7 Jun 2023 • A recent study published in the BMJ, assessed the effectiveness of oral spironolactone for acne vulgaris in adult women. The findings suggest that spironolactone improved outcomes compared with placebo, with greater differences at week 24 than week 12 & is a useful alternative to oral antibiotics for women with acne.

Guidelines support use of spironolactone for its antiandrogenic effects in women with moderate-to-severe acne vulgaris as an alternative to long-term systemic antibiotics. However, spironolactone is not approved by the U.S. FDA for this indication.

• Researchers identified 410 women (age, ≥18; mean age, 29) with facial acne for ≥6 months that warranted systemic therapy; participants were randomized to add spironolactone (50–100 mg daily) or placebo to their usual topical treatments for 24 weeks
• At 12 weeks, patients assigned to spironolactone had a slightly but significantly greater mean improvement in quality of life related to acne symptoms than did those assigned to placebo
• Significant difference was noted at week 24, patients who took spironolactone also were more likely to report overall acne improvement.
• Adverse reactions were slightly more common in the spironolactone group with more headaches reported (20% v 12%)

Source: BMJ | Read full story