Topical Spironolactone is a compounded prescription treatment that targets hormonal acne and androgen-driven hair thinning directly at the skin. Spironolactone calms the effect of androgens — the hormones that drive excess oil and clogged pores — and in its oral form it's been used for PCOS-related acne for years.
Both the topical and oral versions contain the same active ingredient, but they work in different places.
The oral pill works systemically, affecting androgen activity throughout your body, which is why it's prescribed for acne, unwanted hair, and hair loss together — and why it comes with considerations like effects on your cycle and is not used during pregnancy.
Topical Spironolactone is applied to the skin and concentrates its effect where you use it, with far less absorbed into the rest of the body. For many women, that makes it a good option when the main concern is skin or a localized area of thinning, or when they'd prefer to avoid a systemic medication.
At Oana, it's compounded at 5% and shipped as a 20g bottle monthly or a 60g bottle quarterly. Which version fits you depends on your symptom pattern and goals — your provider will evaluate what you describe and recommend the right approach.