TLDR Spironolactone and clascoterone are promising acne treatments with fewer side effects.
The document reviews traditional and alternative acne treatments, focusing on reducing side effects and improving efficacy. Traditional treatments like isotretinoin and spironolactone are effective but have side effects such as skin irritation and dryness. Spironolactone shows promise, particularly in women, with a 75% reduction in inflammatory lesions in clinical trials. Clascoterone, a new topical anti-androgen, has shown significant efficacy and a favorable safety profile. Benzoyl peroxide remains effective against Cutibacterium acnes. The document emphasizes the need to limit oral antibiotic use due to rising antibiotic resistance and suggests more evidence is needed to fully endorse spironolactone for acne treatment.
4 citations
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January 2022 in “Dermatologic Therapy” Spironolactone is useful for treating acne and other skin conditions like excessive hair growth and certain types of hair loss.
22 citations
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October 2020 in “Anais Brasileiros de Dermatologia” The Brazilian Society of Dermatology agrees that oral isotretinoin is effective for acne and other skin conditions, and it's safe when monitored, but more research is needed on dosing and duration.
1 citations
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September 2020 in “Actas Dermo-Sifiliográficas” 
3 citations
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August 2019 in “Journal of The American Academy of Dermatology” Clascoterone safely promotes hair growth similar to minoxidil.
117 citations
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February 2017 in “American Journal of Clinical Dermatology” Oral spironolactone's effectiveness for adult female acne is not well-supported by strong evidence.
4 citations
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December 2021 in “Experimental and Therapeutic Medicine” Adult female acne is complex and requires a combination of treatments for effective management.
13 citations
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January 2024 in “Cureus” Acne significantly affects both physical health and mental well-being.
January 2022 in “Springer eBooks” 
5 citations
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January 2024 in “Journal of the American Academy of Dermatology” Use benzoyl peroxide, retinoids, antibiotics, and isotretinoin for acne, and combine treatments for better results.
116 citations
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December 2017 in “International Journal of Women's Dermatology” Adult female acne treatment should be personalized, considering individual preferences and pregnancy, using various topical and oral medications while managing side effects and resistance.
