TLDR Spironolactone may reduce excessive hair growth in women but its effectiveness for acne is not supported.
The review investigated the effectiveness of spironolactone, alone or in combination with steroids, in treating hirsutism and acne in women. Nine trials were included, with two comparing 100 mg of spironolactone to placebo showing significant subjective improvements in hair growth but not in objective measures. The evidence suggested that spironolactone was effective in reducing hirsutism but not acne vulgaris. The studies were small and scarce, limiting the generalizability of the results. Spironolactone appeared more effective than finasteride, metformin, and low-dose cyproterone acetate for hirsutism.
Cited in this study
8 / 8 results
78 citations
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October 2003 in “Cochrane library” Cyproterone acetate with estradiol may subjectively improve excessive hair growth in women, but it's not clinically better than other treatments.
56 citations
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April 2003 in “Fertility and Sterility” All three treatments reduce hirsutism, but spironolactone works best long-term.
12 citations
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December 2002 in “Fertility and Sterility” Spironolactone plus finasteride works better for treating hirsutism.
34 citations
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January 1995 in “The Journal of Clinical Endocrinology and Metabolism” 
23 citations
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July 1989 in “Postgraduate medical journal” Spironolactone did not make hair thinner in women with excess hair growth.
16 citations
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January 1987 in “Dermatology” The spironolactone cream did not reduce hair growth in women with hirsutism.
44 citations
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June 1985 in “Fertility and sterility” Combination drug therapy is effective for hirsutism that doesn't improve with just one medication.
142 citations
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February 1985 in “Fertility and sterility” Spironolactone reduced hair thickness and some testosterone levels in women with excessive hair growth.
47 citations
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March 2004 in “European journal of endocrinology” Spironolactone plus finasteride reduces hirsutism more effectively.
124 citations
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September 1980 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism” Spironolactone is effective in treating excessive hair growth in women.
