Oral Spironolactone Therapy for Female Patients with Acne, Hirsutism, or Androgenic Alopecia

In a study from 1985, spironolactone was used to treat female patients with androgenic alopecia, hirsutism, and acne. The study included 12 patients with hirsutism, 7 with androgenic alopecia, and 8 with acne. Ten hirsutism patients were satisfied with the treatment, and 6 out of 7 patients with androgenic alopecia were pleased after 6 months, although this was a subjective assessment. For acne, 6 out of 8 patients noticed considerable improvement, with a mean improvement of 52% at 6 months based on the Leeds grading technique. The treatment also resulted in a significant reduction in sebum excretion rate (SER), with a 51 ± 6.5% reduction at 1 month, which was favorable compared to other treatments but less than the 90% reduction seen with 13-cis retinoic acid. The authors concluded that spironolactone has antiandrogenic potential and relatively few side effects, but they advised against its use in patients under 30 without good reason.