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Background: There is limited evidence on the safety and efficacy of spironolactone in the treatment of women with acne. Thus, for many dermatologists spironolactone remains an alternative rather than a mainstay treatment for female patients with acne.
Methods: An electronic medical records search tool was used to select data from a group of women w...
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Citations
... Spironolactone, an antiandrogenic diuretic, has proven effective against acne, particularly in female patients, by blocking androgen receptors to reduce sebum production [202,207,211]. Comparable in effectiveness to oral antibiotics, spironolactone is frequently prescribed for long-term management, often alongside oral contraceptives to enhance its antiandrogenic effects and to prevent pregnancy [212,213]. Recent studies suggest that the risk of hyperkalemia in healthy young women taking spironolactone is similar to the baseline risk in this demographic, indicating that routine monitoring of serum potassium may be unnecessary [214]. Common side effects include menstrual irregularities in women not on combined oral contraceptives and potential gynecomastia, though it is not linked to an increased risk of breast or gynecological cancers [213]. ...
... Recent studies suggest that the risk of hyperkalemia in healthy young women taking spironolactone is similar to the baseline risk in this demographic, indicating that routine monitoring of serum potassium may be unnecessary [214]. Common side effects include menstrual irregularities in women not on combined oral contraceptives and potential gynecomastia, though it is not linked to an increased risk of breast or gynecological cancers [213]. Given the risk of feminization of male fetuses, contraception is advised when prescribing spironolactone to women of childbearing potential [215]. ...
Acne vulgaris is a common dermatological condition that can present across different ages but predominantly affects adolescents and young adults. Characterized by various lesion types, the pathogenesis of acne is complex, involving genetic, hormonal, microbial, and inflammatory factors. This review comprehensively addresses current and emerging acne management strategies, emphasizing both topical and systemic treatments, procedural therapies, and dietary modifications. Key topical agents include retinoids, benzoyl peroxide, antibiotics, and other specialized compounds. Systemic options like antibiotics, hormonal therapies, and retinoids offer significant therapeutic benefits, particularly for moderate to severe cases. Procedural treatments such as laser devices, photodynamic therapy, chemical peels, and intralesional injections present viable alternatives for reducing acne symptoms and scarring. Emerging therapies focus on novel biologics, bacteriophages, probiotics, and peptides, providing promising future options. This review underscores the importance of personalized approaches to treatment due to the multifaceted nature of acne, highlighting the potential of innovative therapies for improving patient outcomes.
... Dentro do perfil clínico analisado em todos os estudos, 100% dos pacientes são do gênero feminino. A faixa etária selecionada se inicia a partir dos 12 anos (Grandhi et al., 2017) durante toda a fase adulta (Grandhi et al., 2017;Charny et al., 2017;Bienefeld et al., 2019;. Dentro da classificação de acne, em geral são pacientes que ocupam os grupos B ou C (moderada -grave) com formações pustulosas ou não. ...
... Os estudos analisados demonstraram que a espironolactona pode ser utilizada como monoterapia ou associada com anticoncepcionais, antibióticos e retinóides tópicos (Grandhi et al., 2017;Charny et al., 2017;. Os dados sobre a efetividade da espironolactona são limitados e gerados principalmente por pesquisas observacionais. ...
Introdução: A acne adulta (AMA) é uma preocupação crescente pelo seu impacto na autoestima e na estética da pele. Este estudo investigou a eficácia da espironolactona no tratamento da AMA. O presente artigo tem como objetivo fornecer uma atualização abrangente dos tratamentos disponíveis para a acne, com foco em um agente terapêutico emergente e promissor: a espironolactona. Metodologia: Foram utilizados termos como "Acne and Spironolactone", "Woman and acne" e "Spironolactone and acne treatment". Dez artigos foram selecionados, incluindo estudos clínicos e observacionais de trabalhos publicados entre 2017 e 2023, pesquisados nas bases de dados SciELO, PubMed, Google Acadêmico e BVS. Resultados e discussão: A espironolactona, inicialmente indicada para outras condições, tem efeitos promissores na AMA devido ao seu potencial antagonismo andrôgenico. A espironolactona é frequentemente usada em combinação com outros tratamentos, e apesar de efeitos colaterais, sua tolerância é geralmente boa. A dosagem média usada foi de 100 mg durante seis meses, ajustada conforme efeitos adversos. Estudos multicêntricos indicaram um baixo risco de hiperpotassemia com o uso da espironolactona para tratar a AMA. Pesquisas também apontaram a capacidade da espironolactona em tratar lesões em diversas áreas, incluindo rosto e tronco. Conclusão: A espironolactona emerge como uma opção terapêutica promissora para a acne adulta, apesar da evidência científica limitada. Seu uso demonstrou eficácia no controle das lesões, especialmente quando associada a retinoides tópicos. É crucial monitorar função renal e níveis de potássio. Estudos adicionais são necessários para consolidar seu papel no tratamento da AMA e entender plenamente sua eficácia e segurança.
