl peroxide and salicylic acid.

Relative to spironolactone's mechanism of action as antihypertensive and diuretic, its principle as an anti-acne is also established. Dr. Joshua Zeichner stated that spironolactone blocks the effect of hormones in oil glands thus, reducing the excretion of oil in the skin.

The lesser the oil on the surface of the skin, the fewer will be the blockages in the pores. Oil can also strengthen the bacteria that causes acne and later, inflammation. Altogether, the goal of the drug is to reduce the volume of oil on the surface of the skin to prevent the formation of acne.

Furthermore, spironolactone blocks the androgen hormone receptors. Androgen also called male hormones is activated when it binds to its receptor which can initiate acne formation. The drug's ability to block the hormone's receptor does not affect the amount of hormone rather the reaction of the body to the hormone is the thing that is affected.

As reported by Self, Spironolactone is not approved by FDA for treating acne although is secretly used to treat skin problems for more than a decade. Usually, proven dermatologists who specialize in acne are the only ones who are allowed to provide prescriptions to properly diagnosed patients.

Considering its diuretic effect, taking spironolactone in doses of 25mg or 50mg won't severely affect one's bathroom routine. Some side effects of the drug include; dizziness, breast tenderness, and irregular periods.  Moreover, it also affects the development of secondary sex organs, especially in males. It is, therefore, safe to consider the side effect of the drug before taking it and it is better to get a prescription from a dermatologist for proper diagnosis and counseling.   

On the other hand, unlike spironolactone, isotretinoin is a current drug that is approved for the treatment of acne. Isotretinoin come in brand names such as Accutane and Roaccutane. Isotretinoin is taken orally treating severe nodular acne. The approved drug should not be used by pregnant and breastfeeding women including persons with vitamin allergy. 

Isotretinoin should not be also used in patients taking contraceptive pills and other antibiotics. Like Spironolactone, the drug also needs a prescription for proper counseling and diagnosis from the dermatologist.