{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T02:17:06Z","timestamp":1777083426580,"version":"3.51.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100003009","name":"Science and Technology Development Fund,Egypt","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003009","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Naunyn-Schmiedeberg's Arch Pharmacol"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1007\/s00210-025-03840-6","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T10:33:56Z","timestamp":1738146836000},"page":"9005-9019","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Oral and topical spironolactone in acne treatment: A meta-analysis of effectiveness and safety"],"prefix":"10.1007","volume":"398","author":[{"given":"Esraa M.","family":"AlEdani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8165-9470","authenticated-orcid":false,"given":"Mohamed","family":"Abo Zeid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1037-9095","authenticated-orcid":false,"given":"Kareem","family":"Khalefa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed W.","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amira A.","family":"Aboali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hager Ahmed Shawky","family":"Raslan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaid","family":"Shakhatreh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim Abdelnasar","family":"Yakout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr","family":"Elrosasy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"1","key":"3840_CR1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3109\/09546634.2010.488260","volume":"23","author":"BM Afzali","year":"2012","unstructured":"Afzali BM, Yaghoobi E, Yaghoobi R, Bagherani N, Dabbagh MA (2012) Comparison of the efficacy of 5% topical spironolactone gel and placebo in the treatment of mild and moderate acne vulgaris: a randomized controlled trial. J Dermatol Treat 23(1):21\u20135","journal-title":"J Dermatol Treat"},{"issue":"2","key":"3840_CR2","doi-asserted-by":"publisher","first-page":"89","DOI":"10.4103\/ejdv.ejdv_36_18","volume":"39","author":"EM Attwa","year":"2019","unstructured":"Attwa EM, Ibrahim ASM, El-Halim MFA, Mahmoud HM (2019) Efficacy and safety of topical spironolactone 5% gel versus placebo in the treatment of acne vulgaris. Egypt J Dermatol Venerol 39(2):89","journal-title":"Egypt J Dermatol Venerol"},{"issue":"3","key":"3840_CR3","doi-asserted-by":"publisher","first-page":"e317","DOI":"10.1002\/hsr2.317","volume":"4","author":"A Ayatollahi","year":"2021","unstructured":"Ayatollahi A, Samadi A, Bahmanjahromi A, Robati RM (2021) Efficacy and safety of topical spironolactone 5% cream in the treatment of acne: a pilot study. Health Sci Rep 4(3):e317","journal-title":"Health Sci Rep"},{"issue":"2","key":"3840_CR4","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.pnpbp.2007.07.001","volume":"32","author":"JD Bremner","year":"2008","unstructured":"Bremner JD, McCaffery P (2008) The neurobiology of retinoic acid in affective disorders. Prog Neuropsychopharmacol Biol Psychiatry 32(2):315\u201331","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"1","key":"3840_CR5","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1111\/j.1365-2133.1984.tb04020.x","volume":"111","author":"BM Burke","year":"1984","unstructured":"Burke BM, Cunliffe WJ (1984) The assessment of acne vulgaris\u2014the Leeds technique. Br J Dermatol 111(1):83\u201392","journal-title":"Br J Dermatol"},{"issue":"1","key":"3840_CR6","doi-asserted-by":"publisher","first-page":"e14680","DOI":"10.1111\/dth.14680","volume":"34","author":"R Dhurat","year":"2021","unstructured":"Dhurat R, Shukla D, Lim RK, Wambier CG, Goren A (2021) Spironolactone in adolescent acne vulgaris. Dermatol Ther 34(1):e14680","journal-title":"Dermatol Ther"},{"issue":"5","key":"3840_CR7","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1016\/j.jaad.2020.12.071","volume":"84","author":"V Garg","year":"2021","unstructured":"Garg V, Choi JK, James WD, Barbieri JS (2021) Long-term use of spironolactone for acne in women: a case series of 403 patients. J Am Acad Dermatol 84(5):1348\u20131355","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"3840_CR8","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/j.1365-2133.1984.tb04045.x","volume":"111","author":"A Goodfellow","year":"1984","unstructured":"Goodfellow A, Alaghband-Zadeh J, Carter G, Cream