Spironolactone is generally prescribed as an “off label” acne
treatment for women. This drug, though intended to help people
with heart problems not zit problems, reduces the production of
the hormone androgen. Androgen promotes excess facial oil
secretion.
Less oil secretion limits the possibility of having clogged
pores and acne flare-ups.
Spironolactone works as an androgen receptor blocker. This drug
decreases androgen production in the ovaries and adrenal glands.
Side effects from spironolactone can include breast tenderness
and menstrual irregularity.
For this reason, doctors usually add oral contraceptives like
Ortho Tri-Cyclen and Estrostephave to compliment acne treatments
and ease potential spironolactone side effects. Ironically
though, spironolactone is recommended for women who are not
candidates for oral contraceptives.
So should a woman over 35 with acne go with spironolactone?
According to the American College of Physicians, the answer is
“No”.
In the 2004 May/June edition of the American College of
Physicians (ACP) published a medical review of studies that
tested the effectiveness of spironolactone for controlling
hirsutism, acne, or both in fertile or postmenopausal women. The
ACP review found insufficient evidence to recommend
spironolactone as an acne treatment.
Nevertheless, Dr. Diane Thiboutot of Pennsylvania State
University, Hershey uses spironolactone for female patients with
acne accompanied by a suspected endocrine disorder.
For example, when a woman experiences a sudden onset of severe
acne or acne that is linked with excessive facial hair growth,
irregular menstrual periods, increased libido, dark patches of
skin, deepening of the voice, insulin resistance and hair loss,
spironolactone may be helpful.
Dr. Thiboutot noted that spironolactone “seems to control quite
well those cystic-type nodules that they [women] get on their
lower face and chin.”
Yet Dr. Julie C Harper Dr. Harper of the department of
dermatology at the University of Alabama, Birmingham doesn’t
recommend spironolactone so easily. Only if neither topical
retinoids nor antibiotics have not worked for a woman’s case of
acne would Dr. Harper then suggest using spironolactone for
women over 35.
Author of “Acne Messages”, Naweko San-Joyz, says “A woman’s
response to androgens is so varied that limiting herself to an
androgen blockers like spironolactone certainly does not
guarantee a cure, or even a quick treatment.”
San-Joyz adds that overproduction of androgens is just one step
in a series of potential events that could lead to acne.
Instead of hormonal manipulation with drugs, San-Joyz suggests
women with acne regulate this conditional using food, stress
control and greater awareness of potential acne triggers like
environmental estrogens.
Women with acne have numerous treatments options. If a woman
does decide to go with spironolactone, it’s best to get her
prescription filled with her gynecologist rather that her
general practitioner.
It’s most likely that the gynecologist will be more aware of how
a patient may respond to hormonal treatments like spironolactone
and oral contraceptives, thus making recovery faster.
|