... Topical retinoids, BPO, topical erythromycin, clindamycin, nadifloxacin, or antibiotics, and topical azelaic acid are available topical agents for acne [8][9][10][11][12][13] . Systemic treatments include oral isotretinoin 14,15 , oral antibiotics such as doxycycline 16,17 and minocycline 18,19 , and oral spironolactone 20,21 . Maintenance treatment in acne patients, particularly those using topical agents, is often challenging due to patient preferences for the vehicles used for topical treatment, which is a major cause of treatment failure 7, 22 . ...
Background
More than half of acne patients have truncal acne on their chest, back, and shoulders. However, since most studies on acne have focused on the face, data on clinical characteristics and proper management for truncal acne are insufficient.
Objective
To establish a Korean Acne Rosacea Society (KARS) consensus for experts’ perception and treatment patterns of truncal acne.
Methods
We conducted two rounds of the Dephi technique to gather expert opinion and reach a consensus on truncal acne. The first round comprised 48 questionnaires focusing on various aspects such as epidemiology, clinical features, diagnosis, treatment, prognosis and more, while second rounds consisted of 26 questionnaires.
Results
A total of 36 dermatologists (36/38 KARS members, 94.7%) completed this survey. In the first-round survey, consensus was reached on 20 out of the 48 questions (41.7%). In the second-round questionnaire, consensus was achieved on 9 of the 26 questions (34.6%). The most unresponsive lesion to truncal acne treatment was scars (atrophic/hypertrophic). The most commonly used treatments for each non-inflammatory and inflammatory truncal acne lesions were selected to use topical retinoids (78.1% of the responders) and oral antibiotics (93.8% of the responders).
Conclusion
Our study has yielded valuable insights into the epidemiology, clinical manifestations, diagnosis, treatment, and quality of life of patients with truncal acne. We anticipate that this study will inspire further comprehensive research for individuals with truncal acne.
... 6 Hal ini sesuai dengan American Academy of Dermatology (AAD) yang memang menyarankan penggunaan beberapa agen dengan mekanisme kerja yang berbeda untuk pengobatan akne. 7 Untuk mengukur tingkat derajat akne memang belum terdapat sistem yang dapat diterima secara universal, dalam penelitian ini pun terdapat beberapa sistem penilaian yang digunakan untuk menilai perbaikan akne, seperti CASS (Comprehensive Acne Severity Scale), ASI (Acne Severity Index), GAGS (Global Acne Grading System), dan lain-lain. Penelitian Charny et al., menggunakan CASS untuk mengevaluasi perbaikan klinis, didapati bahwa terdapat perbaikan masing-masing 73,1%, 75,9%, dan 77,6% pada wajah, dada, dan punggung. ...
... Penelitian Charny et al., menggunakan CASS untuk mengevaluasi perbaikan klinis, didapati bahwa terdapat perbaikan masing-masing 73,1%, 75,9%, dan 77,6% pada wajah, dada, dan punggung. 7 Hal serupa didapatkan oleh Gaarg et al., berdasarkan skor CASS didapati perbaikan komplit (skor CASS 0) sebesar 75,5% pada wajah, 84,0% pada dada, dan 80,2% pada punggung. 14 Oleh karena itu, hasil penelitian Charny et al., dan Gaarg et al., menunjukkan bahwa spironolakton juga sama efektifnya dalam mengobati akne pada wanita dewasa dengan lesi yang paling umum terdapat di bagian wajah, namun berpengaruh juga untuk lesi yang timbul di batang tubuh. ...