JJ, Holland S, Scully J et al (1984) Oral spironolactone improves acne vulgaris and reduces sebum excretion. Br J Dermatol 111(2):209\u2013214","journal-title":"Br J Dermatol"},{"issue":"1","key":"3840_CR9","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s13555-020-00481-w","volume":"11","author":"JJ Han","year":"2021","unstructured":"Han JJ, Faletsky A, Barbieri JS, Mostaghimi A (2021) New acne therapies and updates on use of spironolactone and isotretinoin: a narrative review. Dermatol Ther (Heidelb) 11(1):79\u201391","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"1","key":"3840_CR10","doi-asserted-by":"publisher","first-page":"27","DOI":"10.5009\/gnl15114","volume":"10","author":"T Haque","year":"2016","unstructured":"Haque T, Sasatomi E, Hayashi PH (2016) Drug-induced liver injury: pattern recognition and future directions. Gut Liver 10(1):27","journal-title":"Gut Liver"},{"key":"3840_CR11","doi-asserted-by":"publisher","unstructured":"Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ (2019) Cochrane handbook for systematic reviews of interventions. sixth. https:\/\/doi.org\/10.1002\/9781119536604","DOI":"10.1002\/9781119536604"},{"issue":"2","key":"3840_CR12","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/S2352-4642(22)00314-5","volume":"7","author":"AM Layton","year":"2023","unstructured":"Layton AM, Ravenscroft J (2023) Adolescent acne vulgaris: current and emerging treatments. Lancet Child Adolesc Health 7(2):136\u201344","journal-title":"Lancet Child Adolesc Health"},{"issue":"2","key":"3840_CR13","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s40257-016-0245-x","volume":"18","author":"AM Layton","year":"2017","unstructured":"Layton AM, Eady EA, Whitehouse H, Del Rosso JQ, Fedorowicz Z, van Zuuren EJ (2017) Oral spironolactone for acne vulgaris in adult females: a hybrid systematic review. Am J Clin Dermatol 18(2):169\u2013191","journal-title":"Am J Clin Dermatol"},{"issue":"4","key":"3840_CR14","doi-asserted-by":"publisher","first-page":"424","DOI":"10.4103\/0019-5154.160547","volume":"60","author":"B Madke","year":"2015","unstructured":"Madke B, Prasad K, Kar S (2015) Isotretinoin-induced night blindness. Indian J Dermatol 60(4):424","journal-title":"Indian J Dermatol"},{"issue":"2","key":"3840_CR15","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/j.1365-2133.1986.tb05722.x","volume":"115","author":"MF Muhlemann","year":"1986","unstructured":"Muhlemann MF, Carter GD, Cream JJ, Wise P (1986) Oral spironolactone: an effective treatment for acne vulgaris in women. Br J Dermatol 115(2):227\u2013232","journal-title":"Br J Dermatol"},{"issue":"8","key":"3840_CR16","first-page":"e17606","volume":"13","author":"A Noaimi","year":"2021","unstructured":"Noaimi A, Al-Saadi SR (2021) Treatment of acne vulgaris by topical spironolactone solution compared with clindamycin solution. Cureus 13(8):e17606","journal-title":"Cureus"},{"issue":"1","key":"3840_CR17","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","volume":"5","author":"M Ouzzani","year":"2016","unstructured":"Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan\u2014a web and mobile app for systematic reviews. Syst Rev 5(1):210","journal-title":"Syst Rev"},{"key":"3840_CR18","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jclinepi.2021.02.003","volume":"134","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol 134:103\u2013112","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"3840_CR19","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3109\/09546634.2010.488260","volume":"23","author":"M Patiyasikunt","year":"2012","unstructured":"Patiyasikunt M, Chancheewa B, Asawanonda P, Noppakun N, Kumtornrut C (2012) Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: a randomized, double-blind, placebo-controlled trial. J Dermatol Treat 23(1):21\u20135","journal-title":"J Dermatol Treat"},{"issue":"12","key":"3840_CR20","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1111\/1346-8138.15559","volume":"47","author":"M Patiyasikunt","year":"2020","unstructured":"Patiyasikunt M, Chancheewa B, Asawanonda P, Noppakun N, Kumtornrut C (2020) Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: a randomized, double-blind, placebo-controlled trial. J Dermatol 47(12):1411\u20131416","journal-title":"J Dermatol"},{"issue":"12","key":"3840_CR21","doi-asserted-by":"publisher","first-page":"e073245","DOI":"10.1136\/bmjopen-2023-073245","volume":"13","author":"S Pyne","year":"2023","unstructured":"Pyne