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Spironolactone reveals greater long-term efficacy for moderate-to-severe acne in women, with continuous improvement observed over 6 months, making it a highly effective option for extended treatment.
Spironolactone is commonly used off-label for adult female acne due to its sebum-reducing properties and lowering androgen hormones in the body. A new study published in Acta dermato-venereologica explored the effectiveness of Spironolactone compared to Doxycycline therapy for moderate acne in adult women.
Brigitte Dreno and colleagues investigated 133 women with moderate acne in a multicenter, randomized, double-blind prospective study. The women were divided into two treatment groups: one receiving Doxycycline with Benzoyl peroxide, followed by a placebo, and the other receiving Spironolactone with Benzoyl peroxide for a total of 6 months. Success was measured using the Adult Female Acne Scoring Tool (AFAST) score at months 4 and 6. Additional assessments included Echelle de Cotation des Lésions d'Acné or Acne Lesion Score Scale (ECLA) scores, lesion counts, safety, and quality of life.
Spironolactone demonstrated superior performance, showing a statistically significant improvement in treatment success at 4 and 6 months compared to Doxycycline. At these time points, Spironolactone was 1.37 and 2.87 times more effective.
Improvements in AFAST and ECLA scores and lesion counts were consistently greater with Spironolactone. Patients reported better quality of life with Spironolactone, which was well-tolerated overall.
Acta Dermato-Venereologica
Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study
Brigitte Dreno et. al.
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