... 14 Oleh karena itu, hasil penelitian Charny et al., dan Gaarg et al., menunjukkan bahwa spironolakton juga sama efektifnya dalam mengobati akne pada wanita dewasa dengan lesi yang paling umum terdapat di bagian wajah, namun berpengaruh juga untuk lesi yang timbul di batang tubuh. 7,14 Penelitian Sanai et al., dengan pasien rata-rata berrusia 25 tahun dengan akne sedangberat diberikan spironolakton 100 mg/hari selama 3 bulan dan terdapat peningkatan skor ASI ≥50% pada 94% kasus (nilai p ≤0.001). 12 Hasil tersebut menunjukkan bahwa spironolakton memberikan respons yang baik untuk akne sedang-berat pada wanita dewasa yang biasanya dapat berupa akne persisten atau akne awitan lambat (dimulai saat usia ≥25 tahun). ...
Acne vulgaris is a skin disease that attacks pilosebaceous follicles which can be either inflammatory or non-inflammatory lesion. One of the important factors causing acne vulgaris is androgen hormone. One of the hormonal therapies that can be given for acne vulgaris is spironolactone which has a function as an antiandrogen. The purpose of writing this literature review is to determine the effectiveness, mode of action, indications, contraindications, and side effects of spironolactone in the treatment of acne vulgaris. The method in making this final project is Literature Review. Literature searches were obtained using electronic databases such as Google Scholar, PubMed, Proquest, International Journal of Women's Dermatology, and NCBI. The keywords used were spironolactone, hormonal therapy, acne vulgaris, effectiveness of spironolactone for acne vulgaris. There are 10 supporting journals based on the suitability of topics in the last 10 years. The results showed that the administration of spironolactone for acne vulgaris proved to be effective with an average dose of 50-100 mg/day which resulted in 70-90% clinical improvement and caused minimal side effects. Spironolactone has good effectiveness and tolerability for alternative therapy of acne vulgaris in adult women and for patients who do not respond well to conventional therapy.
... Based on risk-benefit assessment, the health complicacy and risk factors of death increase significantly. Short-term and long-term complications with existing cardiovascular therapy (Table 1) [66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84] ...
... It was reported that spironolactone (118) is effective in the treatment of acne on the face, back, and chest in women, and its efficacy has been maintained with longterm use. Of the 110 patients who met all eligibility requirements, 94 have improved their CASS scores, and 61 had complete clearance to 0 [288]. Olumacostat glasaretil (119) is a well-tolerated prodrug inhibitor of fatty acid synthesis, with statistically and clinically significant reduction of lesion numbers in patients with moderate to severe acne [289]. ...
The global cosmetics market reached US$500 billion in 2017 and is expected to exceed US$800 billion by 2023, at around a 7% annual growth rate. The cosmetics industry is emerging as one of the fastest-growing industries of the past decade. Data shows that the Chinese cosmetics market was US$60 billion in 2021. It is expected to be the world's number one consumer cosmetics market by 2050, with a size of approximately US$450 billion. The influence of social media and the internet has raised awareness of the risks associated with the usage of many chemicals in cosmetics and the health benefits of natural products derived from plants and other natural resources. As a result, the cosmetic industry is now paying more attention to natural products. The present review focus on the possible applications of natural products from various biological sources in skin care cosmetics, including topical care products, fragrances, moisturizers, UV protective, and anti-wrinkle products. In addition, the mechanisms of targets for evaluation of active ingredients in cosmetics and the possible benefits of these bioactive compounds in rejuvenation and health, and their potential role in cosmetics are also discussed.
... 8 Dating back to the 1980s, prospective studies on oral spironolactone have shown statistically significant efficacy against acne vulgaris in women. [8][9][10][11] Although studies have shown efficacy in spironolactone for acne, they have been small in sample size. A recent retrospective study of 110 patients concluded that spironolactone therapy provided patients with improvement in their acne. ...
... A recent retrospective study of 110 patients concluded that spironolactone therapy provided patients with improvement in their acne. 11 Similar to COCs, the systemic exposure of oral anti-androgens poses risks for potential side effects. Common side effects are menstrual irregularities, dizziness, breast enlargement, and nausea. ...
