Retrospective Study of the Prevalence of Hyperkalemia in Women Taking Spironolactone for Acne, Hair Loss, and Hirsutism

This retrospective study examined the prevalence of hyperkalemia in 974 women taking spironolactone for acne, hair loss, and hirsutism. Out of 1273 courses of spironolactone, 447 courses (35.1%) showed an increase in potassium levels from baseline to end, with 171 courses (13.4%) showing an increase of ≥10%. Only 25 courses (2.0%) had end potassium values outside the upper limit of normal. Age, race, ethnicity, course duration, and cumulative dose were not significant predictors of hyperkalemia. The study concluded that while the overall rate of hyperkalemia was low, dermatologists should monitor potassium trends during treatment, especially in patients with a history of elevated potassium levels.