Spironolactone for Female Acne: A Meta-Analysis of Safety and Efficacy

This meta-analysis of 12 studies with 1,548 participants found that spironolactone significantly improves acne symptoms in females, with a 78.8% improvement rate and a 31.3% incidence of adverse events. It is more effective than placebo, with an odds ratio of 3.79 for symptom improvement, and serves as a viable alternative to antibiotics, especially for those concerned about antibiotic resistance. Spironolactone benefits both facial and truncal acne with minimal side effects, such as irregular menstruation and hyperkalaemia. The study suggests spironolactone is a well-tolerated and effective treatment, particularly for teenage girls with acne unresponsive to topical treatments. However, variations in doses and study designs, along with the lack of placebo groups in most studies, highlight the need for further randomized controlled trials.