Aldactone hair loss. Aldactone for Hair Loss: Benefits, Side Effects, and Effectiveness

15.08.197817.11.2021 by alexxlab

How does Aldactone work for hair loss in women. What are the pros and cons of using Aldactone for female pattern baldness. Is Aldactone an effective treatment for androgenetic alopecia in females. What should patients know before taking spironolactone for hair thinning.

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Understanding Aldactone and Its Role in Treating Female Hair Loss

Aldactone, also known by its generic name spironolactone, is a medication that has shown promise in treating female pattern hair loss. While not originally designed for this purpose, its ability to influence hormone levels has made it a valuable tool in combating hair thinning in women.

Female pattern hair loss, medically termed androgenetic alopecia, is a common condition affecting many women, particularly as they age. It’s characterized by gradual thinning of hair, often most noticeable on the top and front of the scalp.

What Causes Female Pattern Hair Loss?

The primary culprit behind this type of hair loss is an overproduction or increased sensitivity to androgens, which are typically male hormones. While women naturally produce small amounts of androgens, an excess can lead to hair follicle miniaturization and eventual hair loss.

Genetic predisposition
Hormonal changes (e.g., menopause)
Conditions like polycystic ovary syndrome (PCOS)

These factors can contribute to elevated androgen levels or increased sensitivity to these hormones, resulting in progressive hair thinning.

How Does Aldactone Work to Combat Hair Loss?

Aldactone’s effectiveness in treating female pattern hair loss stems from its anti-androgenic properties. But how exactly does it work?

Slows androgen production: Aldactone helps reduce the production of androgens by the adrenal glands and ovaries.
Blocks androgen action: It prevents androgens from binding to their receptors, diminishing their effects on hair follicles.
Inhibits dihydrotestosterone (DHT): Aldactone specifically targets DHT, a potent form of testosterone responsible for hair loss, by preventing it from affecting hair follicles.

By addressing the root cause of androgen-related hair loss, Aldactone can help slow or stop the progression of hair thinning in women. However, it’s important to note that while it can improve the thickness and fullness of existing hair, it cannot stimulate the growth of new hair follicles.

The Benefits of Using Aldactone for Hair Loss

Aldactone offers several advantages as a treatment option for female pattern hair loss:

Targeted approach: It addresses the hormonal imbalance causing hair loss
Easy diagnosis: A simple blood test can determine if you’re a suitable candidate
Affordable: Generally covered by insurance and relatively inexpensive even without coverage
Versatile: Can be combined with other hair loss treatments like minoxidil
Additional benefits: May help with acne and unwanted facial hair growth

These benefits make Aldactone an attractive option for women struggling with androgen-related hair loss. However, as with any medication, it’s crucial to consider potential drawbacks and side effects.

Potential Side Effects and Considerations

While Aldactone can be effective in treating female pattern hair loss, it’s not without potential side effects:

Increased urination: As a diuretic, it may cause more frequent bathroom trips
Menstrual irregularities: Hormonal changes can affect menstrual cycles
Elevated potassium levels: Regular monitoring is necessary to prevent complications
Pregnancy risks: Not safe for use during pregnancy due to potential fetal harm

It’s essential to discuss these potential side effects with a healthcare provider before starting Aldactone treatment. They can help weigh the benefits against the risks and determine if it’s the right choice for your specific situation.

Aldactone Dosage and Treatment Protocol

The dosage of Aldactone for hair loss can vary depending on individual needs and response to treatment. Typically, doctors start with a lower dose and gradually increase it if necessary.

Starting dose: Often 25-50 mg daily
Maintenance dose: Can range from 100-200 mg daily
Duration: Long-term treatment is usually required for continued benefits

Is dose adjustment necessary? Your doctor may adjust your dosage based on your response to treatment and any side effects you experience. Regular follow-ups are crucial to monitor progress and ensure the medication is working effectively.

Combining Aldactone with Other Hair Loss Treatments

For enhanced results, Aldactone is sometimes used in conjunction with other hair loss treatments:

Minoxidil (Rogaine): A topical solution that can complement Aldactone’s effects
Oral contraceptives: May help regulate menstrual cycles and provide additional hormonal balance
Nutritional supplements: Vitamins and minerals to support overall hair health

Combining treatments can potentially yield better results, but it’s important to do so under medical supervision to avoid any adverse interactions.

