Trends in Adolescent Spironolactone Use, 2014-2018

child taking pill
Cropped shot of an unrecognizable teenage girl drinking medication
Trends in spironolactone use for acne and hidradenitis suppurativa (HS) are assessed.

Spironolactone use in adolescents has increased significantly over the past several years, indicates study data published in the Journal of the American Academy of Dermatology.

Investigators conducted a cross-sectional analysis of insurance claims data from the IBM MarketScan database. Girls aged 13 to 19 years of age with at least 1 claim for acne or hidradenitis suppurativa (HS)  from 2014 to 2018 were included. Prescriptions for spironolactone were identified using the associated drug codes. Investigators calculated the rates of unique patients treated with spironolactone per year, then compared rates over time.

From 2014 to 2018, a total of 13,045 patients with acne and 215 patients with HS were prescribed treatment with spironolactone. During this period, the prescribing rate of spironolactone for acne and HS increased 2-to-3-fold in each age group. The use of spironolactone also increased with patient age: spironolactone use was approximately 10 times greater in patients aged 19 years compared with patients aged 13 years.

Although prior research suggests that spironolactone is effective for the treatment of acne and HS in adolescents, long-term efficacy and safety data are lacking. Given the rapid rise in spironolactone use during the past several years, investigators advocated for additional research into its use in young patients. “[F]urther comparative effectiveness studies are needed to investigate the efficacy of spironolactone in adolescent acne and HS and to assess short and long-term safety issues associated with early use of this antiandrogen,” authors wrote.


Horissian M, Maczuga S, Barbieri JS, Zaenglein AL. Trends in prescribing pattern of spironolactone in adolescents for acne and hidradenitis suppurativa. J Am Acad Dermatol. Published online December 8, 2021. doi:10.1016/j.jaad.2021.12.005