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Efficacy and tolerance of acne treatment using both spironolactone and a combined contraceptive containing drospirenone.

Krunic A, Ciurea A, Scheman A

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. sasakrun@hotmail.com

BACKGROUND: The use of either oral contraceptives or antiandrogens has been shown to be helpful in the treatment of women with acne. OBJECTIVES: We investigated the safety and efficacy of acne treatment using both spironolactone and a combined contraceptive containing drospirenone. METHODS: Twenty-seven women with either severe papular or nodulocystic facial acne were treated with a combined oral contraceptive containing 30 mug ethinyl estradiol and 3 mg drospirenone (EE/DRSP; Yasmin) and spironolactone (SL) 100 mg taken daily. A serum potassium level was obtained before initiation of therapy. Between 4 and 6 weeks after the start of both medications, a second serum potassium level was obtained. Side effects were recorded. RESULTS: No significant elevation of serum potassium was found in any of the subjects nor were there any reported additional side effects significant enough to discontinue treatment. At follow up, 85% of subjects were entirely clear of acne lesions or had excellent improvement, 7.4% were mildly improved, and 7.4% were not improved. LIMITATIONS: This was a small prospective study. CONCLUSION: The combination of EE/DRSP and SL 100 mg daily appears to have efficacy and is well tolerated in the treatment of severe papular and nodulocystic acne in women.

Published 26 December 2007 in J Am Acad Dermatol, 58(1): 60-2.
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