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Research project

SAFA study (Spironolactone for Adult Female Acne)

Project overview

Acne is a common condition and it can be very distressing. A range of acne treatments are available but many of the oral medications cannot be used long term and some have side effects.

We are completing an acne research study to find out whether spironolactone might offer an alternative treatment to help women with acne or spots.

Evaluating spironolactone as an acne treatment
Spironolactone is widely used to help with high blood pressure and other conditions. The drug also lowers some of the hormones that cause the skin to make oil. In acne, the skin produces more oil than normal.

Some dermatologists have been using spironolactone 'off licence' to treat acne for many years, particularly in the US, but only small trials have been carried out to test its effectiveness.
Why we need new acne treatments
We think that spironolactone tablets could, for some women, replace antibiotics (taken by mouth) for acne. Currently, patients are often prescribed long courses of antibiotics. Growing antibiotic resistance presents a major global health concern. So, there is an urgent need to find alternative treatments.

Although some combined oral contraceptive pills are effective in treating acne, many are not licensed for this use. Some are also not suitable or well tolerated by patients. Dianette (co-cyprindiol) is licenced for use in acne. It can be very effective, but it is not recommened for long-term use due to safety concerns.

Many topical acne treatments are available (such as benzoyl peroxide, antibiotics and retinoids) but these are not always effective for persistent or more severe cases.

Helping UK acne research
The National Institute for Health Research (Department of Health) commissioned this acne research study (SAFA) to determine whether spironolactone would be a suitable alternative treatment for women with persistent moderate or severe acne.

We are no longer recruiting participants for this study. Results will be available later in 2023.


Lead researcher

Professor Miriam Santer

Professor of Primary Care Research

Research interests

  • Self-management of long-term conditions
  • Primary Care Dermatology - particularly eczema, acne and cellulitis

Connect with Miriam

Other researchers

Professor Paul Little

Professor in Primary Care Research

Connect with Paul

Doctor Ingrid Muller BSc, MSc, PhD, CPsychol, FHEA

Associate Professor

Research interests

  • Self-management of long-term conditions
  • Behavioural health interventions

Connect with Ingrid

Professor Gareth Griffiths

Director Clinical Trials Unit

Connect with Gareth

Professor Nick Francis

Clinical Professor of Primary Care Res

Research interests

  • Infections in primary care
  • Antimicrobial stewardship

Connect with Nick

Research outputs

Susanne Renz,
Beth Stuart,
Laura Day,
Irene Soulsby,
Jacqui Nuttall,
Karen Thomas,
Kim Suzanne Thomas,
Tracey Sach,
Louise Stanton,
Matthew J Ridd,
Zina Eminton,
Alison M Layton,
, 2021 , BMJ Open , 11 (8) , e053876
Type: article
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