Who Is an Ideal Candidate for Aldactone Hair Loss Treatment?

Aldactone is not suitable for everyone experiencing hair loss. Ideal candidates typically include:

Women with confirmed androgen-related hair loss
Those with normal blood pressure and kidney function
Patients who are not pregnant or planning to become pregnant
Individuals without a history of breast cancer or other hormone-sensitive conditions

A thorough medical evaluation, including blood tests to check hormone levels and overall health, is necessary before starting Aldactone treatment.

When to Avoid Aldactone

Certain conditions and circumstances may make Aldactone unsuitable:

Pregnancy or breastfeeding
History of breast cancer or other hormone-sensitive cancers
Severe kidney or liver disease
High potassium levels
Use of certain medications that can interact with Aldactone

Always provide your doctor with a complete medical history and list of medications to ensure Aldactone is safe for you.

Monitoring and Managing Aldactone Treatment

Successful treatment with Aldactone requires ongoing monitoring and management:

Regular blood tests: To check potassium levels and kidney function
Blood pressure monitoring: Aldactone can affect blood pressure
Periodic scalp examinations: To assess hair growth and thickness
Adjusting dosage: Based on response and side effects

How often should you have check-ups? Initially, more frequent visits (every 4-6 weeks) may be necessary, but once stabilized, check-ups can be spaced to every 3-6 months.

Managing Side Effects

If you experience side effects while taking Aldactone, don’t hesitate to discuss them with your doctor. They may suggest:

Adjusting the dosage
Changing the timing of medication
Adding supportive treatments
Exploring alternative options if side effects are severe

Remember, open communication with your healthcare provider is key to successful treatment.

Alternative Treatments for Female Pattern Hair Loss

While Aldactone can be effective, it’s not the only option for treating female pattern hair loss. Other treatments include:

Minoxidil (Rogaine): A topical treatment that can stimulate hair growth
Low-level laser therapy: Uses light energy to stimulate hair follicles
Platelet-rich plasma (PRP) therapy: Utilizes growth factors from your own blood to promote hair growth
Hair transplantation: Surgical option for more advanced cases
Nutritional supplements: Vitamins and minerals to support hair health

Each treatment has its own set of benefits and potential drawbacks. Consulting with a dermatologist or hair loss specialist can help determine the best approach for your individual case.

Lifestyle Changes to Support Hair Health

In addition to medical treatments, certain lifestyle changes can support overall hair health:

Balanced diet rich in proteins, vitamins, and minerals
Stress management techniques
Gentle hair care practices
Avoiding harsh chemical treatments
Regular exercise to improve circulation

These lifestyle modifications can complement medical treatments and contribute to healthier, stronger hair.

The Future of Hair Loss Treatment: Emerging Therapies

The field of hair loss treatment is constantly evolving, with new therapies on the horizon:

JAK inhibitors: Showing promise in clinical trials for various types of hair loss
Stem cell therapy: Potential to regenerate hair follicles
Gene therapy: Targeting specific genetic factors involved in hair loss
3D-printed hair follicles: An innovative approach to hair restoration

While these treatments are still in various stages of research and development, they offer hope for even more effective hair loss solutions in the future.

The Importance of Ongoing Research

Continued research into the mechanisms of hair loss and potential treatments is crucial. This ongoing work may lead to:

More targeted therapies
Improved understanding of hair growth cycles
Better prevention strategies
Enhanced combination treatments

Staying informed about the latest developments can help patients and healthcare providers make more informed decisions about hair loss treatment options.

Making an Informed Decision About Aldactone for Hair Loss

Deciding whether to use Aldactone for hair loss treatment is a personal choice that should be made in consultation with a healthcare professional. Consider the following factors:

Severity of hair loss
Underlying causes
Overall health status
Potential risks and benefits
Willingness to commit to long-term treatment
Personal preferences and lifestyle

A thorough discussion with your doctor can help you weigh these factors and determine if Aldactone is the right choice for you.

Questions to Ask Your Doctor

When considering Aldactone for hair loss, prepare a list of questions for your healthcare provider:

Am I a good candidate for Aldactone treatment?
What results can I realistically expect?
How long will I need to take the medication?
What side effects should I watch for?
How will we monitor the treatment’s effectiveness?
Are there any lifestyle changes I should make to support the treatment?

