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Acne (especially jawline, chin, lower-face) Spironolactone went from off-label option to evidence-based first-line for adult female acne in 2023 with the SAFA trial a UK multicenter, double-blind, placebo-controlled RCT of 410 women published in The BMJ and Health Technology Assessment

Follow-up frequently includes repeat labs to ensure platelet counts or coagulation studies normalize and symptom tracking to detect new bleeding signs early

The three main alternatives in 2026 are Zepbound vials through LillyDirect, compounded tirzepatide through licensed telehealth, and compounded semaglutide

Moreover, high-dose icosapent ethyl should be used in combination with statins in patients presenting with hypertriglyceridemia [49]

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