Introduction: A recent study conducted in England and Wales has shown promising results for the effectiveness of spironolactone in treating acne in adult women. The study, called the SAFA trial (Effectiveness of spironolactone for women with acne vulgaris), was a large-scale research project that aimed to evaluate the impact of spironolactone on women with facial acne.

The Study: The SAFA trial was designed as a pragmatic, multicenter, phase 3, double-blind, randomized controlled trial. The researchers recruited women aged 18 and above who had been experiencing facial acne for at least six months and were considered suitable for oral antibiotic treatment. The participants were randomly assigned to receive either a daily dose of 50 mg of spironolactone or a placebo. The dosage was increased to 100 mg/day or placebo after six weeks and continued until week 24. Participants were also allowed to continue using topical treatments alongside the oral medication.

Key Findings: The primary outcome measure of the study was the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12, which reflects the improvement in the quality of life related to acne. Secondary outcomes included Acne-QoL at week 24, self-assessed improvement by the participants, the investigator’s global assessment (IGA) for treatment success, and adverse reactions.

The results of the study demonstrated that spironolactone was more effective in improving acne symptoms compared to the placebo. The Acne-QoL scores at week 12 were significantly higher for the spironolactone group than for the placebo group. The difference between the two groups became even more pronounced at week 24. A greater percentage of participants in the spironolactone group reported improvement in their acne compared to those in the placebo group.

Furthermore, the investigator’s global assessment showed that treatment success was more likely in the spironolactone group at week 12. Although there were slightly more reported adverse reactions, such as headaches, in the spironolactone group, no serious adverse reactions were reported.

Conclusion: Based on the findings of the SAFA trial, spironolactone has shown promise as a treatment for women with acne vulgaris. The study demonstrated that spironolactone significantly improved acne symptoms and quality of life compared to a placebo, with greater differences observed at week 24 compared to week 12.

This research provides valuable insights and suggests that spironolactone could be a useful alternative to oral antibiotics for women with acne. However, it is important to consult with a healthcare professional before starting any new medication to determine the most appropriate treatment option for individual needs.

Further research and long-term studies are needed to fully understand the efficacy and safety of spironolactone as a treatment for acne vulgaris. Nonetheless, these findings contribute to the growing body of evidence supporting the potential benefits of spironolactone in managing acne in women.