Spironolactone may be effective alternative to antibiotics for adult acne in women

Researchers investigating treatment failure rates between spironolactone and oral tetracyclines have found no a significant difference, suggesting they may be equally effective.

Acne, close up woman's face

Spironolactone may provide an alternative to oral antibiotics for the long-term treatment of acne in women, according to the authors of a recent paper published in the June edition of the Journal of Drugs in Dermatology

The researchers studied prescribing data for 6,684 women who received spironolactone and 31,614 women who received oral tetracycline antibiotics for acne.

Within the first year, 14.4% of those prescribed spironolactone switched to an alternative therapy, as did 13.4% of those prescribed antibiotics — a non-significant difference.

Spironolactone is an aldosterone antagonist originally developed for the treatment of hypertension and is sometimes used off-label in acne. However, there has been limited clinical research into its efficacy for acne.

The researchers said the findings indicated that the rate of treatment failure is comparable between spironolactone and tetracycline antibiotics, suggesting they may have equal effectiveness in women.

“While ultimately large clinical trials are needed to determine the optimal management strategy for women with moderate to severe acne, these results provide additional support that spironolactone represents an effective treatment for women with acne,” they concluded.


[1] Barbieri J, Choi J, Mitra N et al. Frequency of treatment switching for spironolactone compared to oral tetracycline-class antibiotics for women with acne: a retrospective cohort study 2010–2016. J Drugs Dermatol 2018;17(6):632–638. PMID: 29879250

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The Pharmaceutical Journal, Spironolactone may be effective alternative to antibiotics for adult acne in women;Online:DOI:10.1211/PJ.2018.20205150

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