AcneAdvice.co.uk
- The acne advice website
Click Here
for more acne articles |
|
|
Spironolactone in the treatment of acne |
by:
Michal R. Pijak |
In his article on acne published
recently in the New England Journal of Medicine James (1) mentions
that androgen antagonist spironolacton is often useful in women
with hyperandrogenism. However, it would be important to point
out, that the effectiveness of this treatment cannot be determined
due to the small sample populations involved in the trials, as
has been shown in recent metaanalysis. (2) It should be also emphasized
that although the long-term use of spironolactone in the treatment
of acne in women appears to be safe, its side-effects seem to
be high. (3) On the other hand, it is worth mentioning that spironolactone
in addition to its antiandrogenic effects might also have antiinflammatory
potential. (4) This emphasizes the need for further properly designed
trials with relevant outcomes to provide robust estimates of the
size and mechanism of any treatment effects. Because of its long
half-life spironolactone should be given once daily and not in
divided doses as recommended by James. This might increase the
compliance which is important in prolonged therapy to achieve
maximal benefits. (5)
1. James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463-72.
2. Farquhar C, Lee O, Toomath R, Jepson R. Spironolactone versus
placebo or in combination with steroids for hirsutism and/or acne.
Cochrane Database Syst Rev 2003;(4):CD000194.
3. Shaw JC, White LE. Long-term safety of spironolactone in acne:
results of an 8-year followup study. J Cutan Med Surg 2002;6:541-5.
4. Hansen PR, Rieneck K, Bendtzen K. Spironolactone inhibits production
of proinflammatory cytokines by human mononuclear cells. Immunol
Lett 2004;91:87-91.
5. McEvoy B, Nydegger R, Williams G. Factors related to patient
compliance in the treatment of acne vulgaris. Int J Dermatol 2003;42:274-80.
About the author:
Dr. Michal R. Pijak is a consultant in rheumatology, allergy and
clinical immunology at the University Hospital in Bratislava,
Slovakia.
|
|
