Do you recommend patients discontinue spironolactone after a certain number of years?   

In general, I think Spironolactone is a fabulous treatment for women with hormonal/stress-induced acne. I am cautious in women with reproductive potential. I also have been careful in prescribing it to women with a history of breast cancer.

I have no limitations on the use of spironolactone, so long as patients have acne it is reasonable to use. At times, we will discontinue the medication for 2 or 3 months after a year just to see if there is a tendency toward relapse.

Probably not. Use for hair loss in older women.