Efficacy and tolerance of acne treatment using both spironolactone and a combined contraceptive containing drospirenone

Background: The use of either oral contraceptives or antiandrogens has been shown to be helpful in the treatment of women with acne. Objectives: We investigated the safety and efficacy of acne treatment using both spironolactone and a combined contraceptive containing drospirenone. Methods: Twenty-seven women with either severe papular or nodulocystic facial acne were treated with a combined oral contraceptive containing 30 mu g ethinyl estradiol and 3 mg drospirenone (EE/DRSP; Yasmin) and spironolactone (SL) 100 mg taken daily. A serum potassium level was obtained before initiation of therapy. Between 4 and 6 weeks after the start of both medications, a second serum potassium level was obtained. Side effects were recorded. Results: No significant elevation of serum potassium was found in any of the subjects nor were there any reported additional side effects significant enough to discontinue treatment. At follow up, 85% of subjects were entirely clear of acne lesions or had excellent improvement, 7.4% were mildly improved, and 7.4% were not improved. Limitations: This was a small prospective study. Conclusion: The combination of EE/DRSP and SL 100 mg daily appears to have efficacy and is well tolerated in the treatment of severe papular and nodulocystic acne in women.