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Spironolactone treats persistent acne in adult women

Findings from a study of oral spironolactone as a treatment for persistent acne in adult women show that the treatment produced significant improvement compared to a placebo at 12 and 24 weeks.

The study, published in The British Medical Journal, recruited over 400 women, aged over 18 years, with acne that had persisted for more than six months and where oral antibiotics would have normally been the next treatment. The researchers randomly allocated half of the women to spironolactone and half to placebo. The dosing was 50 mg/day spironolactone or matched placebo until week six, increasing to 100 mg/day spironolactone or placebo until week 24. Participants could continue using a topical treatment.

The investigators asked the women to complete questionnaires on their acne and related quality of life at the start of the trial and then at 12 and 24 weeks into their treatment.

“The results showed that the women taking spironolactone saw a significant improvement in their acne after 12 and 24 weeks compared to those on the placebo,” said the trial’s co-lead Professor Miriam Santer, in a press release. Dr. Santer is a Professor of Primary Care Research at the University of Southampton in Southampton, UK.

“A significantly higher proportion of people also reported that they felt satisfied that their skin had been helped compared with those receiving placebo, and any side effects were uncommon and very minor,” she said.

Adverse reactions were slightly more common in the spironolactone group, with more headaches reported. The researchers reported no serious adverse reactions.

“These results show that spironolactone could offer an alternative to antibiotics for many women with persistent acne to use alongside topical acne treatments,” said Dr. Santer.


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