Having these discussions can help you feel more confident in your treatment decision and better prepared for the journey ahead.

Aldactone for Hair Loss | Everyday Health

Some women lose their hair because they have an overproduction of male hormones. When that happens, there is a drug that can help: Aldactone.

There are many reasons why women may experience female pattern hair loss, which is when the hair thins gradually over time and eventually leads to thin or bare patches on the top or front of the scalp. This type of hair loss, also referred to as androgenetic hair loss, tends to worsen after menopause, and is usually hereditary.

But some women lose their hair in this type of pattern due to higher-than-normal levels of androgens — hormones normally made in very small quantities by women and in larger quantities by men — or increased sensitivity to androgens such as testosterone, says Chad Prather, MD, clinical assistant professor in the department of dermatology at Louisiana State University Health Sciences Center in Baton Rouge, La. Women with polycystic ovary syndrome (PCOS), for example, tend to produce more androgens, which can cause hair growth on the face and hair loss on the head, as well as infertility and metabolic problems.

Try the Hair Loss Prevention Diet

Aldactone (spironolactone) helps to restore the hormone balance and treat female pattern hair loss.

Aldactone as a Hair Loss Treatment

Aldactone isn’t approved specifically for hair loss treatment, so when doctors use it, it’s considered an “off-label” use. Aldactone is a potassium-sparing diuretic, which means it rids the body of excess fluid as do other diuretics (water pills), but it doesn’t make you lose potassium in the process as many diuretics do. It’s normally used to treat swelling, high blood pressure, and potassium deficiency.

But because Aldactone acts as an anti-androgen, it can help when women are experiencing hair loss due to higher levels of androgens. The drug causes the adrenal glands and ovaries to slow down their production of androgens, and also blocks the action of androgens that are produced. One way it does that is by stopping dihydrotesterone — the form of testosterone that causes the hair loss — from binding to its androgenetic receptor and affecting the hair follicle.

Aldactone won’t help you grow new hair, says Francesca J. Fusco, MD, assistant clinical professor of dermatology at Mount Sinai School of Medicine in New York. But it can help the thinning hairs become thicker and fuller.

Pros and Cons of Aldactone for Hair Loss

Like any drug, Aldactone has its pros and cons. Read on to find out why it may be a good idea to talk to your doctor before deciding to take Aldactone for hair loss:

Pros of Using Aldactone

It’s easy to determine if it’s an appropriate treatment for you. If your dermatologist suspects that androgens are behind your hair loss, a simple blood test can confirm it and let your doctor know if you’re an ideal candidate for the treatment.
It targets the problem. Because it helps stop the production of androgens and the action of androgens by preventing them from binding to their androgenetic receptors, Aldactone gets to the source of the problem. “It helps fight some of those hormones that are causing the hair loss in the first place,” Dr. Prather says. At the same time, it can help get rid of hair growth in unwanted areas, such as on the face, and helps clear up acne, he says.
It’s affordable. Aldactone is a medication that’s usually covered by insurance, Prather says. Even without insurance coverage, it only costs about $20 to $30 a month.
It can be taken with other medications. Some women take Aldactone while using over-the-counter minoxidil (Rogaine), a solution that’s applied to the scalp, for even better results.

Cons of Using Aldactone

It can make you urinate more often. One side effect of taking a diuretic is that it may make you run to the restroom more often. It’s usually not a problem for women taking lower doses of Aldactone (up to 100 milligrams), Prather says. But if you’re taking a higher dose of up to 200 milligrams, you may have to urinate more frequently. Dr. Fusco tells her patients to make sure they’re home or can get to a bathroom for about 90 minutes after taking the medication.
It may cause irregular menstrual cycles. Anything that interferes with your hormones may cause a change in your menstrual cycle, Prather says. Women often take oral contraceptives when they’re taking Aldactone to regulate their cycles and also to be sure they don’t get pregnant while taking the drug.
It can raise potassium levels. It’s important to get your potassium levels checked by your doctor every few months while you’re taking Aldactone, Prather says. “This is one of those times when you want to see somebody who has expertise in this area, such as a dermatologic surgeon” who can monitor you while you’re taking the drug, Prather says. High levels of potassium can cause dangerous side effects, including heart rhythm abnormalities.
It can lower blood pressure. Be aware that dizziness and lightheadedness might be signs that Aldactone is causing your blood pressure to go too low, especially if you tend to have low blood pressure to begin with, Fusco says.
It can interact with other drugs. Aldactone may interact with other medications, such as blood pressure medications, so it’s important to let all of your doctors know when you’re taking it.

