Most hormonal treatments take time, and Topical Spironolactone is no exception. For acne, many women start to notice changes around 6–12 weeks, with continued improvement after that as oil production calms and fewer new breakouts form. For hair thinning, the timeline is longer — typically several months — because hair responds slowly by nature.
It's worth knowing this up front: hormonal acne treatments work gradually, not overnight. If you don't see dramatic change in the first few weeks, that's expected. Stay consistent, and message your provider through your account if you have questions along the way.