Spironolactone for Hair Loss: Side Effects, Does It Work, and Alternatives

beautiful hair

Concerns have been raised over the risks associated with spironolactone, an androgen blocker that can be used to treat female pattern baldness. We researched this popular treatment to find out more about its effectiveness and potential side effects.

If you suffer from female pattern hair loss or telogen effluvium, you’ve probably tried using over-the-counter treatments, and may have even looked into hair transplant surgery. One other option you should know about is prescription medications for hair growth.

Among the most popular is spironolactone, an androgen receptor-blocking drug that claims to help treat female pattern hair loss, among others conditions. It is primarily designed for women, and is generally not recommended as a treatment for male pattern baldness.

Anti-androgens come in two primary forms: receptor-blockers (Aldactone), and finasteride (Propecia). In this post, we’ll discuss the effectiveness of spironolactone for hair loss, which is generally sold under the brand name Aldactone.

What Is Spironolactone?

Spironolactone or Aldactone, often referred to as “spiro” for short, is a synthetic drug that’s available only via prescription. It’s part of a classification of drugs called potassium-sparing diuretics, and is commonly used to treat heart failure and hypertension.

In addition to treating these conditions, secondary uses for the drug include combating hair loss, reducing acne, and treating polycystic ovary syndrome (PCOS), hirsutism and seborrheic dermatitis. It’s also one of the most common drugs prescribed for male-to-female transsexuals, alongside estrogen, and can be used to help transgender women combat bald spots while simultaneously limiting the production of testosterone.

So how does spironolactone work, exactly? As an androgen antagonist, it is designed to block the androgen receptors and ovarian androgen production found in the body.

Androgens — the most common one being testosterone — are the natural hormones that control the development of male characteristics, including scalp, face and body hair. In short, spironolactone combats high dihydrotestosterone (DHT) and testosterone levels, which can lead to different degrees of hair thinning or permanent hair loss.

Spironolactone Side Effects

Doctors will generally prescribe 100 to 200 milligrams of spironolactone daily. It is most often taken in a tablet form. Many doctors will also recommend the use of spironolactone alongside other medications and topical treatments that stimulate the hair follicles and aid in hair regrowth.

The name-brand version of spironolactone, Aldactone, is approved by the U.S. Food and Drug Administration (FDA) for certain conditions, but nothing dermatological as of yet. With that being said, there are some common side effects that you’ll want to consider before trying this treatment.

Because its primary use is as a diuretic, it should not be used by pregnant women or those who have conditions that could be exacerbated by this type of drug. Spironolactone is known to cause vomiting, diarrhea, stomach pain, dry mouth, thirst, large breast tissue in men, breast pain in women, erectile dysfunction, drowsiness and irregular menstrual periods.

More severe side effects are also possible, including paralysis, numbness, decreased urination, muscle pain and others. Make sure that you talk to your doctor about the potential side effects before trying spironolactone.

Spironolactone and Pregnancy

It’s important to note that spironolactone has been shown to cause genital abnormalities in male fetuses, so women who may become pregnant should never take this drug.

This happens because it has the ability to block androgens in the male fetus — just as it does to you — which can cause a “feminization” of fetuses during the early stages of pregnancy and endocrine problems in the later stages.

Women who take spironolactone and haven’t yet reached menopause should always be on birth control to avoid unplanned pregnancy. Some doctors even require patients to take pregnancy urine or blood tests before prescribing spironolactone.

Studies on Spironolactone: Does it Actually Work?

  • Combined TreatmentsStudies show that women who don’t respond positively to minoxidil — a vasodilator used to treat high blood pressure and baldness under the brand names Rogaine, Renewal and Loniten — may benefit from the addition of spironolactone. These studies have found that the combination of spironolactone and minoxidil yielded better results than spironolactone alone.
  • As a Treatment for Female Pattern Hair Loss — In one study, women who suffered female pattern hair loss and took 200 milligrams of spironolactone experienced a reduction in hair loss by 50 to 62.9 percent. The study also showed that women who took another androgen receptor, cyproterone acetate, noticed no difference between the two drugs.
  • Pre-Menopause Hair Loss Treatment — Another important thing to note about spironolactone is that it’s generally considered more effective in women who began to experience symptoms of hair loss before they reached menopause, according to the American Osteopathic College of Dermatology. With that being said, it should also be used with caution by women who could become pregnant.
  • As a Treatment for Male Pattern Baldness — Generally speaking, spironolactone has had the best results in women seeking treatments for baldness and hair thinning. Men experiencing a diminishing hairline and baldness experienced better results with Finasteride — a 5-alpha-reductase type II inhibitor approved for use by the FDA for treating androgenic alopecia — and its more potent version, Dutasteride.
  • As a Hair Loss Treatment for Children — While more studies need to be conducted to determine the effects of spironolactone in children, one case study found that there was a visible improvement in hair loss in the case of a 9-year-old female patient after six months of spironolactone therapy.
  • As a Treatment for Hirsutism — Excessive hairiness, called hirsutism, is another issue that can result from higher levels of DHT in both men and women. Because it decreases the rate of testosterone production by working as an androgen receptor, it can be successfully used to prevent cases of fine hair growth on the face in women as well as to treat cases where hair grows extremely long or thick.

The Best Treatment for You

It’s important to note that there have been few randomized, controlled studies proving the efficacy of spironolactone in treating hair loss. Depending on how you feel about the side effects and the fact that these drugs do not provide immediate results, you may want to consider other, better-proven hair loss treatments.

Hair transplant procedures are by and large considered the most effective options for treating extreme hair loss and thinning, with several options available to patients.

Unlike spironolactone and other prescription medications, hair transplants are designed to offer immediate, post-procedure results. Of course, compared with medications, these procedures can be significantly costlier. They’re better-recommended for patients with extreme cases of androgenetic alopecia, and are a popular choice for treating long-term male pattern baldness and female pattern hair loss.

Before you make a decision about whether you want to see your doctor to ask about anti-androgens, make sure to consider all of your options.

Proven Methods for Treating Hair Loss

Choosing a long-term treatment option for hair loss may seem complicated, but there are a larger variety of options available beyond oral medications. Here are some of the most popular, proven hair loss treatment options.

  • Follicular Unit Extraction (FUE)FUE is a form of surgical hair restoration that requires the one-by-one removal of individual hair follicles to restore hair growth and thickness. It is generally recommended for younger patients and those who have conditions that may cause poor healing and scarring.
  • Follicular Unit Transplantation (FUT) — FUT is another popular surgical hair restoration procedure, but instead of restoring follicles one-by-one, a surgeon will take an entire strip of tissue to replace hair on the head or body. FUT procedures are quicker, but known to cause more scarring.
  • Low-Dose Laser Therapy — Designed for treating genetic hair loss, androgenetic alopecia and male pattern balding, low-light laser therapy can be used to help treat balding over time. Studies show that this type of therapy can significantly increase hair density while encouraging growth. However, much like oral medications, this type of treatment is not immediate and takes several sessions for best results.

The Bottom Line

In short, there are several studies to prove that spironolactone can be an effective treatment for women who are experiencing pattern baldness, especially when combined with other oral medications.

However, a long list of side effects and drawbacks may make other treatment options more desirable. The best course of action is talk to your doctor about a hair loss treatment plan that’s designed specifically for you.

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