The Efficacy of Doxycycline versus Spironolactone in Treating Acne Among Pediatric and Adult Females: A Retrospective Cohort Study

Acne is a common complaint prompting referrals to a dermatologist. Many patients follow a stepwise protocol starting with a topical regimen then progressing to oral medications. Recent data from a small randomized controlled trial suggests that spironolactone is more effective than doxycycline at treating acne in adult females. We sought to validate that finding via a retrospective cohort analysis using a national database. Our results suggested that adult women treated with doxycycline were significantly less likely to subsequently be prescribed isotretinoin as compared to patients treated with spironolactone. However, in pediatric females, the reverse was observed. Pediatric females treated with doxycycline were significantly more likely to subsequently be prescribed isotretinoin as compared to patients treated with spironolactone.