April 8, 2026
IN THIS ISSUE / April 8, 2026
Does oral spironolactone improve acne in women?
A study published in the Journal of Cosmetic Dermatology explored the efficacy and safety of oral spironolactone for women with acne. Overall, five randomized controlled trials consisting of 563 patients were included in the analysis. Acne severity was classified as either mild to severe, moderate to severe, severe, or not reported. The doses ranged from 25 mg to 200 mg daily. The analysis showed a sixfold greater improvement in acne in the spironolactone group versus the placebo group (odds ratio, 6.59).
[Spironolactone: Risk of breast, gynecologic malignancies? Read more.]
Among patients receiving spironolactone compared with those receiving placebo, nonsignificant adverse events included breast enlargement in 14.9% and 11.3% and menstrual irregularities in 18.1% and 20.4% of the groups, respectively.
Spironolactone for alopecia: Blood pressure changes. Read more.
DermWorld What’s Hot: mRNA COVID vaccine and immune checkpoint inhibitor response
Immune checkpoint inhibitors (ICIs) have dramatically improved prognosis for melanoma and other cancers. Once nearly always fatal, advanced melanoma treated with nivolumab plus ipilimumab now has 10-year rates of melanoma-specific survival around 50%. Lack of response to ICIs occurs if the immune system is not primed to attack cancer cells. It turns out that off-the-shelf mRNA vaccines — specifically, mRNA COVID-19 vaccines — might do the trick. Read more from Ken Katz, MD, MSc, MSCE, FAAD.
Herbal medicines for psoriasis
A study published in Complementary Therapies in Medicine reviewed the efficacy of multiple herbs for the treatment of psoriasis. It included 20 randomized clinical trials involving more than 1,000 patients. Herbal interventions evaluated included aloe vera, avocado oil, chamomile-pumpkin seed oleogel, Indigo naturalis, kukui oil, Mahonia aquifolium, turmeric, St. John’s wort, and various others.
[Kava-induced cutaneous adverse reactions. Read more.]
The most effective remedies were Mahonia aquifolium and Indigo naturalis, both of which were supported by multiple studies demonstrating statistically significant reductions in psoriasis severity. Oral turmeric also showed promise in one study, particularly when combined with conventional topical steroids, the authors noted. Remedies with mixed or unfavorable results included aloe vera (inconsistent findings), kukui oil, and evening primrose oil, the latter of which showed no significant effects in three separate trials. Further research is needed to elucidate their efficacy, safety, and optimal use in clinical practice, the authors noted.
Are nutritional supplements aimed at skin care helpful, harmful, or simply a placebo for patients? Read more.
Efficacy of PDT and fractional CO2 laser for onychomycosis
An article published in the Journal of Cosmetic Dermatology evaluated the effectiveness of treating onychomycosis with photodynamic therapy (PDT), fractional CO2 laser, and a combination of both. Forty-five patients with onychomycosis were included in the study. Patients were randomly assigned to three groups: PDT alone, fractional CO2 laser alone, and a combination of both.
The authors found that PDT alone leads to mycological cure in 60% of patients, but a complete cure was seen only in one patient. The group treated with fractional CO2 alone showed a 20% complete cure, despite the mycological cure being 73.3%, which means that this modality may achieve a high enough temperature for killing fungal elements, they speculated. The combined therapy group showed the best results, with 86.7% testing negative for onychomycosis and 26.7% achieving full nail clearance.
What's the fuss about fungus? Nail experts discuss the diagnosis and management of onychomycosis.
Real-world effectiveness of JAK inhibitors in vitiligo
A JAAD study assessed the effectiveness and safety of oral JAK inhibitors in vitiligo treatment. A retrospective study was conducted in vitiligo patients who had received oral JAK inhibitors for at least three months. A total of 96 patients were included, 89.6% of whom achieved different degrees of repigmentation. The overall response rate was 55.2%, and the rate of marked repigmentation (≥76%) was 9.4%. Patients taking oral JAK inhibitors for more than six months had better outcomes than those who received the treatment for a shorter period. No severe adverse events were observed.
Recent advances in vitiligo treatment and research open doors for physicians and patients. Read more.
