Tolerance of Spironolactone in Acne and Hirsutism Treatment

    June 1987 in “ British journal of dermatology/British journal of dermatology, Supplement ”
    B.R. Hughes, W.J. Cunliffe
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    TLDR Most patients tolerated spironolactone for acne and hirsutism despite common side effects like menstrual changes and breast tenderness.
    A study reviewed 44 patients (43 female, 1 male) with an average age of 37 years who were treated with spironolactone for acne and hirsutism to assess their tolerance of the drug. The treatment started at 200 mg daily, with an average duration of 14 months. The most common side effect was menstrual disturbances, affecting 66% of patients, including irregular periods, intermenstrual bleeding, amenorrhea, changes in blood loss, and frequency of periods. Additionally, 27% experienced breast enlargement, 30% had breast tenderness, 18% reported nausea, and 39% had dry skin, with four patients experiencing severe itching and scaling. Two patients reported abnormal facial pigmentation, a side effect not previously associated with spironolactone. Other less common side effects included vomiting, dizziness, drowsiness, headaches, abdominal pain, loss of short-term memory, and malaise. These side effects tended to occur early and persist but were managed by adjusting the dosage. Only four patients discontinued treatment, indicating that despite the high incidence of side effects, the drug's benefits were considered to outweigh the adverse effects.
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