In his article on acne published recently in the Advanced England Statement of Medicine James (1) mentions that androgen antagonist spironolacton is generally advantageous in women with hyperandrogenism. However, it would be big to point out, that the effectiveness of this treatment cannot be curved due to the baby specimen populations involved in the trials, as has been shown in recent metaanalysis. (2) It should be again emphasized that although the continued-chat statement of spironolactone in the treatment of acne in women appears to be protected, its side-effects seem to be aerial. (3) On the other hand, it is worth mentioning that spironolactone in addition to its antiandrogenic effects might again accept antiinflammatory abeyant. (4) This emphasizes the charge for further properly designed trials with relevant outcomes to accommodate robust estimates of the size and mechanism of any treatment effects. As of its continued half-action spironolactone should be accustomed once daily and not in divided doses as recommended by James. This might access the compliance which is big in prolonged therapy to accomplish maximal benefits. (5)
1. James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463-72.
2. Farquhar C, Shelter O, Toomath R, Jepson R. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database Syst Rev 2003;(4):CD000194.
3. Shaw JC, Achromatic LE. Continued-chat safety of spironolactone in acne: results of an 8-year followup study. J Cutan Med Surg 2002;6:541-5.
4. Hansen PR, Rieneck K, Bendtzen K. Spironolactone inhibits production of proinflammatory cytokines by human mononuclear cells. Immunol Lett 2004;91:87-91.
5. McEvoy B, Nydegger R, Williams G. Factors related to patient compliance in the treatment of acne vulgaris. Int J Dermatol 2003;42:274-80.
About the author:
Dr. Michal R. Pijak is a consultant in rheumatology, allergy and clinical immunology at the University Hospital in Bratislava, Slovakia.
Originall posted February 4, 2012