Spironolactone is a useful adjunctive therapy for acne in young women. It is quite safe and can be very effective. The following article is quite extensive, but may interest some readers.
Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris
Practical Considerations for the Clinician Based on Current Data and
J Clin Aesthet Dermatol. 2012 Mar; 5(3): 37–50.
Grace K. Kim, DO and James Q. Del Rosso, DO
Abstract: Oral spironolactone has been used for over two decades in the dermatological setting. Although it is not generally considered a primary option in the management of female patients with acne vulgaris, the increase in office visits by post-teenage women with acne vulgaris has recently placed a spotlight on the use of this agent in this subgroup of patients. This article reviews the literature focusing on the use of oral spironolactone in this subset of women with acne vulgaris, including discussions of the recommended starting dose, expected response time, adjustments in therapy, potential adverse effects, and patient monitoring.
Note: The Free Full-Text Open Access article is “everything you ever wanted to know about spironolactone but were afraid to ask.”
Here is a brief, but informative, web-based resource on spironolactone and acne.