Dr. Eichenfield Previews Consensus Project on Hormonal Therapies for Teens at Maui Derm

A number of important questions regarding hormonal therapies in teens will be answered this year, Lawrence Eichenfield, MD, said at the Maui Derm Hawaii 2025 meeting in Maui, Hawaii.

Presenting as part of “Update 2025: Acne and Rosacea” panel, Dr. Eichenfield said a consensus project on hormonal therapies in teens younger than 16 funded by the Pediatric Dermatology Research Alliance (PeDRA) will provide more answers as the year progresses.

Two studies have shown the efficacy of spironolactone in teens,^1,2 but information is limited as to the differential safety of spironolactone alone vs in combination with contraceptives; safe and reasonable ages to start spironolactone; associated conditions for which it is appropriate; general health risks for patients under 16; and more.

“We’re not going to answer now,” Dr. Eichenfield said, “but next year, we will, because PeDRA has … a consensus project specifically looking at hormonal therapy—which will include spironolactone and combined oral contraceptives—under 16 years of age. So we will have more answers as the year progresses.”

An overview of the project on PeDRA’s website states: “This consensus project will address questions related to using hormonal treatments in younger acne patients. How young is too young to start an oral contraceptive pill for the treatment of acne? Is spironolactone effective for a 12-year-old with acne? What risks are there with starting a hormonal treatment in young adolescents? Will they affect pubertal development? Bone density? Experts in acne, pediatric endocrinology, and adolescent gynecology will methodically review all available research data and provide expert advice when data is not available. At the end of the process, guidelines on the best practices for using hormonal therapies on patients aged 9-15 years will be created and published.”³

1. Roberts EE, Nowsheen S, Davis DMR, Hand JL, Tollefson MM, Wetter DA. Use of spironolactone to treat acne in adolescent females. Pediatr Dermatol. 2021;38(1):72-76. doi: 10.1111/pde.14391. Epub 2020 Oct 3.
2. Berman HS, Cheng CE, Hogeling M. Spironolactone in the treatment of adolescent acne: A retrospective review. J Am Acad Dermatol. 2021;85(1):269-271. doi: 10.1016/j.jaad.2020.11.044. Epub 2020 Nov 27.
3. Expert Recommendations for Use of Hormonal Therapies in Preadolescent and Young Adolescent Patients with Acne Vulgaris. PeDRA website. Accessed January 29, 3035. https://pedraresearch.org/2024/02/21/expert-recommendations-for-use-of-hormonal-therapies-in-preadolescent-and-young-adolescent-patients-with-acne-vulgaris/