Southampton researchers find cheap drug can treat persistent acne

A team of researchers from Southampton took part in the first large-scale clinical trial to provide evidence that spironolactone is an effective treatment for the skin condition.

The result of the trial, led by GP professor Miriam Santer from the University of Southampton, has been published in the British Medical Journal. 

The finding is expected to change the way acne in women is routinely treated, improve acne outcomes, and reduce a large number of antibiotics currently prescribed for the condition.

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SAFA clinical trial to help women treat acne (Image: SAFA)

Professor Santer said: "We hope the publication of these results will mean more GPs and dermatologists feel confident to prescribe spironolactone as a treatment for acne. 

"The drug is already included in treatment guidelines for persistent acne in the US and Europe, and we hope this trial will lead to a change in the UK guidelines."

The trial is funded by the National Institute for Health and Care Research (NIHR) and is called Spironolactone for Adult Female Ace (SAFA). 

Professor Alison Layton, consultant dermatologist and co-lead of the SAFA trial, added: "This is a cheap medication that has been used for decades in the treatment of high blood pressure. The drug also reduces the main hormone that leads to the development of acne."

The SAFA trial recruited over 400 women, aged over 18, with acne that had persisted for more than six months and where oral antibiotics would have normally been the next treatment. 

The participants were asked to complete questionnaires on their acne and quality of life relating to the condition at the start of the trial and then at 12 and 24 weeks into their treatment.

Professor Santer added: "The results showed that the women taking spironolactone saw a significant improvement in their acne after 12 and 24 weeks compared to those on the placebo. 

"A significantly higher proportion of people also reported that they felt satisfied that their skin had been helped compared with those receiving placebo, and any side effects were uncommon and very minor. 

"These results show that spironolactone could offer an alternative to antibiotics for many women with persistent acne to use alongside topical acne treatments."

A participant, Kelly Cornick, says all her spots disappeared within three months after starting the trail. 

The 39-year-old began suffering from severe acne in her teens and was prescribed various creams and antibiotics, as well as the contraceptive pill, to try and control her skin.

Kelly Cornick took part in the clinical trial (Image: SAFA)

Kelly said: "Nothing seemed to work. It might go away for a while, but then it would flare up again. It was sore, almost like blisters. I would get thick, red lumps all along my jawline, and at their worst, they would spread up onto the rest of my face. 

"If I knocked on a spot, it would really hurt and would bleed for ages. It was just horrible."

Since finishing the trial, Kelly has been able to stay on spironolactone and has now been acne-free for over two years.

"Knowing how much it’s helped me, I hope that other people will now be given this treatment as an option instead of just trying the antibiotics.

"I want people to be able to experience it because everyone should feel confident and happy, and not have spots."

The SAFA trial was run by the Southampton Clinical Trials Unit and sponsored by the University of Southampton.