The purpose of this narrative review is to provide a summary of the clinical trials on the efficacy and safety of clascoterone 1% cream (Winlevi) to grant providers an understanding of which patients will benefit most from this novel topical antiandrogen medication. Clascoterone 1% cream (Winlevi) offers a new and exciting treatment approach for a difficult and common skin condition such as acne vulgaris. This topical androgen antagonist is the first of its kind but will hopefully provoke investigations into other androgen receptor antagonists with similar or better efficacy.
... Conventional therapy in form of oral/topical antibiotics and retinoids are the pillars of therapeutics in AV. However, few 17 In another 4 year retrospective study, 86% patients had improvement. 27 A study in adolescent females (n=80) reported improvement in acne in 80% patients on spironolactone. ...
... Spironolactone is one of the oldest androgen receptor blockers, indicated for the management of primary hyperaldosteronism, congestive heart failure, cirrhosis, nephrotic syndrome, essential hypertension due to its mineralocorticoid action (aldosterone antagonist). 17 It is used in treatment of hormone mediated acne with/without alopecia/hirsutism. Different mechanisms contribute to its anti-androgenic action. ...
Acne vulgaris is a multifactorial chronic disorder of the pilosebaceous unit. Established treatments include topical retinoids, antibiotics in mild cases, and oral antibiotics and isotretinoin in moderate to severe cases. Anti-androgens and other hormonal therapies constitute another group of drugs in the armamentarium of acne management. These can be used in patients who do not respond to the aforementioned treatments or when other systemic drugs cannot be tolerated. Recent approval of topical androgen receptor blocker is an additional armamentarium for the management of acne. Considering limited systemic exposure and good efficacy, it has potential for wide usage in patients with acne. In this article, we critically review currently available hormonal treatment options based on published literature search of an electronic database (MEDLINE/PubMed) performed through June 2021. J Drugs Dermatol. 2022;21(6):618-623. doi:10.36849/JDD.6494.
... The drug that acts as an aldosterone antagonist has been used initially as a potassium-sparing diuretic to treat high blood pressure and congestive heart failure. Recently, spironolactone was repositioned to treat acne and alopecia by observing its effect on reducing the activity of 5α-reductase, decreasing the DHT levels with a consequent reduction in androgenic effects on sebaceous glands and hair bulb [6][7][8]. ...
This study proposes developing a topical formulation based on poly-ε-caprolactone (PCL) or methacrylic acid/methyl methacrylate copolymer (EL100) nanoparticles to enable a safer and more effective therapy of alopecia and acne with spironolactone. The effect of the size of the nanoparticle on follicular-targeted drug delivery is also verified. Compatibility studies based on thermal analyses and complementary techniques showed a small interaction of the drug with excipients, which may not compromise the drug stability. PCL nanoparticles of 180.0 ± 1.6 and 126.8 ± 1.0 nm, and EL100 nanoparticles of 102.7 ± 7.1 nm were then prepared. All nanoparticles entrapped more than 75% of spironolactone, were physically stable, and stabilized the drug for at least 90 days. They were also non-irritant according to HET-CAM tests. Drug release from the nanoparticles was reduced in aqueous buffer media but fast when in contact with oil. Finally, in vitro skin penetration experiments revealed the largest nanoparticles (of 180 nm) targeted drug delivery to the hair follicles 5-fold (p < 0.05) more than the control solution, 2.1-fold (p < 0.05) more than nanoparticles produced with the same polymer (PCL) but with smaller size (123 nm), and 4.9-fold (p < 0.05) more than the 102-nm E100 nanoparticles. In conclusion, follicular targeting can be adjusted according to nanoparticle size, and this work succeeded in obtaining polymeric nanoparticles adequate to enable topical treatment of acne and alopecia with spironolactone.
... La espironolactona es un antagonista sintético del receptor de aldosterona, con propiedades diuréticas (ahorrador de potasio) y antiandrogénicas que resultan de su competencia con la testosterona de origen suprarrenal y gonadal, inhibiendo la proliferación de sebocitos y la producción de sebo 16 . Dos ensayos clínicos 24,25 y múltiples estudios observacionales 3,15,26-32 avalan la utilidad de este fármaco en el acné femenino, incluidas adolescentes y preadolescentes desde los 12 años de edad 15,27,30 . En general, del 70% al 90% de las mujeres presentan una mejoría significativa, y entre el 30% y el 60% una respuesta clínica completa 33 . ...
