Spironolactone for hair loss: benefits, dosage, and risks

Ismail Yusibov
Ismail Yusibov is the founder and content writer of the AlopeciaTips.

 Fact checked by Jessica Anderson

Written by Ismail Yusibov | Reviewed by Dr. Michael Carter


Discover how Spironolactone can be a game-changer in the battle against hair loss.


FAST FACTS

Spironolactone is mainly used to treat fluid retention due to high blood pressure, heart failure, liver scarring, and kidney disease.

The use of spironolactone for hair loss is considered off-label; This means that it is not officially approved for this purpose by regulatory agencies such as the FDA.

Spironolactone is thought to help with hair loss because it has anti-androgenic effects. It can block the effects of androgens, such as dihydrotestosterone (DHT), which are often linked to female pattern hair loss.

Spironolactone is primarily prescribed for women with androgenetic alopecia.

Spironolactone has strong side effects and risks. Therefore, it should be used under the supervision of a doctor.

The first effects of spironolactone in hair loss treatment are seen within 6-12 months.
When you stop using spironolactone, your hair loss continues.

What is spironolactone?

Spironolactone belongs to a class of medications called potassium-sparing diuretics. It acts by inhibiting the actions of aldosterone, a hormone involved in regulating fluid and electrolyte balance in the body. 

Spironolactone can also have anti-androgenic effects, making it a potential option for treating conditions influenced by androgen hormones, such as hair loss in certain cases.

Spironolactone is commonly prescribed for the treatment of:

  • Hypertonia
  • Heart failure
  • Hyperaldosteronism

In addition to these approved uses, spironolactone is also used off-label for the treatment of female pattern hair loss. While its effectiveness in this regard has not been conclusively proven, dermatologists often prescribe it as a potential treatment option. 

Spironolactone is typically considered when other treatments, like minoxidil, have proven ineffective.

Can you take spironolactone for hair loss? 

Spironolactone, originally developed as a diuretic, has also been found to have anti-androgenic properties, meaning it can inhibit the actions of male hormones like testosterone. This is significant because excessive levels of testosterone can contribute to hair loss in both men and women.

Spironolactone works by blocking the androgen receptors in the body, preventing the effects of male hormones on the hair follicles. By doing so, it may help slow down hair loss and potentially promote hair regrowth.

In a 2015 study, nearly 75% of women experiencing female pattern hair loss reported hair loss improvement when using spironolactone.

While spironolactone is primarily used to treat conditions like hypertension and edema, some studies and anecdotal evidence suggest that it may help with hair regrowth by reducing the effects of androgens on hair follicles. 

It’s important to note that spironolactone is not approved by the FDA for the treatment of hair loss.

Can spironolactone help regrow hair?

Spironolactone supports hair regrowth in female pattern hair loss. But the effects of using spironolactone for hair loss are seen after long-term use.

Four studies involving 192 patients examined the effects of oral spironolactone treatment on hair loss. The results revealed the following improvements in hair loss rates:

  • Overall, 56.60% of patients experienced a decrease in hair loss (95% CI: 40.49-71.43).
  • In cases where spironolactone was used in combination with other therapies, 65.80% of patients saw an improvement (95% CI: 43.75-82.63).
  • For patients on spironolactone monotherapy, the hair loss improvement rate was 43.21% (95% CI: 32.90-54.15).

What else is spironolactone used for? 

Spironolactone is commonly prescribed to treat conditions such as high blood pressure, heart failure, and fluid retention caused by various medical conditions. Its ability to inhibit androgen activity has also led to its use in some cases of hirsutism (excessive hair growth) and acne in women.

Spironolactone is also used for several off-label purposes in dermatology:

  • Treatment of persistent acne in women
  • Hirsutism
  • Hair loss due to hormone imbalance (female)

How does spironolactone work for hair loss? 

Spironolactone works by blocking the androgen receptors in the body, inhibiting the effects of male hormones like testosterone on the hair follicles. By reducing androgen activity, spironolactone may help slow down hair loss and potentially stimulate hair regrowth.

A 2017 study found that using both spironolactone and minoxidil together resulted in reduced hair shedding, enhanced hair growth, and thicker hair.

Spironolactone treats acne, hair loss, and skin issues in individuals with elevated androgens, especially women with genetically high androgen levels.

Can spironolactone help with hair thinning?

