From the Guidelines
Spironolactone for acne should be initiated at a dose of 100mg daily, with the possibility of increasing to 150mg or 200mg daily if needed, as evidenced by recent observational studies 1. The dosing of spironolactone for acne treatment is crucial for its efficacy and safety.
- The typical starting dose is 100mg daily, which can be taken in the evening, as suggested in Table 2 of the study 1.
- The dose can be increased to 150mg or 200mg daily if there is no improvement or if the patient has a partial response, as seen in the study by Charny et al. 1, where 32 patients improved or cleared by increasing the dose to 150mg/day and another 13 improved or cleared at 200mg/day.
- It is essential to note that spironolactone is a potassium-sparing diuretic, and monitoring potassium levels may be necessary, especially at higher doses, although routine monitoring is not required in young women without hypertension, renal, or cardiac disease, as stated in Table 2 1.
- Common side effects of spironolactone include menstrual irregularities, breast tenderness, dizziness, nausea, headache, polyuria, and fatigue, as listed in Table 2 1.
- Spironolactone has been shown to be effective in treating acne in women, with studies demonstrating improvement in 84% of patients treated with 100mg/day, and 71% of patients having a good clinical response, with a median time to response of 6 months, as reported in the studies by Charny et al. and Isvy-Joubert et al. 1.
From the Research
Spironolactone Dosage for Acne
- The dosage of spironolactone for acne can vary, but studies have shown that a daily dose of 50-200 mg can be effective 2.
- A retrospective chart review of 41 female patients with cyclical acne found that an initial dose of 50 mg per day was increased in 25 mg increments every 3 months if significant improvement was not seen within the first 3-6 months 2.
- Another study of 395 adult patients found that a median spironolactone dose of 100 mg daily was effective in treating acne, with approximately two-thirds of patients having a complete response 3.
Factors Affecting Dosage
- The severity of acne may affect the dosage of spironolactone, with more severe cases potentially requiring higher doses 2, 3.
- The response to treatment can also affect the dosage, with some patients requiring dose adjustments or switches to different systemic agents 4.
- Combination therapy with topical retinoids or other agents may also impact the dosage of spironolactone 2, 5.