Adult female acne treated with spironolactone: a retrospective data review of 70 cases.
The prevalence of acne in the adult population is increasing, particularly in women. Spironolactone regulates sebaceous gland activity by blocking androgen receptor. To evaluate retrospectively the efficacy of spironolactone in women with acne. Data from 70 women of at least 20 years, treated for their acne between 2010 and 2015 with low-dose spironolactone (≤150 mg/day), were analysed. Remission was defined by the number of retentional lesions inferior or equal to five and inflammatory lesions inferior or equal to two on the face. Variables influencing the response were studied using the Cox model. The mean age was 31.3 years; 39 (56%) women had prior courses of isotretinoin and 53 (76%) had an oral contraception prior to treatment. Remission data from a median treatment period of six months (95% CI: 4-9) were obtained from 47 (71%) women. Markers for a positive response to spironolactone were a high number of inflammatory lesions at inclusion (OR: 1.08; 95% CI: 1.03-1.13; p = 0.001) and relapse with previous isotretinoin (OR: 2.46; 95% CI: 1.09-5.54; p = 0.03). The marker for a negative response was an association with oral contraceptives containing first or second-generation progestin (OR: 2.77; 95% CI: 1.35-5.71; p = 0.005). This retrospective data analysis confirms that the use of low doses of spironolactone is a valuable alternative in women with acne in whom oral isotretinoin has failed. Moreover, the analysis shows that first and second-generation oral contraceptives decrease the efficacy of spironolactone, confirming the interest of using two third or fourth-generation oral contraceptives.
['Isvy-Joubert|Anne|A|', 'Nguyen|Jean-Michel|JM|', 'Gaultier|Aurélie|A|', 'Saint-Jean|Mélanie|M|', 'Le Moigne|Marie|M|', 'Boisrobert|Elodie|E|', 'Khammari|Amir|A|', 'Dreno|Brigitte|B|']
D000152:Acne Vulgaris D000328:Adult D059002:Androgen Receptor Antagonists D001415:Back D003276:Contraceptives, Oral D012628:Dermatitis, Seborrheic D003879:Dermatologic Agents D005148:Facial Dermatoses D005260:Female D006801:Humans D015474:Isotretinoin D008875:Middle Aged D011372:Progestins D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D013148:Spironolactone D016896:Treatment Outcome D055815:Young Adult
adult female acne spironolactone isotretinoin contraception progestin