If you have persistent acne, chances are you've heard of spironolactone. And if you go to a dermatologist, chances are you've tried it or you're currently using it. While it was originally developed to treat high blood pressure, spironolactone is now a dermatologist favourite for fighting hormonal breakouts. It blocks androgens like testosterone that are often responsible for those zits that seem invincible against every pimple cream in your medicine cabinet.
But if you're taking spironolactone right now, you may want to stop for a surprising (and scary) reason: It could make COVID-19 (coronavirus) worse. NYC dermatologist Ellen Marmur, MD, is recommending her patients stop using it.
"The American Academy of Dermatology has not said to stop spironolactone. . . . But since we know that ACE inhibitors and spironolactone upregulate the number of receptors to possibly allow more virus to come into the cell based on this data, which is published . . . I would stop spironolactone," Marmur says in a video posted on her Instagram. "It's not medically necessary for acne. I'm only talking about my acne patients. I would stop the spironolactone until we know further. Get a telemedicine visit to get new medicine if you need it, but this is really important stuff."
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COVID-19 update. Last night @lucky.sekhon asked an insightful question about #spironolactone so we researched it at 5:30 am and found important information. YES spironolactone increased the ACE2 activity by 300% in one study (references below) akin to the studies that show ACE inhibitors increase the ACE2 receptors by 2-3 times. Listen to my next videos for the full explanation and full disclaimers but logically, acne is treatable by other medicines that do not carry the risk of increasing your infection burden by this precise virus. Please ask your #dermatologist for a #telemedicine visit to stop your spironolactone for acne and switch to azithromycin. Arguably azithromycin is not first line for acne but there is some evidence it may treat COVID19. That is up to the judgment of your #boardcertifieddermatologist. #acne #acnetreatment #skin #covid_19 #coronavirus #medicine #research #news I know some of the doctors reading this will disagree so this is just our informed decision. Please decide for yourselves with your doctors who know you best. #❤️ 🙏😷#staysafe
As Marmur suggests, you should definitely call your doctor before making any changes to your medication. If you're taking spironolactone for other reasons (like PCOS), you may need to gradually decrease your dose, so talking to your doctor is even more important. While this news is probably a total bummer, it could be an important precaution to take. And since stress breakouts seem pretty inevitable right now, you won't be the only one dabbing on a little extra concealer.