High-Dose Spironolactone for Acne in Patients with Polycystic Ovarian Syndrome: A Single-Institution Retrospective Study

    August 2019 in “ Journal of The American Academy of Dermatology ”
    Pallavi Basu, Scott A. Elman, Boya Abudu, Ashley Beckles, Prerna Salian, Daniel Yanes, Martina L. Porter, Rachel V. Reynolds
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    TLDR Higher doses of spironolactone may improve acne in PCOS patients, but side effects are a concern.
    The retrospective study analyzed the effectiveness of high-dose spironolactone for treating acne in 59 patients with polycystic ovarian syndrome (PCOS) at a multidisciplinary clinic. The study found that 41% of patients experienced physician-assessed acne improvement, with those showing improvement taking a significantly higher mean dose of spironolactone (166.1 mg/day) compared to those who did not improve (130.7 mg/day). The mean treatment duration was 408.9 days, and over 85% of patients were also using oral contraceptives and topical treatments. Patients on combination therapy with oral antibiotics had more severe acne at baseline and at the last recorded visit. Adverse effects led to discontinuation in 15.3% of patients. The study suggests that higher doses of spironolactone than typically used may be required for acne improvement in PCOS patients, but it acknowledges limitations such as small size, single-center design, and potential selection bias.
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      community Female, 30, PCOS diagnosis, MPB Norwood 2. Endo refuses to give anything other than Spironolactone. Feel like I’m at my wit’s end here.

      in Female  57 upvotes 1 year ago
      A 30-year-old female with PCOS and male pattern baldness is frustrated with her endocrinologist's recommendation of only Spironolactone and minoxidil, feeling that dutasteride, finasteride, and progesterone would be more effective. Other users suggest various online sources for treatments, warn against self-medicating due to potential risks, and recommend seeking a specialized endocrinologist or considering additional treatments like Inositol, Berberine, and dermaneedling.

      community I think this is my stop, gentlepeople. So long and thanks for all the data 👋

      in Transgender  2250 upvotes 3 months ago
      A user shared their successful experience with hair regrowth and transitioning from male to female using minoxidil, finasteride, Nutrafol, microneedling, and hormone replacement therapy (HRT). They expressed gratitude for the results and encouraged others to explore treatments that align with their personal goals.

      community Female on DHT blockers, need some advice.

      in Research/Science  2 upvotes 2 weeks ago
      A female experiencing hair loss while on testosterone replacement therapy is using oral Minoxidil, Spironolactone, and finasteride, but still losing hair. Suggestions include switching to dutasteride, using topical anti-androgens, and reducing Nizoral shampoo use to prevent scalp dryness.

      community Longterm ru58841 users + my experience

      in Treatment  7 upvotes 1 year ago
      RU58841 users report mixed results, with some experiencing no benefits and others noting regrowth but potential side effects. Many prefer finasteride and minoxidil due to better-studied safety profiles.

      community Is this hierarchy of topical anti androgens accurate?

      in Ketoconazole  7 upvotes 3 years ago
      User on fin, minox, and ketoconazole seeks to add another topical anti-androgen. Hierarchy of effectiveness: 1. RU55841, 2. Fluridil - Eucapil, 3. CB-03-01 - Breezula, 4. Ketoconazole; alfatradiol suggested as addition.

      community DHT blockers for women, and your experiences with them?

      in Female  6 upvotes 5 years ago
      A user shared their experience with Spironolactone for hair loss, noting it stopped hair loss and cleared acne but had side effects like frequent urination and potential kidney damage. They also mentioned Bicalutamide as a potentially more potent DHT blocker with fewer side effects and asked for others' experiences with DHT blockers for women.

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