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European Journal of Dermatology

, Volume 27, Issue 4, pp 393–398 | Cite as

Adult female acne treated with spironolactone: a retrospective data review of 70 cases

  • Anne Isvy-Joubert
  • Jean-Michel Nguyen
  • Aurélie Gaultier
  • Mélanie Saint-Jean
  • Marie Le Moigne
  • Elodie Boisrobert
  • Amir Khammari
  • Brigitte Dreno
Therapy

Abstract

Background

The prevalence of acne in the adult population is increasing, particularly in women. Spironolactone regulates sebaceous gland activity by blocking androgen receptor.

Objectives

To evaluate retrospectively the efficacy of spironolactone in women with acne.

Materials & methods

Data from 70 women of at least 20 years, treated for their acne between 2010 and 2015 with low-dose spironolactone (≤150 mg/day), were analysed. Remission was defined by the number of retentional lesions inferior or equal to five and inflammatory lesions inferior or equal to two on the face. Variables influencing the response were studied using the Cox model.

Results

The mean age was 31.3 years; 39 (56%) women had prior courses of isotretinoin and 53 (76%) had an oral contraception prior to treatment. Remission data from a median treatment period of six months (95% CI: 4-9) were obtained from 47 (71%) women. Markers for a positive response to spironolactone were a high number of inflammatory lesions at inclusion (OR: 1.08; 95% CI: 1.03-1.13; p = 0.001) and relapse with previous isotretinoin (OR: 2.46; 95% CI: 1.09-5.54; p = 0.03). The marker for a negative response was an association with oral contraceptives containing first or second-generation progestin (OR: 2.77; 95% CI: 1.35-5.71; p = 0.005).

Conclusion

This retrospective data analysis confirms that the use of low doses of spironolactone is a valuable alternative in women with acne in whom oral isotretinoin has failed. Moreover, the analysis shows that first and second-generation oral contraceptives decrease the efficacy of spironolactone, confirming the interest of using two third or fourth-generation oral contraceptives.

Key words

adult female acne spironolactone contraception isotretinoin progestin 

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Copyright information

© John Libbey Eurotext 2017

Authors and Affiliations

  • Anne Isvy-Joubert
    • 1
  • Jean-Michel Nguyen
    • 2
    • 3
  • Aurélie Gaultier
    • 2
    • 3
  • Mélanie Saint-Jean
    • 1
    • 3
  • Marie Le Moigne
    • 1
    • 3
  • Elodie Boisrobert
    • 1
    • 3
  • Amir Khammari
    • 1
    • 3
  • Brigitte Dreno
    • 1
    • 3
  1. 1.Department of DermatologyNantes University HospitalNantesFrance
  2. 2.Clinical Research DepartmentMethodological UnitNantesFrance
  3. 3.INSERM U892NantesFrance

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