7 Things Not to Do for Hair Loss

Don’t hesitate to call your doctor if you’re experiencing any side effects of Aldactone, Fusco says.

The good news: If you’re experiencing hair loss at a young age and you start this medication, you may be able to restore the hormone balance, see improvement in the thickness of your hair, and eventually stop needing the medication.

Female pattern alopecia: current perspectives

Minoxidil

Topical minoxidil 2% (Rogaine, Johnson and Johnson, New Brunswick, NJ, USA) solution or foam is the only currently approved FDA treatment for FPHL, although a more potent 5% solution is available and approved for male pattern hair loss (MPHL). Oral minoxidil was introduced prior to the development of the topical form as a treatment for hypertension, given its vasodilatory properties through the stimulation of potassium channels. An observed side effect was hypertrichosis and the reversal of balding in male patients.²⁶ Although the subject of over 20 years of research, the stimulatory effects of minoxidil on the hair follicle are not fully known; however, it is known that minoxidil results in an increased growth rate, thicker diameter of the hair follicle, and lengthened anagen phase with a shortened telogen phase of the hair cycle.²⁷ Improvement in hair counts may not be due to enhanced blood supply, as survival has been demonstrated in the absence of a blood supply.²⁸ Some consider topical minoxidil to be a nonspecific biological response modifier, as it appears to increase conversion of testosterone to less active androgens by increasing activity of 17β-hydroxysteroid dehydrogenase, but it also slightly increases 5α-reductase activity in cultured balding scalp human dermal papilla cells.²⁹

Several randomized controlled trials have proven the effectiveness of topical 2% minoxidil for FPHL. ³⁰^,³¹ However, the 5% concentration has demonstrated much superiority over the 2% in a double-blind, placebo-controlled, multicenter trial of 381 patients with FPHL who received minoxidil 5% solution, minoxidil 2% solution, or placebo twice daily.³² Both concentrations were without systemic side effects, but patients in the higher concentration group were more likely to experience treatment-related side effects such as scalp pruritus, irritation, and facial hypertrichosis. The application of 5% minoxidil foam once daily was compared to 2% minoxidil solution twice daily in a subsequent study, with the goal of finding a solution to the treatment-related side effects observed when administering the 5% solution twice daily. At 24 weeks, patients in the 5% once daily group had noninferior hair counts and experienced a nonsignificant improvement in hair counts, hair width, and overall efficacy. Additionally, 5% foam once daily was more aesthetically pleasing to patients, as there was less facial hypertrichosis and scalp pruritus, and the treatment interfered less with hair styling when compared to the 2% solution group. This study concluded that 5% foam once daily was as clinically effective, and offered a significant aesthetic advantage, when compared to the 2% solution administered twice daily.³³ Of note, the foam preparation does not contain propylene glycol, which is a frequent cause of irritant dermatitis and may be a reason for the reduced rate of preparation-induced side effects. Further, the solution form has a higher alcohol content, which is also a known irritant.

Most recently, a meta-analysis of randomized controlled trials for treatment interventions in FPHL demonstrated that a greater proportion of patients treated with topical minoxidil reported an increase in hair growth when compared to placebo with a relative risk of 1.86, indicating that hair growth was more likely to occur in the experimental group.³⁴ Of seven included studies, there was an increase of 13.28/cm² in total hair count when compared to the placebo group. Additionally, adverse events were deemed minimal, but facial hypertrichosis was noted in the 5% solution used twice daily. Price et al determined that after discontinuation of minoxidil 2% and 5% solutions, hair weight and number counts returned to placebo levels in 24 weeks.³⁵

