Old pill helps tackle women’s acne
A 60-YEAR-OLD blood pressure drug could be used as a radical new treatment for acne in women.
A major new UK trial is under way to assess whether spironolactone, launched as a treatment for high blood pressure in 1960, helps the skin condition, too.
While the drug treats high blood pressure by removing excess water from the bloodstream, easing pressure on artery walls, one of its side-effects is reducing the ability of testosterone to bind to receptors on skin cells.
Excess production of testosterone increases the activity of oil glands, causing clogged pores and spots.
For several years, dermatologists in the UK have been using spironolactone, which is also licensed for use in heart failure and kidney disease, to treat severe acne in women on an ‘off label’ basis. This is where drugs licensed for one purpose are used for something different when there is good evidence that they help.
Several small studies have highlighted the benefits of spironolactone for acne in women. Now 400 women with acne in the UK are being recruited to take part in one of the biggest investigations so far, at nine hospitals across the UK. (Spironolactone for acne is not being tested on men, as reducing their testosterone levels can affect sex drive, thin body hair and weaken muscles.)
Acne affects 90 per cent of people in the UK at some point in their lives, mostly during adolescence. But up to 30 per cent of adult women are also affected, often during pregnancy and menopause. Treatment creams can be effective but some people find them difficult to use. Another common treatment is antibiotics, known as tetracyclines. These can give good results but can also have serious side-effects — such as making the skin more sensitive to the sun and reducing the effectiveness of the oral contraceptive pill.
Another option is retinoids, which come as pills or creams and work by removing dead skin cells that clog pores. But side-effects include skin sensitivity, dry eyes and throat, headaches and general aches. In rare cases they have been linked with depression.
Dr Miriam Santer, a professor of primary care research at the University of Southampton, who is leading the new study, said: ‘We think spironolactone could replace oral antibiotics for acne in some women and offer an alternative where other treatments haven’t worked or aren’t suitable.’