Female patients with hormonal acne that typically flares before or after menstrual cycles may be ideal candidates for spironolactone, said Emmy M. Graber, M.D., president of the Dermatology Institute of Boston who spoke on the use of spironolactone for acne on Friday at the American Academy of Dermatology (AAD) annual meeting in San Diego.

Spironolactone is one of four hormonal agents recommended by the AAD in its 2016 treatment guidelines for acne vulgaris.

Women who have failed other therapies — such as antibiotic treatment — may be good candidates for spironolactone, as might patients with recurrent acne after a course of isotretinoin, Dr. Graber said. In addition, women who take progesterone only contraception might also benefit from the anti-androgen effects of spironolactone.