Title: Efficacy and Safety Profile of Spironolactone 50mg v/s Isotretinoin 10mg in the Treatment of Female Patients with Acne Vulgaris Grade 1-2 - A Double Blinded, Randomized Comparative Study

Authors: Natasha Vijayendran, Mohan Kale, Varsha Jamale, Balkrishna Nikam, Asma Hussain, Shraddha J. Patil

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.25

Abstract

Background: The recognition that post-adolescent women with AV respond to antiandrogenic hormonal therapies has prompted a sustained interest in oral spironolactone. We took this as an opportunity to determine the safety and efficacy of two treatment modalities for acne vulgaris grade 1-2 and provide standardized data regarding spironolactone as a treatment agent in acne vulgaris. This is the first double blinded study where low dose spironolactone and low dose isotretinoin has been studied.

Aims: To study the efficacy and safety profile of oral spironolactone v/s oral isotretinoin in the treatment of female patients with acne vulgaris grade 1-2.

Materials and Method: 60 patients were enrolled in the study. Thirty patients were treated with oral spironolactone (50mg/day) with topical clindamycin 1% and the other thirty were given oral isotretinoin (10mg/day) with topical clindamycin 1%. Efficacy variables used were Global Acne Grading System (GAGS) score, Physicians Global Assessment (PGA) and Visual Analogue Scale (VAS). The response was evaluated fortnightly for a total period of 12 weeks.

Results: At the end of the study, there was a 32.8% reduction in GAGS scores in the spironolactone group and 68.4%, in the isotretinoin group. The response of female patients to acne vulgaris grade 1-2 with isotretinoin was superior to that of spironolactone and this difference was statistically significant (p<0.05). The side effects were minimal with no laboratory abnormalities.

Conclusion: Isotretinoin and spironolactone are both efficacious. However, isotretinoin is more efficacious than spironolactonein the treatment of acne vulgaris (grade 1-2).

Keywords: Acne vulgaris, Spironolactone, Isotretinoin, Clindamycin.

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