Acne didn\u2019t take hold of JJ Boparai\u2019s skin until she was in her late 20s.\u00a0<\/p>\n
\u201cI\u2019d never had acne like this, my face was just covered,\u201d said the 31-year-old from Metuchen, New Jersey, adding that experiencing acne as an adult was \u201chorrible psychologically.\u201d\u00a0<\/p>\n
Boparai\u2019s breakouts \u2014 which she described as \u201cvery cystic, like a lot of under the skin, big, painful, ones, a lot on my chin and cheeks\u201d \u2014 were stubborn. After about a year of trying various washes, chemical peels and creams, she went to a dermatologist, who started her on oral antibiotics and a topical medication.<\/p>\n
Her acne persisted.<\/p>\n
It wasn\u2019t until the doctor prescribed spironolactone \u2014 a blood pressure drug approved in 1960 \u2014 that Boparai saw a difference in her skin.<\/p>\n She\u2019s far from alone: According to a study in JAMA Dermatology, the prescribing rates of spironolactone for acne in women rose by nearly 300% from 2017 to 2020. By 2020, dermatologists were prescribing the blood pressure medication at similar rates to antibiotics.<\/p>\n Spironolactone works by blocking a hormone in the body called aldosterone. This hormone holds onto sodium; by blocking it, it helps the kidneys flush salt and water out of the body to lower blood pressure.<\/p>\n The drug, doctors later learned, also disrupts similar hormones in the body, including the ones that cause acne, said Dr. John Barbieri, a dermatologist and epidemiologist at Brigham and Women\u2019s Hospital in Boston and the author of the JAMA Dermatology study.<\/p>\n These hormones are called androgens and include testosterone.<\/p>\n \u201cTestosterone increases the oil production in the skin and when you have a lot of oil in your skin, it clogs the pores and causes acne,\u201d said Dr. Ayman Grada, a dermatologist and adjunct professor at Case Western Reserve University School of Medicine in Cleveland. Spironolactone blocks those effects on the skin.\u00a0\u00a0<\/p>\n After a few small studies in the 1980s showed the drug was effective for acne, some dermatologists began prescribing it to women. <\/strong>Men can also get acne as adults, but as an acne treatment, the drug is prescribed only to women.<\/p>\n \u201cIts use has just grown and grown and grown over time\u201d as word of the medication has spread, Barbieri said.\u00a0<\/p>\n Spironolactone is one of the acne treatments included in the American Academy of Dermatology treatment guidelines.<\/p>\n The drug isn\u2019t generally used as a so-called first-line treatment for acne. It\u2019s considered an option for women if other medications, including creams or oral antibiotics, don\u2019t work.<\/p>\n \u201cI do offer it more often than I used to and I have become more comfortable with it,\u201d said Dr. Jessica Krant, a dermatologist at the Laser and Skin Surgery Center of New York, who noted that she only typically prescribes it when other treatments don\u2019t work.\u00a0<\/p>\n Oral antibiotics are the most common treatment for women with adult acne, but Barbieri expects spironolactone to soon surpass it.\u00a0<\/p>\n \u201cThere\u2019s been growing high quality data to support spironolactone use for acne, which I think has made more people become aware of it and be comfortable prescribing,\u201d he said.<\/p>\n The American Academy of Dermatology, which issues prescribing guidelines for treating acne, has asked dermatologists to limit the use of antibiotics when possible.\u00a0<\/p>\n \u201cIf we could use more spironolactone, that might help us use less antibiotics,\u201d said Barbieri, who also co-chairs the group\u2019s acne guidelines work group. \u201cThat\u2019s going to create less antibiotic resistance in the community, and less antibiotic-associated complications for patients, like disrupting the microbiome.\u201d<\/p>\n Spironolactone isn\u2019t approved by the Food and Drug Administration for acne and is prescribed off-label.<\/p>\n Barbieri noted that because the drug is generic \u2014 and has been for many years \u2014 it\u2019s unlikely that a drugmaker would ever spend the money on the clinical trials that would be needed to apply for approval for its use for acne. \u201cIt\u2019s unclear who would want to expend that effort,\u201d he said.