The first large-scale study of an inexpensive drug used to treat blood pressure has found it could help thousands of women suffering from persistent acne. Unfortunately, the study authors say it’s not suitable for men.
Wednesday, May 17, 2023 at 11.45am, UK
Women suffering from persistent acne have been given hope by a cheap new drug.
The drug, which is used to treat high blood pressure, could change the way acne in women is routinely treated.
Acne is common in adolescence, but can occur in adulthood.
A team of researchers led by the Southampton Clinical Trials Unit conducted a study of over 400 women over the age of 18.
All of the women had acne that had persisted for more than six months so oral antibiotics would normally be the next treatment.
In the first large-scale clinical trial, funded by the National Institute for Health and Care Research (NIHR), half of the participants were randomly assigned to take the drug known as spironolactone.
The other half were given a placebo or a dummy pill.
What were the results?
Researchers have found that spironolactone may offer an alternative for women with persistent acne.
After 12 and 24 weeks, the women who were taking the drug saw significant improvements in their acne.
Professor Miriam Santer, GP and co-lead of the study, said: “The results showed that women taking spironolactone saw a significant improvement in their acne after 12 and 24 weeks compared to those taking placebo.
“These results show that spironolactone may offer an alternative to antibiotics for many women with persistent acne to use alongside topical acne treatments.”
She added: “We hope the publication of these findings means more doctors and dermatologists feel confident prescribing spironolactone as an acne treatment.
“The drug is already included in guidelines for the treatment of persistent acne in the US and Europe, and we hope this study will lead to a change in UK guidelines.”
Unfortunately, the drug isn’t suitable for men, according to Prof. Santer and her co-author Alison Layton.
The couple wrote in the British Medical Journal: “Unfortunately, spironolactone is not considered an acceptable treatment option for men with acne. The use of spironolactone reduces testosterone levels in the blood which can lead to gynecomastia (swelling of the breasts) and concerns have been raised about loss of sexual function in men.”
“People Would Stare”
Kelly Cornick, 39, from Dorset, who has used the medication, said she had previously been prescribed various creams and the contraceptive pill to try and control her acne.
Cornick said she started on a lower dose of spironolactone and has seen an improvement in her acne. She was then given a higher dose of the drug and within a few months her acne disappeared.
She said: ‘It was embarrassing. People were staring at you and you almost felt like they were looking at you like you were dirty and didn’t wash well.
“I think the worst thing for me was when one of my granddaughters said, ‘Do you have chicken pox?’.”
Ms Cornick continued: ‘I initially started on the lowest dose and there was improvement. Then I moved up to the highest dose and within about three months everything was gone, all the spots were gone.
“Knowing how much it has helped me, I hope now that other people get this treatment as an option instead of just trying antibiotics. I want people to be able to experience it, because everyone should feel safe and happy, and not have spots.”
An alternative to antibiotics
Professor Andrew Farmer, director of the NIHR’s Health Technology Assessment programme, said: ‘The treatment provides a viable alternative to antibiotics and ensures that clinicians can also better avoid the harms that can result from antimicrobial resistance.’
The findings come after the Commission on Human Medicines recommended new safety measures for the use of an acne-fighting drug called isotretinoin.
This came after a number of people died by suicide while taking the drug – others also reported depression, anxiety and psychotic symptoms.
Cases of sexual dysfunction have also been reported by patients who were prescribed the medicine, and in some cases, the symptoms continued after the patients stopped taking the medicine.
The review of this drug concluded that the benefits of isotretinoin, also known as Roaccutane, still outweigh the risks.
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What is Spironolactone?
According to the NHS, spironolactone is an anti-androgen, which means it stops male hormones, such as testosterone, from working.
The drug can be used to treat fluid buildup in the body, which can be caused by heart failure, liver disease, kidney disease, and high aldosterone levels.
It is also used to treat high blood pressure (hypertension).
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