Fortunately, minoxidil is inexpensive, generically available, easy to use, and is an effective treatment in restoring the number of nonvellus hairs. Unfortunately, clinical effects are unpredictable, and to some the results may be mild and unappreciated by the patient. Further, if the treatment is not continued continuously and indefinitely, improvements will be lost. It is extremely important to counsel patients that clinical effects may not be noticeable for up to 3–6 months of continued daily use and that hair shedding may occur in the first few months as hairs are transitioned to the anagen phase of growth. If treatment is halted or used inconsistently, there may be lack of appreciable improvement or lost results. Patients should be informed that the goal of treatment is to prevent further hair loss, but treatment may result in new growth and/or thickening of existing hairs. It is not known if the generic version is any different with regards to efficacy and side effects. No treatment is curative, and many patients may have continued progression despite intervention. Facial hypertrichosis can be reduced by applying the product directly to the scalp in a thin layer so there is no excess (the foam preparation is superior in this regard) well before going to bed, or applying a head covering to limit unwanted spreading of the product. It may be best to recommend the 2% version to women concerned of this potential unwanted complication, although topical eflornithine (Vaniqa, Skinmedica, Inc, Carlsbad, CA, USA), waxing/plucking, or laser hair removal are options if this complication were to occur. Topical corticosteroids can be used concomitantly to help limit irritant dermatitis and improve seborrhea. Ongoing clinical trials are investigating new formulations, combinations with other medications and/or supplements, and procedures to increase or improve drug delivery. ³⁶^,³⁷

For example, in one study where an investigational combination product called NuH Hair (a novel combination lotion of minoxidil, finasteride, and dutasteride, the overall contents, composition percentages, and formulation methods of which have not been released), applied daily in combination with administration of oral finasteride, topical 5% minoxidil foam, and/or topical ketoconazole to the scalps of males with patterned hair loss, demonstrated the most significant improvement in hair counts and overall appearance as compared to the investigational product combined with two or fewer other interventions.³⁸ In the patients treated with all four interventions, hair growth was noted as early as 14 days. Although this study had very few patients and was not blinded, it demonstrates that combination therapy improves results in the treatment of patterned alopecia and that there is a complex interplay of multiple mechanisms influencing this condition, each requiring specific targeted treatments. Another study using 200 mg of oral spironolactone for 24 weeks in FPHL demonstrated improvements which plateaued but demonstrated further regrowth with the addition of 5% minoxidil solution twice daily.³⁹

A recent in vitro study demonstrated that iontophoresis delivery of minoxidil gel demonstrated greater accumulation of medication into the hair follicle as compared to passive delivery.⁴⁰ Enhanced follicular drug delivery through various mechanisms, here shown with iontophoresis, may be useful to improve the treatment of androgenic alopecia. It has been published that scalp cooling prior to chemotherapy can have a preventative impact on the amount of hair loss; although through a different mechanism of hair loss (eg, anagen effluvium), the concept that changing growth parameters such as temperature, pH, blood flow, and nutrient content are important factors in the treatment of patterned alopecia and have the potential to improve treatments in the future.⁴¹

+ Spironolactone (Aldactone) — Canadian Hair Loss Foundation

Main uses in hair loss: female pattern hair loss

Other names: Aldactone (trade name)

What is Spironolactone?

Spironolactone is an oral medication that blocks the effects of hormones called ‘androgens. ’
This medication is used to treat hair loss.
One study suggested that it helps stop hair loss in approximately 40 % of women and helped improve hair density in another 40 % of women.

How is Spironolactone prescribed?

Your doctor will advise on spironolactone dosing.
The maximal dose is 100 mg twice daily (200 mg). Your doctor may want you to use less, especially when starting.

Can I use Spironolactone with other treatments?

You should NOT use Spironolactone if you are on these medications: ACE-inhibitors, angiotensin receptor inhibitors, potassium pills, digoxin, lithium, NSAIDS and thiazide diuretics

Who should not use Spironolactone?

Spironolactone is not for everyone, especially men. Many women should also not use spironolactone. Check with your doctor if this medication is right for you.

A woman should not use Spironolactone if she has (or is):

undiagnosed hair loss
kidney problems
high potassium levels in the blood
is pregnant or wish to become pregnant in the very near future (women must not get pregnant on this medication)
is breast feeding
has abnormal uterine bleeding
has family history or personal history of breast, ovarian or uterine cancer
has a history of gastrointestinal bleeding (GI bleeding) or gastric ulcers

What side effects are possible with Spironolactone?

