Women who suffer from persistent acne have been given hope by a new cheap drug.
The drug, which is used to treat high blood pressure, could change the way acne in women is routinely treated.
Acne is common in adolescence but can occur during the adult years.
A team of researchers led by the Southampton Clinical Trials Unit carried out a trial on more than 400 women over the age of 18.
All the women had acne that had persisted for more than six months on which oral antibiotics would normally have been the next treatment.
In the first large-scale clinical trial, funded by the National Institute for Health and Care Research (NIHR), half of the participants were randomly allocated to take the drug known as spironolactone.
The other half were given a placebo or dummy pill.
What were the results?
Researchers found that spironolactone could offer an alternative for women with persistent acne.
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After 12 and 24 weeks, women who were taking the drug saw significant improvements in their acne.
Professor Miriam Santer, GP and co-lead of the trial said: “The results showed that the women taking spironolactone saw a significant improvement in their acne after 12 and 24 weeks compared to those on the placebo.
“These results show that spironolactone could offer an alternative to antibiotics for many women with persistent acne to use alongside topical acne treatments.”
She added: “We hope the publication of these results will mean more GPs and dermatologists feel confident to prescribe spironolactone as a treatment for acne.
“The drug is already included in treatment guidelines for persistent acne in the US and Europe, and we hope this trial will lead to a change in the UK guidelines.”
Unfortunately, the drug is not suitable for men, according to Prof Santer and her co-author Alison Layton.
The pair wrote in the British Medical Journal: “Unfortunately, spironolactone is not considered an acceptable treatment option for men with acne. Use of spironolactone reduces blood testosterone levels which can result in gynaecomastia (breast swelling), and concerns have been raised about loss of sexual function in men.”
‘People would stare’
Kelly Cornick, 39, from Dorset, who used the drug, said that she was previously prescribed various creams and the contraceptive pill to try and control her acne.
Image: Kelly Cornick, who suffered from persistent acne
Ms Cornick said she started with a lower dose of spironolactone and saw improvement in her acne. She was then given a higher dose of the drug and within a few months, her acne cleared up.
She said: “It was embarrassing. People would stare and you almost feel that they’re looking at you like you’re dirty and don’t wash properly.
“I think the worst thing for me was when one of my nieces said: ‘Have you got chicken pox?’.”
Ms Cornick continued: “Initially I started on the lower dose and there was an improvement. I then went on to the higher dose and within about three months everything was gone, all the spots had disappeared.
“Knowing how much it’s helped me, I hope that other people will now be given this treatment as an option instead of just trying the antibiotics. I want people to be able to experience it, because everyone should feel confident and happy, and not have spots.”
An alternative to antibiotics
Professor Andrew Farmer, director of the NIHR’s Health Technology Assessment Programme, said: “The treatment provides a valuable alternative to antibiotics and ensures clinicians can also better avoid the harms that can arise from antimicrobial resistance.”
The results come after the Commission on Human Medicines recommended new safety measures for the use of an anti-acne drug called isotretinoin.
This was after a number of people died by suicide while taking the drug – others also reported depression, anxiety and psychotic symptoms.
Cases of sexual dysfunction were also reported by patients who had been prescribed the medicine and in some cases, symptoms continued after patients stopped taking the drug.
The review of this drug has concluded that the benefits of isotretinoin – also known as Roaccutane – still outweigh the risks.
According to the NHS, spironolactone is an anti-androgen, which means it stops male hormones, such as testosterone, from working.
The drug can be used to treat the build-up of fluid in the body, which can be caused by heart failure, liver disease, kidney disease and high levels of aldosterone.
It is also used to treat high blood pressure (hypertension).
It’s just gone 7.30pm – and outside a synagogue in north Manchester, we’ve heard the shofar, a ceremonial horn, being blown to mark the end of the long day of prayers.
The streets, which had been so quiet all day, fill with people and families.
We’re just minutes away from where the attack took place.
