{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:11:37Z","timestamp":1788826297495,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","award":["RA 61\/015"],"award-info":[{"award-number":["RA 61\/015"]}],"id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Effective therapies for adult female acne (AFA) are limited. Oral spironolactone (SPL), 100\u2013200\u00a0mg\/day, is currently used off\u2010label to treat AFA. However, high\u2010dose SPL results in clinically significant side\u2010effects which prevent widespread use in clinical practice. The efficacy of low\u2010dose spironolactone in AFA is unknown. We examined the efficacy and tolerability of low\u2010dose (25\u201350\u00a0mg\/day) oral SPL in Thai women with moderate AFA. A randomized, double\u2010blind, placebo\u2010controlled trial was conducted for 12\u00a0weeks. Moderate AFA patients aged between 25 and 45\u00a0years received a combination of daily topical benzoyl peroxide (BP) 2.5% plus either SPL 25\u00a0mg (SPL25 group), SPL 50\u00a0mg (SPL50 group) or placebo. We performed total acne counts and Adult Female Acne Scoring Tool (AFAST) grading at 4\u2010week intervals. The success rate, defined as the proportion of participants achieving a \u201cclear\/almost clear\u201d AFAST grade by the end of week 12, was considered as the main outcome. Treatment\u2010related adverse events (TRAE) were recorded. We enrolled 63 participants in the study. The total acne counts decreased significantly in all three groups (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05) as compared with baseline. Participants in the SPL50 group had a significantly higher success rate than those in the placebo group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Serum potassium and creatinine levels showed no significant changes with treatment or between groups. A small number of participants in SPL25 and SPL50 reported mild and temporary TRAE, such as menstrual irregularities, breast tenderness and dizziness. The combination of SPL 50\u00a0mg\/day and topical BP proved effective in improving moderate AFA in Thai women, with an acceptable side\u2010effect profile. We propose this regimen as an option for treating moderate AFA.<\/jats:p>","DOI":"10.1111\/1346-8138.15559","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T20:18:04Z","timestamp":1598645884000},"page":"1411-1416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Efficacy and tolerability of low\u2010dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double\u2010blind, placebo\u2010controlled trial"],"prefix":"10.1111","volume":"47","author":[{"given":"Mattana","family":"Patiyasikunt","sequence":"first","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8469-3358","authenticated-orcid":false,"given":"Bussabong","family":"Chancheewa","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravit","family":"Asawanonda","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nopadon","family":"Noppakun","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Chulalongkorn University Bangkok 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