S, Sach TH, Lawrence M, Renz S, Eminton Z, Stuart B et al (2023) Cost-effectiveness of Spironolactone for Adult Female Acne (SAFA): economic evaluation alongside a randomised controlled trial. BMJ Open 13(12):e073245","journal-title":"BMJ Open"},{"issue":"1","key":"3840_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1600-0846.2011.00542.x","volume":"18","author":"R Ramli","year":"2012","unstructured":"Ramli R, Malik AS, Hani AFM, Jamil A (2012) Acne analysis, grading and computational assessment methods: an overview. Skin Res Technol 18(1):1\u201314","journal-title":"Skin Res Technol"},{"issue":"2","key":"3840_CR23","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/1346-8138.16637","volume":"50","author":"ST Rehan","year":"2023","unstructured":"Rehan ST, Khan Z, Abbas S, Imran L, Munir S, Tahir MJ et al (2023) Role of topical spironolactone in the treatment of acne: a systematic review of clinical trials-does this therapy open a path towards favorable outcomes? J Dermatol 50(2):166\u2013174","journal-title":"J Dermatol"},{"issue":"1","key":"3840_CR24","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1111\/pde.14391","volume":"38","author":"EE Roberts","year":"2021","unstructured":"Roberts EE, Nowsheen S, Davis DMR, Hand JL, Tollefson MM, Wetter DA (2021) Use of spironolactone to treat acne in adolescent females. Pediatr Dermatol 38(1):72\u201376","journal-title":"Pediatr Dermatol"},{"key":"3840_CR25","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1136\/bmj.p1114","volume":"381","author":"M Santer","year":"2023","unstructured":"Santer M, Layton A (2023) What do we know about prescribing spironolactone for acne? BMJ 381:1114","journal-title":"BMJ"},{"key":"3840_CR26","doi-asserted-by":"publisher","first-page":"e074349","DOI":"10.1136\/bmj-2022-074349","volume":"381","author":"M Santer","year":"2023","unstructured":"Santer M, Lawrence M, Renz S, Eminton Z, Stuart B, Sach TH et al (2023) Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ 381:e074349","journal-title":"BMJ"},{"issue":"8","key":"3840_CR27","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1111\/ced.14340","volume":"45","author":"TN Searle","year":"2020","unstructured":"Searle TN, Al-Niaimi F, Ali FR (2020) Spironolactone in dermatology: uses in acne and beyond. Clin Exp Dermatol 45(8):986\u2013993","journal-title":"Clin Exp Dermatol"},{"issue":"5","key":"3840_CR28","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1093\/bjd\/ljad270","volume":"189","author":"A Shields","year":"2023","unstructured":"Shields A, Barbieri JS (2023) Effectiveness of spironolactone for women with acne vulgaris (SAFA) trial: a critically appraised topic. Br J Dermatol 189(5):509\u2013510","journal-title":"Br J Dermatol"},{"key":"3840_CR29","doi-asserted-by":"publisher","unstructured":"Spironolactone for acne in women (2023) Drug Ther Bull 61(9):132\u2013132. https:\/\/doi.org\/10.1136\/dtb.2023.000040","DOI":"10.1136\/dtb.2023.000040"},{"key":"3840_CR30","first-page":"14898","volume":"366","author":"JA Sterne","year":"2019","unstructured":"Sterne JA, Savovi\u0107 J, Page MJ, Elbers RG, Blencowe NS, Boutron I et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:14898","journal-title":"BMJ"},{"issue":"1","key":"3840_CR31","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.clindermatol.2023.11.005","volume":"42","author":"A Tahir","year":"2024","unstructured":"Tahir A, Khan S, Shah RR, Waqas N, Sharif S, Rao B (2024) Efficacy of combined spironolactone and topical retinoids in South Asian women with acne. Clin Dermatol 42(1):89\u201390","journal-title":"Clin Dermatol"}],"container-title":["Naunyn-Schmiedeberg's Archives of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-03840-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00210-025-03840-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-03840-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T04:29:16Z","timestamp":1757132956000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00210-025-03840-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,29]]},"references-count":31,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["3840"],"URL":"https:\/\/doi.org\/10.1007\/s00210-025-03840-6","relation":{},"ISSN":["0028-1298","1432-1912"],"issn-type":[{"value":"0028-1298","type":"print"},{"value":"1432-1912","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,29]]},"assertion":[{"value":"24 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}