Effectiveness of spironolactone on adult female acne: Critical practice

Authors

DOI:

https://doi.org/10.33448/rsd-v13i4.45557

Keywords:

Acne Vulgaris; Spironolactone; Drug Prescriptions; Dermatology.

Abstract

Introduction: Adult acne (AMA) is a growing concern due to its impact on self-esteem and skin aesthetics. This study investigated the effectiveness of spironolactone in the treatment of AMA. The present article aims to provide a comprehensive update of available treatments for acne, focusing on an emerging and promising therapeutic agent: spironolactone. Methodology: Terms such as "Acne and Spironolactone", "Woman and acne" and "Spironolactone and acne treatment" were used. Ten articles were selected, including clinical and observational studies of works published between 2017 and 2023, searched in the SciELO, PubMed, Google Scholar and VHL databases. Results and discussion: Spironolactone, initially indicated for other conditions, has promising effects in AMA due to its potential androgenic antagonism. Spironolactone is often used in combination with other treatments, and despite side effects, its tolerance is generally good. The average dosage used was 100 mg for six months, adjusted according to adverse effects. Multicenter studies have indicated a low risk of hyperkalemia with the use of spironolactone to treat AMA. Research has also highlighted spironolactone's ability to treat injuries in several areas, including the face and trunk. Conclusion: Spironolactone emerges as a promising therapeutic option for adult acne, despite limited scientific evidence. Its use has demonstrated effectiveness in controlling lesions, especially when associated with topical retinoids. It is crucial to monitor kidney function and potassium levels. Additional studies are needed to consolidate its role in the treatment of AMA and fully understand its effectiveness and safety.

References

Addor, F. A. S., & Schalka, S. (2010). Acne da mulher adulta: aspectos epidemiológicos, diagnósticos e terapêuticos. Anais Brasileiros De Dermatologia, 85(6), 789–795. https://doi.org/10.1590/S0365-05962010000600003

Bagatin, E., Freitas, T. H. P., Rivitti-Machado, M. C., Machado, M. C. R., Ribeiro, B. M., Nunes, S., & Rocha, M. A. D. D. (2019). Adult female acne: a guide to clinical practice. Anais brasileiros de dermatologia, 94(1), 62–75. https://doi.org/10.1590/abd1806-4841.20198203.

Barbieri, J. S., Spaccarelli, N., Margolis, D. J., & James, W. D. (2019). Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments. Journal of the American Academy of Dermatology, 80(2), 538–549. https://doi.org/10.1016/j.jaad.2018.09.055

Barros, A. B. de, Sarruf, F. D., Fileto, M. B., & Robles Velasco, M. V. (2020). Acne vulgar: aspectos gerais e atualizações no protocolo de tratamento. BWS Journal, 3, 1–13. Recuperado de https://bwsjournal.emnuvens.com.br/bwsj/article/view/125

Bienenfeld, A., Azarchi, S., Lo Sicco, K., Marchbein, S., Shapiro, J., & Nagler, A. R. (2019). Androgens in women: Androgen-mediated skin disease and patient evaluation. Journal of the American Academy of Dermatology, 80(6), 1497–1506. https://doi.org/10.1016/j.jaad.2018.08.062

Brucker, M. C., & King, T. L. (2017). The 2015 US Food and Drug Administration Pregnancy and Lactation Labeling Rule. Journal of midwifery & women's health, 62(3), 308–316. https://doi.org/10.1111/jmwh.12611

Charny, J. W., Choi, J. K., & James, W. D. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International journal of women's dermatology, 3(2), 111–115. https://doi.org/10.1016/j.ijwd.2016.12.002

Costa, A., Mota, M., & Cristina, M. (2008). Fatores etiopatogênicos da acne vulgar. Anais Brasileiros de Dermatologia, 83(5), 451–459. https://doi.org/10.1590/s0365-05962008000500010

Costa, C. S., & Bagatin, E. (2013). Evidence on acne therapy. São Paulo medical journal = Revista paulista de medicina, 131(3), 193–197. https://doi.org/10.1590/1516-3180.2013.1313616

Federman, D. G., & Kirsner, R. S. (2000). Acne vulgaris: pathogenesis and therapeutic approach. The American journal of managed care, 6(1), 78 89.

Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol. 1999 Oct;41(4):577-80. PMID: 10495379.

Goulden, V., Stables, G. I., & Cunliffe, W. J. (1999). Prevalence of facial acne in adults. Journal of the American Academy of Dermatology, 41(4), 577–580.

Grandhi, R., & Alikhan, A. (2017). Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study. Dermatology (Basel, Switzerland), 233(2-3), 141–144. https://doi.org/10.1159/000471799

Ministério da Saúde. (2023). Retrieved November 15, 2023, from Saude.gov.br website: https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0060_17_12_2010.html

Plovanich, M., Weng, Q. Y., & Mostaghimi, A. (2015). Low Usefulness of Potassium Monitoring Among Healthy Young Women Taking Spironolactone for Acne. JAMA dermatology, 151(9), 941–944. https://doi.org/10.1001/jamadermatol.2015.34

Roberts, E. E., Nowsheen, S., Davis, M. D. P., McEvoy, M. T., Newman, C. C., Sartori Valinotti, J. C., Sciallis, G. F., Torgerson, R. R., & Wetter, D. A. (2020). Treatment of acne with spironolactone: a retrospective review of 395 adult patients at Mayo Clinic, 2007-2017. Journal of the European Academy of Dermatology and Venereology: JEADV, 34(9), 2106–2110. https://doi.org/10.1111/jdv.16302

Santer, M., & Layton, A. (2023). What do we know about prescribing spironolactone for acne? BMJ (Clinical research ed.), 381, 1114. https://doi.org/10.1136/bmj.p1114

Santer, M., Lawrence, M., Renz, S., Eminton, Z., Stuart, B., Sach, T. H., Pyne, S., Ridd, M. J., Francis, N., Soulsby, I., Thomas, K., Permyakova, N., Little, P., Muller, I., Nuttall, J., Griffiths, G., Thomas, K. S., Layton, A. M., & SAFA trial investigators (2023). Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ (Clinical research ed.), 381, e074349. https://doi.org/10.1136/bmj-2022-074349

Silva, A. M. F. da, Costa, F. P. da, & Moreira, M. (2014). Acne vulgar: diagnóstico e manejo pelo médico de família e comunidade. Revista Brasileira De Medicina De Família E Comunidade, 9(30), 54–63. https://doi.org/10.5712/rbmfc9(30)754

Vargas-Mora, P., & Morgado-Carrasco, D. (2020). Spironolactone in Dermatology: Uses in Acne, Hidradenitis Suppurativa, Female Pattern Baldness, and Hirsutism. Uso de la espironolactona en dermatología: acné, hidradenitis supurativa, alopecia femenina e hirsutismo. Actas dermo-sifiliograficas, 111(8), 639–649. https://doi.org/10.1016/j.ad.2020.03.001

Vaz, A. L. (2003). ACNE vulgar: Bases para o seu tratamento. Revista Portuguesa De Medicina Geral E Familiar, 19(6), 561–70. https://doi.org/10.32385/rpmgf.v19i6.9989

Published

21/04/2024

How to Cite

SANTOS, L. P. .; MACHADO, C. Z. .; FORMOSO, C. N. P. .; SCHNEIDEWIND, I.; CANAL, J. S. G. .; AZIZI, G. G. . Effectiveness of spironolactone on adult female acne: Critical practice. Research, Society and Development, [S. l.], v. 13, n. 4, p. e8313445557, 2024. DOI: 10.33448/rsd-v13i4.45557. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/45557. Acesso em: 16 may. 2024.

Issue

Section

Health Sciences