But people haven’t had their phones on in synagogue – and we find ourselves in the slightly surreal position of having to tell people what happened to members of their community, just a few roads away.
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Earlier in the day on these streets, we saw additional police patrols, with officers telling us they were here to reassure members of the public.
But people are accustomed to seeing security here.
Both paid and volunteer security staff, in their hi-vis jackets, are a permanent fixture outside every synagogue.
It’s to help protect a community that, even before this attack, has felt under threat.
Image: ‘The security is not the solution,’ this man said
“The security is not the solution,” one man tells me as he heads home from prayers. “Those who really want to do [something like this], they will do it with lots of security, it doesn’t matter.”
Among everyone we spoke to, there was a sense of shock at what had happened, but perhaps not necessarily surprise amid rising acts of antisemitism in the UK.
Image: David Yehudi
David Yehudi and the rabbi he studied with said it had felt like a long time coming.
“As a grandchild of a Holocaust survivor, I feel as if this is before 1935 again,” he says. “That’s the overwhelming feeling all over the world.”
Image: The rabbi asked ‘where is the United Nations?’
The rabbi adds: “The United Nations was set up with the intention of ‘never again’, and where is the United Nations? In terms of the global support against antisemitism. It’s just not there anymore. We are as unsafe as we were before the war.”
It is a shocking thing to hear, on this, the most solemn of days.
The UK’s chief rabbi has described the terror attack at a synagogue in Manchester as “the tragic result of Jew hatred”.
Two Jewish men were killed outside Heaton Park Synagogue on Yom Kippur, the holiest day in the Jewish calendar.
The attacker, named by police as Jihad al Shamie, a British citizen of Syrian descent, was shot dead by police seven minutes after officers were alerted to the incident.
Image: Britain’s chief rabbi Sir Ephraim Mirvis. Pic: PA
Sir Ephraim Mirvis said it was “the day we hoped we would never see, but which deep down, we knew would come”.
He celebrated the “courageous leadership” of rabbi Daniel Walker, who has been praised for his efforts to keep his congregation safe as the terrorist tried to get inside.
In a post on X, Sir Ephraim wrote: “For so long we have witnessed an unrelenting wave of Jew hatred on our streets, on campuses, on social media and elsewhere – this is the tragic result.
“This is not only an assault on the Jewish community, but an attack on the very foundations of humanity and the values of compassion, dignity and respect which we all share.”
He added: “May the victims’ memories be for a blessing and may the injured be granted a swift recovery.
“I pray that this tragedy strengthens our collective resolve to confront antisemitism, in all its guises, once and for all.”
It is a solemn day of observance and atonement, and marks the peak of the High Holidays.
It comes after Jewish New Year, Rosh Hashanah, with both occasions bookmarking the Ten Days of Repentance.
Jews observe Yom Kippur by prayer and fasting from sunset the day before to the sunset of the day itself.
No work is permitted, and for some, the day is spent at a synagogue.
The occasion falls on the 10th day of Tishrei – a Hebrew month between late September and early October.
The Board of Deputies of British Jews and the Jewish Leadership Council said the attack “was sadly something we feared was coming” at a time of rising antisemitism in the UK.
They said: “We are devastated at the loss of two members of our Jewish community, and our thoughts are with their families, those who are injured and receiving treatment, and all those who have been affected by this act of antisemitic terror.”
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Thanking the government, the King, the prime minister and senior politicians for their support, they added: “At this dark time, these acts of solidarity will be a comfort to our community.
“At a time of rising antisemitism in the UK, this attack was sadly something we feared was coming. We call on all those in positions of power and influence to take the required action to combat hatred against Jewish people.”
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2:35
‘We’re not safe, we’re not safe’
The chief executive of the Holocaust Memorial Day Trust, Olivia Marks-Woldman, said antisemitism “has no place in our society” and “we must confront it whenever it arises”.
“We are horrified by today’s antisemitic attack in Manchester. Taking place on Yom Kippur, a moment of atonement and reflection, it is a truly horrendous event,” she said.
