Research on the use of a specific diuretic to treat acne in women was reported in the British Medical Journal 2023;381; e074349.
Women age 18 or older with acne on their face that was bad enough to consider using an oral antibiotic were studied. Half of the women were given a diuretic (spironolactone) and the others were given a placebo (an inactive substance).
The group taking spironolactone had noticeably better control of acne than the group on placebo. This was not apparent after 12 weeks of treatment but was significant by week 24.
During the study, the women were allowed to continue any topical treatments for acne that their doctor recommended.
Spironolactone has been around for many years. It is approved for treating acne. Doses range from 25 mg to 200 mg. It is also used for a number of different medical conditions, including the treatment of swelling, excessive body hair, high blood pressure, and others.
The most common side effects include elevation of blood potassium, nausea, vomiting, abdominal cramps, and other less common ones. The majority of people tolerate it very well.
It should not be taken by pregnant women but is safe if breastfeeding.
The bottom line is that spironolactone is a reasonable alternative to oral antibiotics for the treatment of facial acne in women.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
