Spironolactone for Female Acne is Safe and Effective
by Jeffrey Dach MD
My patient, Rebecca lives in Shanghai so we do our follow up called via Skype video conference. On the last call, I asked Rebecca, “how are you doing?”, and she informed me , ” Oh, I’m OK except for these annoying acne breakouts.” We then launched into a discussion of acne prevention with vitamin B5 and L-carnitine as described in my previous article.
Afterwards, I realized I forgot to mention an old blood pressure drug called spironolactone which also serves as an anti-acne drug by inhibiting testosterone. We have many patients finding it is helpful in controlling acne. Usual dosage is 100 mg daily. Left Image Mona Lisa with Acne courtesy of Leonardo Da Vinci and Paris Louvre Museum..
Dr. Marchbein believes spironolactone should be first-line therapy and standard of care for adult women with acne. He says:
“even though spironolactone is not indicated as a first-line treatment in the newest acne guidelines. I think we are doing a disservice to our acne patients by not positioning spironolactone as first-line therapy.”(1)
Jeffrey Dach MD
Articles with Related Interest:
1) Spironolactone safe and effective for adult female acne. Bob Kronemyer Jun 23, 2017 Dematology Times.2)Layton, Alison M., et al. “Oral spirono-lactone for acne vulgaris in adult females: a hybrid systematic review.” American journal of clinical dermatology 18.2 (2017): 169-191.
3) Barbieri, J. S., et al. “Frequency of Treatment Switching for Spirono-lactone Compared to Oral Tetracycline-Class Antibiotics for Women With Acne: A Retrospective Cohort Study 2010-2016.” Journal of drugs in dermatology: JDD 17.6 (2018): 632-638.
4) Charny, J. W., J. K. Choi, and W. D. James. “Spirono-lactone for the treatment of acne in women, a retrospective study of 110 patients.” International journal of women’s dermatology 3.2 (2017): 111-115.
5) Kelidari, Hamid Reza, et al. “Spirono-lactone loaded nanostructured lipid carrier gel for effective treatment of mild and moderate acne vulgaris: A randomized, double-blind, prospective trial.” Colloids and Surfaces B: Biointerfaces 146 (2016): 47-53.
6) Grandhi, Radhika, and Ali Alikhan. “Spirono-lactone for the Treatment of Acne: A 4-Year Retrospective Study.” Dermatology 233.2-3 (2017): 141-144.
7) Layton, Alison M. “Top ten list of clinical pearls in the treatment of acne vulgaris.” Dermatologic clinics 34.2 (2016): 147-157.
8) ur Rehman, Habib, et al. “Treatment of Post Adolescent Female Acne with Spirono-lactone and Low Dose Isotretinoin.” National Editorial Advisory Board 29.5 (2018).
9) Carter, David. “Potassium Monitoring in Young Women Taking Spirono-lactone for Acne is Unnecessary.” AJN The American Journal of Nursing 115.6 (2015): 57.
10) Harper, Julie C., et al. “Treating Acne in Adult Women.” Dermatology News® (2018): 12.
11) Bagherani, Nooshin. “Efficacy of topical spirono-lactone in treatment of acne.” Dermatologic therapy 28.3 (2015): 176-176.
12) Schlosser, Bethanee J. “Hormonal Therapy for Acne: Pros and Controversies.” (2017).
13) Diri, Halit, et al. “Comparison of spirono-lactone and spirono-lactone plus metformin in the treatment of polycystic ovary syndrome.” Gynecological Endocrinology 32.1 (2016): 42-45.
14) Carol, R. “Hormonal therapies serve as key adjunct acne treatment.” Dermatol World. 2012 May (Acne suppl). 2-6.
15) Ebede TL, Arch EL, et al. “Hormonal treatment of acne in women.” J Clin Aesthet Dermatol. 2009; 2(12): 16–22.
16) Harper JC. “Use of oral contraceptives for management of acne vulgaris. Practical considerations in real world practice.” Dermatol Clin. 2016;34(2):159-65.
17) Kim GK, Del Rosso JQ. “Oral spironolactone in post-teenage female patients with acne vulgaris: Practical considerations for the clinician based on current data and clinical experience.” J Clin Aesthet Dermatol. 2012;5(3):37-50.
18) Plovanich M; Weng QY, et al. “Low usefulness of potassium monitoring among healthy young women taking spironolactone for acne.” JAMA Dermatol. 2015;151(9):941-4.
19) Reynolds RVS. ‘Hormonal treatment for acne.” Presented during the forum: Acne guidelines: Translating evidence into practice. 2017 Annual Meeting of the American Academy of Dermatology; 2017 March 3-7. Orlando, FL.
20) Zaenglein AL, Pathy AL et al. “Guidelines of care for the management of acne vulgaris.” J Am Acad Dermatol. 2016;74:945-73.