Is topical spironolactone effective for acne?

A systematic review published in The Journal of Dermatology investigated the efficacy and safety of topical spironolactone in the treatment of acne. The use of topical spironolactone 5% showed a reduction in the number of closed comedones and papules at four and eight weeks. Topical spironolactone 2% was also effective in reducing the number of papules, pustules, and comedones, with efficacy similar to that of clindamycin 1.5% solution. The authors observed that the 2% formulation given for 12 weeks yielded more favorable outcomes compared to 5% spironolactone for six to eight weeks, which, according to the authors, may be due to a longer treatment duration. Despite having a greater drug concentration in the gel formulation (5%), 2% topical spironolactone in solution form displayed more promising results.

[Read about potassium monitoring in women on spironolactone in DermWorld Weekly.]

There were no significant side effects with topical spironolactone. The authors concluded that topical spironolactone is an effective treatment for acne, although more trials are needed with a standardized dose and larger sample size to determine its role in treatment.

Is spironolactone use associated with risk of cancer? Read more in DermWorld Weekly.

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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