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Long-Term Spironolactone Appears Safe For Acne Treatment In Women

The long-term use of spironolactone to treat acne in women appears to be safe, according to results of a long-term study.

Side effects to the medication are common, but they do not appear to be a usual cause of stopping treatment. These were the overall conclusions of a study by Dr James Shaw (Division of Dermatology, University of Toronto, Toronto Western Hospital, Canada) and Dr Lucile White (Department of Medicine, MacNeal Hospital, Berwyn, Illinois, United States).

Although spironolactone has been used for over 20 years as antiandrogen therapy in the treatment of acne and hirsuitism, the authors say that no long-term studies of the safety of the drug in this use have been published. Dr Shaw and Dr White completed this study of 91 women who were followed for up to 8 years.

Initially, 210 patients were sent a survey questionnaire. In all, 91 completed surveys were put forward for analysis, representing 506 person-years of follow up and 200 person-years of spironolactone exposure. The mean treatment time was 28.5 months (range 0.5 to 122 months).

The researchers say, "During the 8-year follow up period, there were no cases of serious illness attributable to spironolactone use". However, he added, 59% of patients had side effects. These side effects resulted in stopping therapy in 15% of patients. The most common side effects were the diuretic effect, and menstrual irregularities.
J Cutan Med Surg. 2002 Nov-Dec;6:6:541-5. "Long-Term Safety of Spironolactone in Acne: Results of an 8-Year Followup Study"

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