Spironolactone may help keep skin healthy after corticosteroids

French dermatologists have made an interesting discovery regarding the effect of corticosteroids on the skin. Researchers have found that the drug spironolactone is able to exert an antihypertensive effect by reducing skin atrophy after topical corticosteroids.

In a report published on the Journal of Investigative Dermatology website, researchers from the French National Institute of Health and Medical Research (Inserm) hypothesized that skin atrophy associated with the use of corticosteroids, which form the basis of dermatological creams, may be associated with the activation of these topical means of mineralocorticoid receptors in the epidermis.

"These receptors, present in the kidneys, heart, eyes, and some neurons in particular, interacted with aldosterone, a hormone that regulates blood pressure. In addition, previous studies also showed that these receptors were very sensitive to corticosteroids," the release text said.

Why Spironolactone was chosen for the study

In the course of the study, it was found that applications of corticosteroids to an area of ​​cultured skin resulted in thinning of the skin as a result of application. Within six days of corticosteroid use, the thickness of the epidermis was reduced by one-third. To eliminate the side effect, the researchers induced pharmacological blockade of the receptor by adding an antagonist to corticosteroid treatment. Spironolactone has become such a mineralocorticoid receptor antagonist.

This drug is a potassium - and magnesium-sparing diuretic, and most importantly in a situation with the skin – that spironolactone is known as a competitive aldosterone antagonist that increases the excretion of water, sodium and potassium salts, reduces the excretion of urea and reduces the titratable acidity of urine. Metabolization of the drug occurs in the liver, the main active metabolite – carnenon. The drug is excreted by the kidneys during the day, a small amount of – leaves with bile.

Spironolactone study methods and results

The study was conducted on 23 healthy volunteers who applied creams in various compositions to four areas of the hands for 28 days. The researchers used the following tools in the study:

• cream containing a corticosteroid used in dermatology;
  
  cream containing spironolactone;
• combination of both drugs;
• placebo.

They found that when spironolactone was added to a corticosteroid, skin atrophy was significantly limited.

Director of Research at the French National Institute of Health and Medical Research, Nicolette Farman, MD, pointed out in the Dermatology Times that if the drug is ultimately approved for topical use (oral use is not effective in this case), dermatologists may administer topical spironolactone in patients with skin conditions requiring short-term glucocorticoid applications, such as some patients with eczema or psoriasis.

perform clinical studies of its effectiveness in patients with skin diseases. We have filed a patent application and are currently looking into how we can move forward with this drug in patients in the future."

According to Dermatology times