Hello, my name is Dr. Stephen Mandy and I am a dermatologist associated with South Beach Dermatology in South Beach, Florida. Let's talk a little bit of Spironolactone and the treatment of acne. Spironolactone is a diuretic and as with, that was it's original intent, however spironolactone happens to have a characteristic of being what we call an anti-androgen, meaning it poses as a male hormone. In women, what male hormones, which are present in all women, happen to be one of the inciting causes of acne. So, spironolactone added to other types of say topical acne therapies helps women to overcome acne. In Europe, there are forms of anti-androgens which are available as prescriptions, but those are not available in the United States, currently. Probably spironolactone could be compounded by what we call a compounding pharmacy, but it is not available currently as a brand name product that a doctor can write a prescription for. In addition to spironolactone, it is essential that most patients are on a form of topical treatment that will open the pores. These are generally, as I mentioned earlier, retinoids. There are a whole variety of retinoids available. There's a classic one that is Tretinoin, which is known as Retin-A. There are others such as Differin, Tazorac. These are all prescription items and they are very effective at opening the pores or unplugging the pores to allow the oil glands not to be blocked and for the oil to flow freely and that's the underlying problem with acne. The other thing that is helpful is a topical form of acne treatment is benzoyl peroxide. That's available over the counter in many forms such as panoxyl bar, there's Clearasil agents that are containing benzoyl peroxide. Benzoyl peroxide has a mild effect on plugging the pores, but it's most effective at killing the bacteria that plays a role in acne. And finally, we use topical antibiotics in addition to what we call a polypharmacy approach, meaning the use of two, three, or four medicines to get the best result.
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