Several side effects are possible with Spironolactone. Be sure to review all side effects with your physician. A partial list is shown below:

Menstrual irregularities (being on the birth control pill may helpf make periods regular)
Breast tenderness and enlargement
Rarely you can feel dizzy when you stand up quickly
High potassium in the blood (rare in healthy women)
Fatigue
Decreased libido (sex drive)
GI upset: Nausea, vomiting, diarrhea, ulcers and bleeding are very rare
Teratogenicity – This means that it may cause abnormalities in a developing fetus (baby) if a woman gets pregnant while on this medication. Women can have healthy babies once they stop this medication but must never get pregnant while on this medication.

What side effects should prompt me to STOP Spironolactone and get medical advice?

Stop taking Spironolactone and get medical help if you develop a rash, hives, shortness of breath, swelling in the lips or feel unwell
Stop if you have any concerns at all
Stop if you develop breast enlargement, bumps or lumps in the breast or discharge.
What tests should I have when I am on this medication?
Your blood pressure will be monitored while you are on this medication.
You may be advised to get blood work while on this medication.

Spironolactone and Minoxidil Promote Hair Regrowth for Balding Women

There is no “cure” for hair loss, but a prescription from your dermatologist may be on the horizon. An observational study in the International Journal of Dermatology suggests that taking low doses of both spironolactone (a drug typically used to treat high blood pressure and acne) and oral minoxidil (the active ingredient in Rogaine) can help combat female-pattern hair loss. One hundred testers popped a combo pill once daily for 12 months.

It’s science, not magic. When ingested together in this one pill, the two drugs act synergistically and tackle different problems associated with thinning hair. Spironolactone stops hair shedding by inhibiting the effects of androgens (like testosterone) that combine with an enzyme to create a hormone that causes hair loss, explains study author Rodney Sinclair, a dermatologist in Australia. Minoxidil, on the other hand, works to widen the hair fibers and stimulate growth.

When taking this pill over a period of one year, testers across a wide age range (they were between the ages of 18 and 80) saw a fuller head of hair and decreased fallout. They started seeing results within three to six months and were shedding approximately three times less by the end of the trial. As expected, some subjects experienced a few side effects, including hair growth in unexpected places (i.e. their faces) — which is nothing a wax or some tweezers can’t fix. Some saw urticaria (itchy, raised skin or hives) and low blood pressure. Those who had these side effects were asked to stop using the pill.

So what does this mean for the future? For those suffering from female-pattern baldness, with a few tweaks and clinical trials, there could be a treatment that can drastically alter the state of their scalps. There is the potential for a little pill to be the answer to female-pattern hair loss. So sure, it is science, but it could be a little magic too.

For more on hair loss:

Now, learn more about why your hair is breaking (and how to fix it)

Rogaine, Medications, Estrogen, and More

When it comes to drug treatments for androgenetic alopecia, women are in a difficult position. While many drugs may work to some degree for certain women, doctors hesitate to prescribe them. What’s more, drug companies aren’t falling over themselves to test drugs specifically for their ability to prevent and treat female pattern baldness.

Physicians are reluctant to prescribe systemic treatments (pills or other form of treatment that affects your entire system) because they can tamper with your body’s own androgen levels (see Causes for an explanation of androgens). The doctor will first want to confirm that the hair loss is due to an excess of androgen (another name for male hormones) in the system or a sensitized “over-response” to normal amounts of androgen. Therefore, physicians often choose topical treatments, which are applied directly to the scalp.

Beginning treatment as soon as possible after the hair loss begins gives the best results, because prolonged androgenetic alopecia may destroy many of the hair follicles. The use of anti-androgens after prolonged hair loss will help prevent further damage and encourage some hair regrowth from follicles that have been dormant but are still viable. Stopping treatment will result in the hair loss resuming if the androgens aren’t kept in check in some other way. Maintaining your vitamin and mineral levels helps while you’re on anti-androgen medications.

Below you will find a list of treatments used to treat hair loss in women. Currently there is only one FDA-approved treatment for female pattern hair loss. Others have not been approved by the FDA for this particular application, but have been approved for other applications and are used “off-label” to treat hair loss.

The effectiveness of these agents and methods varies from person to person, but many women have found that using these treatments have made a positive difference in their hair and their self-esteem. As always, treatments have the best chance of being effective if they are geared to the cause of the hair loss as well as to triggering hair growth.

