Effects and side‐effects of spironolactone therapy in women with acne

Yemisci, A; Görgülü, Adnan; Pişkin, Süleyman

doi:10.1111/j.1468-3083.2005.01072.x

Cited by 65 publications

(35 citation statements)

References 12 publications

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“…Yemisci et al (2005) performed a similar study and demonstrated an 85% response rate with significant improvements in acne for responders. In another study on the effects of treatment with topical spironolactone, 78 patients were enrolled in a randomized, double-blind, placebo controlled trial.…”

Section: Spironolactonementioning

confidence: 86%

A Review of hormone-based therapies to treat adult acne vulgaris in women

Trivedi

Shinkai

Murase

2017

International Journal of Women's Dermatology

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Hormone-based therapies including combined oral contraceptive medications and spironolactone are considered effective therapies to treat adult acne in women. Our objective is to provide a concise and comprehensive overview of the types of hormonal therapy that are available to treat acne and comment on their efficacy and safety profiles for clinical practice. A systematic search using the PubMed Database was conducted to yield 36 relevant studies for inclusion in the review and several conclusions were drawn from the literature.Treatment with oral contraceptive pills leads to significant reductions in lesion counts across all lesion types compared with placebo. There were no consistent differences in efficacy between the different combined oral contraceptive formulations. In terms of risk, oral contraceptive pill users had three-times increased odds of venous thromboembolism versus non-users according to a recent meta-analysis (95% confidence interval 2.46-2.59). Data on oral contraceptive pill use and breast cancer risk are conflicting but individual patient risk factors and histories should be discussed and considered when prescribing these medications. However, use of these medications does confer measurable protection from endometrial and ovarian cancer. Spironolactone was also shown to be an effective alternative treatment with good tolerability.Combined oral contraceptive medications and spironolactone as adjuvant and monotherapies are safe and effective to treat women with adult acne. However, appropriate clinical examinations, screening, and individual risk assessments particularly for venous thromboembolism risk must be conducted prior to initiating therapy.

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Section: Spironolactonementioning

confidence: 86%

A Review of hormone-based therapies to treat adult acne vulgaris in women

Trivedi

Shinkai

Murase

2017

International Journal of Women's Dermatology

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“…To date, there have been 4 small-scale clinical studies, 6-9 each fewer than 100 patients, that have measured serum potassium as a secondary outcome in patients taking spironolactone for acne. Three studies [6][7][8] yielded zero cases of hyperkalemia, and one study 9 showed a 13.7% rate of mild hyperkalemia, which was defined as a serum potassium measurement of 4.8 to 5.3 mEq/L (to convert potassium level to millimoles per liter, multiply by 1.0). Although the US Food and Drug Administration recommends frequent potassium monitoring in patients taking spironolactone, it is unclear whether this guideline is applicable to healthy patients taking spironolactone for acne.…”

mentioning

confidence: 99%

Low Usefulness of Potassium Monitoring Among Healthy Young Women Taking Spironolactone for Acne

2015

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pironolactone is an androgen receptor antagonist that is an effective treatment for hormonally mediated acne. [1][2][3][4] Although generally well tolerated, spironolactone use is associated with hyperkalemia among patients with heart failure taking additional drugs that interfere with potassium excretion. 5 However, the prevalence of spironolactoneinduced hyperkalemia among young women taking spironolactone for acne is unclear. To date, there have been 4 small-scale clinical studies, 6-9 each fewer than 100 patients, that have measured serum potassium as a secondary outcome in patients taking spironolactone for acne. Three studies 6-8 yielded zero cases of hyperkalemia, and one study 9 showed a 13.7% rate of mild hyperkalemia, which was defined as a se-rum potassium measurement of 4.8 to 5.3 mEq/L (to convert potassium level to millimoles per liter, multiply by 1.0).Although the US Food and Drug Administration recommends frequent potassium monitoring in patients taking spironolactone, it is unclear whether this guideline is applicable to healthy patients taking spironolactone for acne. If the rate of hyperkalemia in this population is low and clinically insignificant, the cost of regular potassium monitoring may exceed the benefit of capturing these cases. In addition, concerns over hyperkalemia and frequent laboratory testing may contribute to health care spending and discourage the use of this effective drug. The objective of this retrospective study was to measure the rate of hyperkalemia in a large population IMPORTANCE Spironolactone has been shown to be an effective treatment option for hormonally mediated acne but can cause hyperkalemia. The prevalence of hyperkalemia among healthy young women taking spironolactone for acne is unclear.OBJECTIVE To measure the rate of hyperkalemia in healthy young women taking spironolactone for acne or for an endocrine disorder with associated acne.

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“…Furthermore, spironolactone causes a decrease in plasma testosterone and an increase in estradiol by altering the peripheral metabolism of testosterone [117]. In fact, spironolactone has been shown to be useful in conditions of excess androgen, such as hirsutism [118], polycystic ovary syndrome [119] and acne vulgaris [120].…”

Section: Side Effectsmentioning

confidence: 98%

Aldosterone-receptor antagonism in hypertension

Jansen

Danser

Imholz³

et al. 2009

Journal of Hypertension

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The role of the renin-angiotensin-aldosterone system (RAAS) in hypertension has since long been recognized and aldosterone has been acknowledged as one of the key hormones in the pathophysiology, not only in primary aldosteronism but also in essential hypertension and drug-resistant hypertension. Aldosterone-receptor antagonists (ARAs) are increasingly used in patients with resistant hypertension, often with impressive results. However, definitive evidence for the benefit of ARAs in these patients from randomized, controlled trials is lacking. This review gives an overview of the current data on this topic. Future studies should focus on the identification of factors that are able to predict the response to treatment, as to select patients who will benefit most from treatment with ARAs. On the basis of the current knowledge, we recommend prescription of ARAs to patients with primary aldosteronism, resistant hypertension and patients with hypertension and hypokalemia.

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Effects and side‐effects of spironolactone therapy in women with acne

Abstract: Spironolactone is a safe and effective medication for women with acne vulgaris. Although its side-effects seem to be high, they are in the majority of cases not a reason to stop treatment.

Cited by 65 publications

References 12 publications

A Review of hormone-based therapies to treat adult acne vulgaris in women

A Review of hormone-based therapies to treat adult acne vulgaris in women

Low Usefulness of Potassium Monitoring Among Healthy Young Women Taking Spironolactone for Acne

Aldosterone-receptor antagonism in hypertension

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