TLDR Spironolactone is effective and safe for treating acne with minimal side effects.
In a 4-year retrospective study evaluating the use of spironolactone for acne treatment, involving 291.5 patient-years and 400 patients who had not previously used spironolactone, 86% showed improvement with minimal side effects. The study found that spironolactone is an effective second-line treatment for postadolescent acne, with a low risk of short-term adverse effects such as hyperkalemia. Combination therapy with spironolactone, oral treatments, and topical agents was the most common regimen among those who improved. Side effects were less frequent than previously reported, with only 0.25% experiencing menstrual irregularities, and no cases of estrogen-dependent cancers were observed. The study suggests that spironolactone is a safe and tolerable option for acne management and may reduce reliance on oral antibiotics.View this study on karger.com →
Hormonal treatments can help with acne but are not the first choice due to side effects and the need for careful patient selection.