A blood pressure medication that costs less than a penny per pill could help clear up severe acne in women and could offer an alternative to medications currently in use that have been linked to mental health problems.
In addition to controlling blood pressure, the drug, spironolactone, affects the levels of hormones in the body that are thought to trigger acne.
Although dermatologists have been prescribing it for skin problems, a clinical trial, the first of its kind, has shown that it can significantly reduce blemishes in six months.
Acne is one of the most common skin problems, affecting more than one in ten adults. Specialists say they hope the drug will change the way the condition is typically treated in women. However, men cannot take it as its hormonal effect has been found to trigger abnormal growth of breast tissue in male patients.
University of Southampton Professor Miriam Santer, GP, who led the trial, said: “We hope these results mean more doctors feel confident prescribing spironolactone as an acne treatment.”
CLEAR SKIN: Kelly Cornick has been taking spironolactone for three years
Spironolactone, a blood pressure medication that costs less than a penny per pill, could help clear up severe acne in women
“The drug is already included in treatment guidelines for persistent acne in the US and Europe, and we hope this trial will lead to a change in UK guidelines.”
Spironolactone is a diuretic that causes the body to expel salt and water in the urine faster than normal. This helps remove water from the blood, decreasing the volume of fluid that flows through the body, which lowers blood pressure.
But it also has a side effect on the levels of the hormones testosterone and progesterone in the body, which are known to cause acne.
The recent trial enrolled more than 400 women, aged 18 and over, with acne that had persisted for more than six months. Half received spironolactone, while the other half received a placebo. The women were asked to complete questionnaires about their acne and condition-related quality of life at the start of the trial and then at 12 and 24 weeks of treatment.
“The results showed that the women who took spironolactone experienced a significant improvement in their acne compared to those who took placebo,” said Professor Santer. “And the side effects were rare and minor.”
Most cases of acne can be controlled with over-the-counter treatments, but more severe cases may require antibiotics or other medications. If these are unsuccessful, isotretinoin is often prescribed, a powerful medication that can only be given by a specialist, often known by the brand name Roaccutane.
In April, the NHS’s watchdog, the Medicines and Healthcare Products Regulatory Agency, announced new rules on the prescription of isotretinoin, following reports that it could increase the risk of mental and sexual health problems. There have also been suggestions that these side effects may have been a factor in at least 88 cases of youth suicide in recent decades. Approximately 40,000 isotretinoin prescriptions are written each year in the UK and the drug is considered to be extremely safe and beneficial for most.
But health chiefs now say those under 18 will only receive the drug if all other standard treatments have failed and two medical professionals agree it is necessary.
“Spironolactone gives us another option to try before isotretinoin,” said Professor Santer. Also, isotretinoin cannot be taken long term. Spironolactone is very low risk, so it can be taken for as long as needed.
Kelly Cornick, 39, from Dorset, who said she had been prescribed various creams, as well as the contraceptive pill, to try to control her ‘horrible’ acne.
One patient in the trial, Kelly Cornick, 40, has not had acne since she started taking spironolactone three years ago.
Previously, the official was prescribed antibiotics and the contraceptive pill to try to control her skin but nothing had worked.
She said: ‘It could go away for a while, then it would flare up again. I would get thick, red bumps along my jaw line, and at worst spread to the rest of my face.
Kelly, who lives in Dorset, was referred to a dermatologist who offered her isotretinoin. “I was deliberating about it, but decided against it because of the side effects,” she said. She didn’t want to risk it.
Kelly’s dermatologist then offered her a place on the spironolactone trial. “Within about three months it was all gone, all the spots were gone,” she said. ‘Knowing how much it has helped me, I hope other people now get this treatment as an option.
“I want people to be able to experience it, because everyone should feel safe and not have blemishes.”