“Our thoughts are first and foremost with the victims and with the Jewish community in Manchester and across the UK, who will understandably feel shocked and afraid.”
The president of the Conference of European Rabbis, Pinchas Goldschmidt, called for more to be done to “stamp out murderous ideologies”.
He added: “Jews in Manchester, England, woke up this morning to pray, and were murdered in their own synagogue. Governments from the world over should spare us the statements about fighting antisemitism and instead ensure Jews are safe.”
Prince William has said “change is on my agenda” when he becomes king, in his most open and personal explanation to date about how he sees his future role and the future of the monarchy.
The revelations come during a discussion with Hollywood actor Eugene Levy as they were filming at Windsor Castle for Levy’s travel series The Reluctant Traveller.
When asked if the monarchy will be shifting in a slightly different direction when he becomes king, William says: “I think it’s safe to say that change is on my agenda.
“Change for good, and I embrace that and I enjoy that change. I don’t fear it, that’s the bit that excites me – the idea of being able to bring some change. Not overly radical change, but changes that I think need to happen.”
Image: Pic: Apple TV+
What could be described as William’s manifesto for the monarchy comes out in an unexpectedly candid interview with the Schitt’s Creek star.
The Prince of Wales also opens up about being “overwhelmed” by family problems last year – as both Kate and the King were diagnosed with cancer – and his desire to try to “make sure you don’t do the same mistakes as your parents”.
Describing how he is driven by both his passion to protect his family and his desire to ensure everything is in place when Prince George one day becomes king, he says: “I want to create a world in which my son is proud of what we do, in a world and a job that actually does impact people’s lives for the better.
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“That is caveated with, I hope we don’t go back to some of the practices in the past that Harry and I grew up in. And I’ll do everything I can to make sure we don’t regress in that situation.”
Image: Pic: Apple TV+
Analysis: Interview was personal, open and significant
Over a pint of cider, with his pet dog Orla by his feet, Prince William sets out, in one sentence, his manifesto for the monarchy: “Change is on my agenda.”
The setting and the choice of platform for it, a travel series with a Hollywood actor, could not feel more unexpected, and we are told it wasn’t necessarily planned to happen this way.
A free-flowing conversation is how it was described to me. And the result was the most personal and open interview, on topics that would usually be considered off limits.
Those close to William would say it’s the most publicly vulnerable we have seen him.
On being monarch one day, he says: “It’s not something I wake up in the morning and think about.”
But in an earlier part of the programme, he does talk more about his desire to potentially shake things up, albeit with a caveat.
He says: “I think it’s very important that tradition stays, and tradition has a huge part in all of this, but there’s also points where you look at tradition and go, is that still fit for purpose today?”
In an incredibly open admission about sometimes feeling overwhelmed, especially last year – “the hardest year” – he also appears to reveal a man now more at peace with the role that lies ahead for him.
Image: Eugene Levy and Prince William. Pic: Apple TV+
Speaking in St George’s Hall inside the castle, he says: “Stuff to do with family overwhelms me, quite a bit.
“You know, worry or stress around the family side of things, that does overwhelm me quite a bit. But in terms of doing the job and things like that, I don’t feel too overwhelmed by that. Not now anyway.”
His own childhood, and how that has impacted his thoughts on the media, also come across clearly, at times appearing to echo his brother Prince Harry’s thoughts on the press and drive to protect his own family from what they went through as children.
Image: William, front, pictured with his mother, Princess Diana, and Harry in 1985. Pic: Reuters
As he talks to Levy in a pub in Windsor, William says: “Growing up, I saw that with my parents … the media were so insatiable back then.
“And if you let that creep in, the damage it can do to your family life is something that I vowed would never happen to my family.”
Those close to the prince believe the interview is the most publicly vulnerable they’ve ever seen him on camera.
The special episode of The Reluctant Traveller With Eugene Levy on Apple TV+ with William airs from today.