Minoxidil (Rogaine)

Minoxidil was first used in tablet form as a medicine to treat high blood pressure (an antihypertensive). It was noticed that patients being treated with minoxidil developed excessive hair growth (hypertrichosis) as a side effect. Further research showed that applying a solution of minoxidil directly to the scalp could also stimulate hair growth.

When applied topically, the amount of minoxidil absorbed through the skin into the bloodstream is usually too small to cause internal side effects.

Widely available in generic versions and under the brand name Rogaine, minoxidil seems to be more effective for women suffering from diffuse androgenetic alopecia than it is for men. Product labeling recommends that women only use the 2% concentration of minoxidil, not 5%, because the FDA has not approved use of the higher concentration in women.

Many dermatologists do prescribe 5% for women with androgenetic alopecia if used under their supervision. Small clinical trials have shown that the 5% minoxidil solution is significantly more effective in both retaining and regrowing hair in women with androgenetic alopecia than the 2% solution.

Results from clinical studies of mostly white women ages 18 to 45 years with mild to moderate degrees of hair loss report that after using minoxidil for eight months, 19% of users had moderate regrowth and 40% had minimal regrowth. Of those using a liquid without active minoxidil (a placebo) during the same time period, 7% reported moderate hair regrowth while 33% had minimal regrowth.

Androgen Receptor Inhibitors

Spironolactone (Aldactone)
Spironolactone, brand name Aldactone, is in a class of drugs called potassium-sparing diuretics (often called water pills). Spironolactone is typically used to reduce fluid in your body without causing the loss of potassium. It is also used to treat potassium deficiency, high blood pressure (hypertension), swelling (edema), and a hormonal disorder called hyperaldosteronism.
Spironolactone acts as an anti-androgen in two ways. First, it slows down the production of androgens in the adrenal glands and ovaries. Second, it blocks the action of androgens in part by preventing dihydrotestosterone (DHT) from binding to its androgenetic receptor.
Cimetidine (Tagamet)
Cimetidine, brand name Tagamet, belongs to a class of histamine blockers used mainly to treat gastrointestinal ulcers. The histamine-blocking action prevents the stomach from producing excess acid, allowing the body to heal the ulcer. Cimetidine also has a fairly powerful anti-androgenic effect and has been shown to block dihydrotestosterone from binding the follicle receptor sites.
Cimetidine has been used to treat excess facial hair growth (hirsutism) in women and has shown promising results in studies of women with androgenic alopecia. High doses are needed to achieve results, so men should not take cimetidine to treat their hair loss due to possible feminizing effects, including adverse sexual side effects.
Cyproterone Acetate
Cyproterone acetate is used to reduce excessive sex drive in men and to treat pronounced sexual aggression. It is also prescribed for severe hirsutism in woman of childbearing age and for androgenetic alopecia in women. Cyproterone acetate exerts its effects by blocking the binding of dihydrotestosterone (DHT) to its receptors.
Cyproterone acetate is not available in the U.S. Doctors consider it one of the last resorts for treating female pattern hair loss because of its possible toxicity and long-term side effects. As with any drug, side effects other than those listed on the package may occur. Contact your doctor if you notice a side effect that is unusual or particularly bothersome.

Estrogen and Progesterone

Estrogen and progesterone pills and creams may be an effective treatment for women with androgenetic alopecia who are going through menopause or whose estrogen and/or progesterone are lacking for other reasons.

Oral Contraceptives

Since birth control pills decrease the production of ovarian androgens, they can be used to treat women’s androgenetic alopecia. Keep in mind, however, that the same cautions must be followed whether a woman takes contraceptive pills solely to prevent contraception or to treat female pattern baldness. For example, smokers age 35 and older who take the Pill are at higher risk for blood clots and other serious conditions.

Discuss your medical and lifestyle history thoroughly with your doctor. Contraceptive pills come in various hormonal formulations, and your doctor can determine which is right for your specific needs, switching pills if necessary until you are physically and emotionally comfortable with the formulation.

Only low-androgen index birth control pills should be used to treat hair loss. High androgen index birth control pills may contribute to hair loss by triggering it or enabling it once it has been caused by something else. See Causes for more information about oral contraceptives and hair loss.