<\/p>\n As a blood pressure medication, spironolactone is usually prescribed at a dose of 25 milligrams\u00a0a day.\u00a0<\/p>\n For acne, the dosage is higher: it\u2019s often started at 50 mg and then titrated up to 100 mg, and in some cases, 200 mg.\u00a0<\/p>\n Those dosages haven\u2019t been studied in large, long-term clinical trials. What\u2019s more, the original studies on the drug were primarily carried out in older white men, not young women.\u00a0<\/p>\n It shouldn\u2019t be prescribed to men for acne, because at these high doses, can cause gynecomastia, or enlargement of breast tissue in men, Barbieri said.<\/p>\n As use of spironolactone for acne has increased, there have been a handful of small studies looking at the short-term safety and efficacy of the medication.\u00a0<\/p>\n \u201cIt has been used for a long time but there are limited clinical trials,\u201d Grada said. He\u2019s comfortable prescribing the drug but would like to see long-term studies.\u00a0<\/p>\n \u201cThe side effects are very mild, you know, comparable to other drugs, but there\u2019s no long-term safety data,\u201d he added.<\/p>\n One phase 3 clinical trial, published in The BMJ last year, followed 400 women taking either spironolactone or a placebo for 24 weeks. Side effects were slightly more common in women who got the drug compared to the placebo but, overall, they were mild.\u00a0<\/p>\n Like other blood pressure drugs, it can cause side effects including dizziness, lightheadedness and headaches. In older women taking it, or those with certain medical conditions, potassium levels should be monitored.<\/p>\n Krant said she has had a few women go off the medication because of breast tenderness or decreased sex drive. She also said it can disrupt the menstrual cycle and cause irregular bleeding.\u00a0<\/p>\n The drug shouldn\u2019t be used during pregnancy, according to the American Academy of Dermatology, because it can cross the placenta and potentially affect the fetus.\u00a0<\/p>\n Spironolactone does carry a FDA warning based on a study showing that at extremely high levels \u2014 up to 150 times greater than human doses \u2014 it caused cancer in rats. A recent meta-analysis didn\u2019t find an increased risk of cancer in humans, though the researchers noted \u201cthe certainty of the evidence was low and future studies are needed.\u201d<\/p>\n \u201cAs a whole, spironolactone is a safe medicine with the data we know,\u201d said Dr. Christopher Bunick, a dermatologist and an associate professor at Yale University School of Medicine.\u00a0<\/p>\n However, \u201cthere needs to be more high-quality studies to truly understand the correlation between spironolactone use and cancer,\u201d he said. \u201cIt\u2019d be foolish to sweep it under the rug.\u201d<\/p>\n<\/div>\n[ad_2]\n","protected":false},"excerpt":{"rendered":" [ad_1] Acne didn\u2019t take hold of JJ Boparai\u2019s skin until she was in her late 20s.\u00a0 \u201cI\u2019d never had acne like this, my face was just covered,\u201d said the 31-year-old from Metuchen, New Jersey, adding that experiencing acne as an adult was \u201chorrible psychologically.\u201d\u00a0 Boparai\u2019s breakouts \u2014 which she described as \u201cvery cystic, like a …<\/p>\n","protected":false},"author":1,"featured_media":35351,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"_links":{"self":[{"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/posts\/35349"}],"collection":[{"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/comments?post=35349"}],"version-history":[{"count":0,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/posts\/35349\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/media\/35351"}],"wp:attachment":[{"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/media?parent=35349"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/categories?post=35349"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/farratanews.online\/wp-json\/wp\/v2\/tags?post=35349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Before](\"https:\/\/media-cldnry.s-nbcnews.com\/image\/upload\/t_fit-760w,f_auto,q_auto:best\/rockcms\/2024-04\/240404-JJ-Boparai-spironolactone-ew-524p-11cc5d.jpg\")
<\/picture>What is spironolactone and why does it treat acne?<\/strong><\/h2>\n
Is spironolactone safe for acne treatment?<\/strong><\/h2>\n