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
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References:
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.
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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.
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