Spironolactone Research Paper

3205 Words7 Pages

Background Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Acne vulgaris is a disease of pilosabaceous follicles with four pathogenic factors. These factors are follicular hyperkeratinization, increased sebum production, infection with Propionibacterium acnes within the follicle, and resulting inflammation. Follicular hyperkeratinization is increased proliferation and decreased desquamation of keratinocytes lining the follicular orifice. This results in partial obstruction of the follicle with sebum and keratin, the microcomedo. Sebaceous glands enlarge with adrenarche due to DHEA-S rise and sebum production increases. Sebum provides a growth medium for P. acnes, an anaerobic diphtheroid that is …show more content…

The drug competitively inhibits the binding of androgens to androgen receptors [Katsambas]. Additional antiandrogenic effects of spironolactone may also include inhibition of enzymatic conversion of androstenedione to testosterone, inhibition of 5-alpha reductase, and increased steroid-hormone binding globulin [George]. The drug decreases 17-beta-hydroxysteroid dehydrogenase, therefore halting the conversion of androstenedione to testosterone [Archer]. Spironolactone may also inhibit 5-alpha-reductase, thereby preventing the conversion of testosterone to dihydrotestosterone (DHT). Additionally, spironolactone may increase steroid-hormone binding globulin [Zouboulis]. Together these mechanisms of action result in a 30 to 50 percent reduction in sebum excretion [Thiboutot 2003]. In addition, spironolactone competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions. For this reason foods with high sodium and potassium should be avoided[Lexicomp]. Excess salt intake can be avoided by decreased intake of frozen foods, preserved foods, canned vegetables, vegetables juices, packaged deli meat, soups, marinades/flavorings, spaggetti sauce, salted nuts, chips, pretzels, ketchup, relish, and capers. Foods with high potassium levels include banana, papaya, prune …show more content…

Milk consumption has been associated with increased levels of serum IGF [Holmes]. IGF is also increased by ingestion of high glycemic loads and could potentially link diet and acne. A 12-week randomized trial that compared low and high glycemic load diets in 43 male patients with acne found a greater reduction in lesion counts with the low glycemic load diet [Smith]. However, the participants on that diet also lost more weight than those on the high glycemic load diet, so it is possible that the results were due to changes in weight rather than the composition of the diet. IGF-1 is typically found in dairy products, as well as in other foods of animal origin, such as meat and liver [Kang 2007, Ma]. A preliminary study has linked high protein diet to increased IGF. Serum IGF-1 was 35% lower in the low protein group when compared to animals fed the high protein diet. Conversely, serum IGFBP-1 was 136% higher in the low protein group compared to the high protein

More about Spironolactone Research Paper

Open Document