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Adult Acne
Acne is bad enough when it strikes with puberty. But when it continues or strikes again in adulthood, it can be a real nuisance. Acne is a skin condition that usually begins around the time of puberty. More than eighty percent of teenagers and...
How South beach diet works?
Dr Agatson, created the South Beach diet. It is a low carb diet
and has been followed by millions of people worldwide. The main
thing about this diet is highly processed foods and soft drinks
are to be cut down completely. Lowering these carbs...
How to Use natural Remedies for Asthma or Allergies
A lot people have asthma. My daughter, 41 years, included. She has suffered from attacks for many years. Recently I encounter three natural remedies that I asked my daughter to try. I have not yet received a report on these, so I would like to pass...
The #1 Sin Made by Success Seekers!
Have you ever wondered why some people are able to make their dreams a reality while others’ hopes and dreams remain only a fantasy? What is it that propels some people to higher level of fulfillment; lifestyle and happiness while others remain...
The Value Of The Mineral Selenium To Overall Health
In recent years, the value of the trace mineral selenium to overall health and well being has come to light. Many vital health benefits have come to be associated with maintaining sufficient levels of selenium in the body and recent study indicates...
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Spironolactone in the treatment of acne
In his article on acne published recently in the New England Journal of Medicine James (1) mentions that androgen antagonist spironolacton is often useful in women with hyperandrogenism. However, it would be important to point out, that the effectiveness of this treatment cannot be determined due to the small sample populations involved in the trials, as has been shown in recent metaanalysis. (2) It should be also emphasized that although the long-term use of spironolactone in the treatment of acne in women appears to be safe, its side-effects seem to be high. (3) On the other hand, it is worth mentioning that spironolactone in addition to its antiandrogenic effects might also have antiinflammatory potential. (4) This emphasizes the need for further properly designed trials with relevant outcomes to provide robust estimates of the size and mechanism of any treatment effects. Because of its long half-life spironolactone should be given once daily and not in divided doses as recommended by James. This might
increase the compliance which is important in prolonged therapy to achieve maximal benefits. (5)
1. James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463-72.
2. Farquhar C, Lee O, Toomath R, Jepson R. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database Syst Rev 2003;(4):CD000194.
3. Shaw JC, White LE. Long-term safety of spironolactone in acne: results of an 8-year followup study. J Cutan Med Surg 2002;6:541-5.
4. Hansen PR, Rieneck K, Bendtzen K. Spironolactone inhibits production of proinflammatory cytokines by human mononuclear cells. Immunol Lett 2004;91:87-91.
5. McEvoy B, Nydegger R, Williams G. Factors related to patient compliance in the treatment of acne vulgaris. Int J Dermatol 2003;42:274-80.
About the author:
Dr. Michal R. Pijak is a consultant in rheumatology, allergy and clinical immunology at the University Hospital in Bratislava, Slovakia.
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