Abstract
Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist with an anti-androgenic effect.
 This drug has proven to be useful in several dermatological entities, however its use has not been well explored. Its use in diseases such as acne has opened the door to the possibility of new therapies depending on the clinical manifestations of the patients, as well as its possible to use it as a first line treatment. Other diseases associated with the use of spironolactone where its effects have been shown to be useful are hidradenitis suppurativa, hirsutism and female pattern androgenetic alopecia. In this review we discuss the use of spironolactone in different skin diseases that are common in our environment, dosage according to different studies, treatment recommendations and adverse effects; all of the above mentioned in order to use this drug in a daily clinical practice.
Highlights
INTRODUCTIONSpironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist
Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist.The adrenal cortex produces 2 classes of steroids: androgens and corticosteroids which are further divided into mineralocorticoids and glucocorticoids
Inhibits angiogenesis, decreases vascular tone and reduces portal hypertension, which is why it has been used in liver cirrhosis, and has been shown to reduce the number of people hospitalized for heart failure, It has been shown to reduce hormone reactivation in patients with stable heart failure treated with angiotensin-converting enzyme inhibitors (ACE inhibitors) and there has been renewed interest in this drug because recent clinical studies have shown its potential use in acne, hirsutism, hidradenitis suppurativa, female pattern androgenetic alopecia and precocious puberty [1]
Summary
Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist. The main mineralocorticoid is aldosterone, the receptor for which is expressed in the kidney, colon, some glands and in the hippocampus In the kidney it acts in the epithelium of the distal cortical tubule and cortical collecting tubule to reabsorb sodium and increase excretion of potassium (K+) and hydrogen (H+) and it has been studied that aldosterone is produced locally in the heart and its vasculature so it is considered to act as a local hormone. Inhibits angiogenesis, decreases vascular tone and reduces portal hypertension, which is why it has been used in liver cirrhosis, and has been shown to reduce the number of people hospitalized for heart failure, It has been shown to reduce hormone reactivation (aldosterone-escape) in patients with stable heart failure treated with angiotensin-converting enzyme inhibitors (ACE inhibitors) and there has been renewed interest in this drug because recent clinical studies have shown its potential use in acne, hirsutism, hidradenitis suppurativa, female pattern androgenetic alopecia and precocious puberty [1]
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