Research has shown that hair loss can be stopped when Minoxidil and Spironolactone are used together. The use of minoxidil and spironolactone ensures that the hair follicles are fed with more oxygen, thus thickening them.

How much is prescribed?

The appropriate dosage of spironolactone for hair loss can vary depending on factors such as the individual’s health, age, and other medications they may be taking. Typically, dermatologists may start with a low daily dose, such as 25 mg, which can be increased if necessary and well-tolerated.

How to use spironolactone for hair loss?

If your doctor prescribes spironolactone for hair loss, you’ll typically start with a 25 mg dose. Ensure you take the medication at the same time daily, and it can be taken before or after a meal. Due to the potential drowsiness it may cause, taking it at night is advisable.

Spironolactone is often prescribed as an additional treatment for hair loss and is commonly used alongside minoxidil.

For women, it’s important to exercise caution when using spironolactone. Pre-menopausal women should use spironolactone in conjunction with birth control pills. If you’re a woman considering spironolactone for hair loss, consult your doctor for specific usage guidelines.

Is 50 mg of spironolactone enough for hair loss?

The appropriate dosage of spironolactone for hair loss can vary among individuals. 

While 50 mg is a common starting dose, some individuals may require higher doses, while others may require lower doses.

The optimal dosage of spironolactone should be determined by a healthcare professional, taking into account factors such as the individual’s health, medical history, and response to treatment. Regular monitoring and follow-up appointments may be necessary to assess the effectiveness and adjust the dosage if needed.

Alternatives to spironolactone for hair loss

If spironolactone is not suitable or desired as a treatment for hair loss, there are alternative options available. Some of these include minoxidil, finasteride, low-level laser therapy, and hair transplantation.

Minoxidil, available over the counter, is a topical treatment that can be applied directly to the scalp. Finasteride, on the other hand, is a prescription medication that is typically more commonly used for male pattern hair loss.

Low-level laser therapy involves using specialized devices that emit laser light onto the scalp. This light is believed to stimulate hair follicles and promote hair growth. Hair transplantation, on the other hand, involves surgically transplanting hair follicles from areas of the scalp with hair to areas experiencing hair loss.

How long does it take to work?

When using spironolactone for hair loss, it may take time to see the first effects. Patients usually notice changes after the first 6 months of use. Others notice visible changes after 12-16 months of use.

What are the side effects of spironolactone?

The general purpose of spironolactone is to lower blood pressure. Therefore, if you do not have high blood pressure, using this medicine may be dangerous.

Since spironolactone may have some serious side effects, it is not recommended to use the drug without a doctor’s supervision.

The most common side effects of spironolactone are as follows:

  • Irregular heartbeat
  • Tingling in hands and feet
  • Muscle weakness
  • Difficulty breathing
  • Dark urine
  • Thirst
  • Diarrhea
  • Stomach ache
  • Vomiting
  • Tiredness
  • Irregular menstrual periods
  • Chest pain

Rare but serious side effects:

  • High potassium levels
  • Digestive system bleeding
  • Vaginal bleeding in post-menopausal
  • Extreme tiredness
  • Difficulty breathing or swallowing
  • Fainting

Spironolactone vs finasteride for female hair loss 

Finasteride is a medication primarily utilized to alleviate symptoms associated with an enlarged prostate and benign prostatic hyperplasia in men. It is also commonly prescribed to address male pattern baldness. Finasteride is FDA-approved and stands out as the most effective DHT blocker available. Extensive research demonstrates its efficacy in managing male pattern hair loss.

While Finasteride can reduce hair loss in women, it’s essential to acknowledge the associated risks and inconveniences when used by females. However, when under the guidance of a medical professional, it can serve as a viable treatment for hair loss in women.

It’s crucial to note that Finasteride and Spironolactone operate differently and yield distinct results. Spironolactone tends to be more effective in treating female pattern hair loss, whereas Finasteride excels in addressing male pattern baldness.

THE BOTTOM LINE

Spironolactone, known by the brand name Aldactone, is a medication used primarily to treat fluid accumulation due to heart failure, liver scarring, or kidney disease. The drug has recently been prescribed by dermatologists for use in hair loss treatments. Spironolactone has the effect of stopping and slowing down female pattern hair loss. Compared to Minoxidil and Finasteride, Spironolactone is a new drug and little research has been done on it.
Ismail YusibovIsmail Yusibov is the founder and content writer of the AlopeciaTips.

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