Topical Spironolactone: Anti-acne powerhouse popular in US now available in UK

Popular in the US already, the prescription-only ingredient targets the underlying hormonal drivers of acne, decreasing sebum production in the skin and reducing the redness and swelling associated with acne and leaving skin looking clearer and less oily.

In the UK the oral form of spironolactone is most commonly used, where it works from the inside out to prevent hormonal acne. But with some people not tolerating the side effects that may come with it, Topical Spironolactone can be an effective alternative.

Used topically it doesn’t cause the same systemic side effects, while helping with hormonal causes of acne at skin level. It is now available via online prescription skincare brand, Uncouth.

What is it?

Topical Spironolactone is a medication used to manage acne, especially hormonal breakouts.

How does it work?

It works by blocking androgen receptors in the skin, reducing the effects of hormones that cause acne.

How do I use it?

Apply once in the evening onto dry skin, after cleansing and before moisturising, unless otherwise specified by your prescriber.

How quickly will I see results?

Improvements typically appear at around 12 weeks.

Any side effects?

Side effects include redness, dryness, and mild irritation. (This is not a complete list of side effects and others may occur. Always read your patient information prior to treatment).

Can I use while pregnant or breastfeeding?

No, Spironolactone should not be used during pregnancy or whilst breastfeeding.

Topical Spironolactone is prescription ingredient and requires an online consultation at Uncouth.co.uk, a no-nonsense skincare brand with a patient-centred approach. The brand was founded by Dr. Emma, a dermatologist and busy mum of four, who wanted to create a service providing all-in-one formulas that gave results, without ‘faffy’, multi-stage skincare routines. Its online consultations save people time, and there’s no need to visit the pharmacy, as the prescription skincare is delivered to your door.

While some online prescription skincare brands leave you guessing as to what formula you will be prescribed, Uncouth asks about preferences in all its consultations. While final formulation decisions rest with its medical team, it is a much more collaborative and transparent process than those offered by other brands in the same space.

Dr Emma explains: "I wanted our service to reflect what would happen in a face-to-face dermatology consultation, where patient history and preferences are considered. We delve into what our customers have used before in terms of prescription skincare, and create formulations that will work for them. Everything is adjustable, with virtual check-ins allowing customers to have formulas tweaked to suit skin needs”.

Dr Emma continues: “Our acne treatments can be formulated with topical spironolactone. Many women struggle with persistent adult hormonal acne, particularly along the chin and jawline, often feeling they have to just put up with it. After multiple courses of topical and oral antibiotics— which are limited by concerns over antimicrobial resistance—options can feel frustratingly scarce. Topical spironolactone can be an effective alternative for those who want a topical solution but have tried these other prescription treatments and experienced relapses. It targets the underlying hormonal drivers of acne without contributing to antibiotic resistance and provides a well-tolerated and sustainable option for long-term skin clarity."

The base of Uncouth anti-acne formulas contains natural moisturising factors and skin soothers such as aloe, vitamin E, triglycerides and hyaluronic acid. It then uses a technique called ‘compounding’ to carefully combine prescription ingredients, such as Topical Spironolactone with other actives such as niacinamide and tranexamic acid at tailored concentrations to boost and brighten skin.

All prescriptions are fragrance free and vegan. Uncouth prices start at £24.20/ month (most formulas come in 30mls which is a two monthly supply). Hormonal acne formulas cost £59.99 for 15mls (which is one month supply), including delivery to your door. For further information, visit Uncouth.co.uk