Therapeutic evaluation of spironolactone and finasteride in the treatment of acne vulgaris

ABSTRACT

Antiandrogens have been developed to treat acne; spironolactone, an androgen receptor blocker, and fmasteride, 5 alpha reductase inhibitor, are two antiandrogens that can be used to treat acne vulgaris. To evaluate the effectiveness and safety of spironolactone, fmasteride, and combination of both drugs in the treatment of acne vulgaris. This single blinded uncontrolled clinical therapeutic trial was done in the Department of Dermatology and Venereology - Baghdad Teaching Hospital- in a period from December 2004 to October 2006. The patients were classified according to the number of inflammatory lesions as having mild, moderate and severe acne. Severe acne was excluded from the study. History and close examination were performed to all patients regarding all points related to the disease. Sixty-nine patients with acne were divided into three groups and were instructed to take the following drugs for two months; group A spironolactone 100 mg/day, group B fmasteride 5 mg/day, and group C combination of both drugs. The clinical assessment was done by counting the number of inflammatory lesions every two weeks for two months, recording any local or systemic side effects, and comparison between the number of inflammatory lesions before and after treatment was done. Sixty patients had completed this work, whose mean +/- SD of their ages of the three groups totally was 18.8 +/- 2.3 years and for group A, group B, and group C as follow 19 +/- 2.6, 19.3 +/- 1.9, and 18.1 +/- 2.4 respectively, with 20 patients in each group. Spironolactone was statistically significant in reducing the number of inflammatory lesions, fmasteride was beneficial but did not reach a statistically significant level as spironolactone, and combination of both drugs was more effective in the treatment of acne vulgaris than spironolactone alone but did not reach a statistically significant level. Spironolactone is a good alternative drug to be used in patients with acne singly or in combination therapy with fmasteride