Winlevi (clascoterone cream 1%) is applied as a thin layer to acne-affected skin twice daily, once in the morning and once in the evening. It’s the first topical acne treatment that works by blocking hormonal activity directly in the skin, making it a unique option for people whose acne is driven by oil production and hormonal factors. Here’s how to use it correctly and what to expect.
Step-by-Step Application
The routine is straightforward. Gently cleanse the affected area first, then let your skin dry completely before applying. Once dry, spread a thin, uniform layer of cream over the entire area where you break out, not just on individual pimples. The target amount is roughly 1 gram per application, which is about the size of a large pea or a fingertip unit depending on how much skin you’re covering.
You’ll do this twice a day, every day. Morning and evening. Because the cream needs contact with your skin to work, apply it before heavier products like moisturizers or sunscreen. If you’re using other topical acne treatments alongside it, spacing them out or layering carefully matters, which is covered below.
How Winlevi Works Differently
Most topical acne treatments fight bacteria, unclog pores, or reduce surface inflammation. Winlevi does something none of them do: it blocks the hormone that triggers excess oil production in the first place.
Your skin contains androgen receptors, and a hormone called DHT (dihydrotestosterone) normally binds to those receptors in oil glands and hair follicles. When DHT activates these receptors, your glands ramp up oil production and trigger inflammatory processes that lead to clogged pores, nodules, and cysts. Clascoterone, the active ingredient in Winlevi, competes with DHT for those same receptors. It essentially blocks DHT from docking, which means less oil, less inflammation, and fewer breakouts.
One important detail: clascoterone is rapidly broken down into an inactive form by enzymes in the outer layer of your skin. This means it acts locally, right where you apply it, without meaningful absorption into the rest of your body. That’s a significant advantage over oral hormone-blocking medications like spironolactone, which affect your entire system.
How Long Until You See Results
In the two main clinical trials that led to FDA approval, patients applied Winlevi twice daily for 12 weeks. By the end of that period, significantly more people using Winlevi had clear or almost-clear skin compared to those using a placebo cream. Both inflammatory acne (red, swollen bumps) and non-inflammatory acne (blackheads and whiteheads) improved.
Twelve weeks is the benchmark. Like most acne treatments, Winlevi isn’t a quick fix. You likely won’t notice dramatic changes in the first few weeks. Consistent twice-daily use over three months is what the clinical evidence supports, so sticking with it matters even if early progress feels slow.
Combining Winlevi With Other Acne Products
Winlevi is stable when layered with the most commonly prescribed topical acne treatments. Lab testing showed no chemical degradation when it was combined with tretinoin cream, adapalene gel, dapsone gel, azelaic acid, benzoyl peroxide/clindamycin combinations, and benzoyl peroxide/adapalene combinations. The clascoterone remained fully intact in all cases.
This is good news if your dermatologist has you on a multi-product regimen. A common approach is pairing Winlevi with a retinoid or benzoyl peroxide product to attack acne through multiple pathways simultaneously. If you’re layering treatments, a typical strategy is applying one in the morning and the other in the evening, or waiting a few minutes between layers if using both at the same time. Your prescriber can advise on the best sequence for your specific combination.
Side Effects to Watch For
Winlevi is well tolerated. In clinical trials involving over 670 people, the rates of local skin reactions were nearly identical between Winlevi and a plain moisturizer base (the vehicle cream). The most common reactions were redness (12.2%), scaling or dryness (10.5%), itching (7.7%), and stinging or burning (4.2%). Notably, the placebo group experienced these at similar or even slightly higher rates, which suggests many of these reactions come from the cream base itself or from twice-daily application of any product.
Because clascoterone is structurally similar to spironolactone, there was concern about two systemic effects: suppression of cortisol production and elevated potassium levels. Both were studied carefully. A small percentage of trial participants showed temporary changes in cortisol response (5% of adults, 9% of adolescents), but all returned to normal within four weeks of stopping. Potassium shifts were detected in lab work in about 6.7% of users versus 3.9% on placebo, but no one in the trials developed symptoms from either issue. These remain theoretical risks worth knowing about, but routine blood monitoring is not currently required.
Storage Matters More Than Usual
Winlevi has specific storage requirements that differ from most topical creams. Your pharmacy stores it refrigerated between 36°F and 46°F. Once dispensed to you, keep it at room temperature (68°F to 77°F). Do not freeze it.
Here’s the part that’s easy to miss: you need to discard any unused cream either 180 days after the pharmacy dispensed it or 1 month after you first open the tube, whichever comes first. If you open the tube and use it sporadically, that one-month clock is what matters. Writing the date you first opened it on the tube can help you track this.
Getting the Most Out of Treatment
The biggest factor in whether Winlevi works for you is consistency. Twice a day, every day, on clean and dry skin. A few practical tips to keep in mind:
- Apply to the whole area, not spot-treat. Winlevi works by reducing oil and inflammation across the skin, not by treating individual pimples after they appear.
- Let your skin dry after washing. Applying to damp skin can dilute the cream and reduce contact with the areas that need it.
- Give it a full 12 weeks. Hormonal mechanisms take time to shift. Early dropout is the most common reason acne treatments “don’t work.”
- Don’t double up if you miss a dose. Just apply your next regular dose and continue as normal.