Efficacy and safety of systemic spironolactone for acne in female patients in Sulaymaniyah teaching center of dermatology

Background and objectives: Acne vulgaris is a common disease in which hormone plays a role in its pathogenesis. Spironolactone, an androgen receptor blocker is used to treat acne. This study aims to evaluate the efficacy and safety of systemic spironolactone for acne in female patients in our local area. Methods: Open-label therapeutic trial study performed in the Sulaymaniyah teaching center of dermatology between 1/2/2022 - 1/9/2022, on a total of 47 patients aged 12-38 years old. Patients were divided into two groups in regard to age. Hormonal profile was assessed for all the patients. The 4-grade European classification system was used to classify the acne severity. Spironolactone 100 mg once daily at morning was given to them with follow up monthly for 3 months. Clinical response of the drug was assessed through a decrease in the number of the lesions. Signs and symptoms of the side effects were checked monthly. Results: In a total of 47 patients, 22 patients were ? 25 years and 25 patients were >25 years. A significant difference was recorded in the response rate among the patients' ages and hormonal status of them as 83.3%, 61.1% and 50% of the complete response was in those who were >25 years old and had abnormal testosterone and DHEA-s levels respectively. 100% of non-responder patients were below 25 years old with normal hormonal levels. 55.32% of the patients had no side-effect and menstrual irregularity was the most commonly reported side effect. Conclusion: Spironolactone is statistically considered an effective and safe line for the treatment of acne vulgaris particularly for acne in female over 25 with abnormal hormonal levels.