Ketoconazole (Nizoral)

Available as a topical treatment by prescription, ketoconazole is currently used to treat fungal infections. It curbs the production of testosterone and other androgens by the adrenal gland and reproductive organs (in women, the ovaries).

These anti-androgenic effects can be used to help treat hair loss. Nizoral shampoo contains 2% ketoconazole and is prescribed not only for the treatment of scalp conditions, but also in combination with other treatments for androgenetic alopecia. A 1% version is now available over-the-counter, but it may not be as effective as the 2% prescription strength. There are no significant side effects.

Finasteride (Propecia, Proscar)

The drug finasteride inhibits the enzyme 5-alpha reductase in the hair follicle, thereby inhibiting the production of follicle-harming dihydrotestosterone (DHT). DHT shrinks hair follicles and makes it difficult for healthy hair to survive.

Finasteride was first marketed under the brand name Proscar to treat the prostate gland. It was available in 5 mg pills. In 1998, a 1 mg version with the brand name Propecia entered the market as the first pill approved by the FDA for men’s hair loss.

It works quite well to prevent hair loss and trigger regrowth for most men, and it may work for some women, although women must not take it if they are pregnant. Also, women should not get pregnant while on the drug because of the risk of birth defects in a male infant. Less than 2% of men have transient sexual side effects, including erectile and libido difficulties, while taking finasteride. However, in women these side effects do not occur. Learn more about the difference between finasteride and minoxidil.

Cyproterone Acetate with Ethinyloestradiol (Diane 35, Diane 50)

Sold under the brand names Diane 35 and Diane 50, these contraceptive tablets are prescribed in Europe for women’s androgenetic alopecia. Currently, both versions of this contraceptive are not available in the U.S.

The drug is a combination of cyproterone and estradiol, an estrogen. Both Diane 35 and Diane 50 contain 2 mg of cyproterone. Diane 35 contains 0.035 mg of estradiol, while Diane 50 contains 0.050 mg.

They work by blocking some of the actions of male hormones commonly present in women. Although it’s possible for the drug to stop further hair loss and trigger regrowth of hair within about a year, it needs to be used on an ongoing basis to maintain regrowth and eliminate hair loss.

Possible side effects include breast tenderness, headaches, and decreased libido.

Published on March 1, 2010

How It Works, Dosage, and Side Effects

Most women experience hair loss at some point in their lives. Hair loss and hair thinning is prevalent in post-menopausal women due to various underlying reasons. However, this can be treated with spironolactone. This FDA-approved anti-androgen drug can help prevent hair loss (1).

Spironolactone was mainly used to treat hypertension and fluid retention. However, it was found to reduce adrenal androgen production and minimize female pattern hair loss or androgenetic alopecia (1). In this article, we have explored how spironolactone works and how you can use it to prevent hair loss. Scroll down for more information.

What Is Spironolactone?

Spironolactone is an anti-androgen drug. It was mainly used for treating hypertension, symptoms of polycystic ovary syndrome (PCOS) and hirsutism. However, spironolactone prevents adrenal androgen production in the body and thus, minimizes PCOS hair loss or androgenetic alopecia (1). Besides treating female pattern hair loss (FPHL), it may also be beneficial in reducing hirsutism and acne. The section below delves further into how it works to prevent hair loss.

How Does Spironolactone Work?

Spironolactone slows down androgen production. Androgens are a group of male sex hormones, including testosterone. In females with PCOS, excess production of androgens may cause hair loss. A study found that the daily consumption of spironolactone in the prescribed dosage can reduce hair loss and increase the number of hair follicles in the anagen phase (1).

The dosage of spironolactone depends on the purpose it is being used for.

How Much Of Spironolactone Is Prescribed For Hair Loss?

A study found that a dose of 200 mg of oral spironolactone effectively improved female pattern hair loss (1). Doctors generally prescribe a dosage between 50-200mg of spironolactone for hair loss. However, the dosage may vary, depending on the severity of your hair loss. The doctor may even prescribe a combination of drugs to be taken with spironolactone, such as (1):

Spironolactone With Oral Contraceptive: This combination is often used to prevent menstrual irregularities and improve female pattern hair loss and acne.
Spironolactone With Minoxidil: A 2% topical minoxidil solution improves hair growth rate and hair thickness by lengthening the anagen (growth) phase and shortening the telogen (hair fall) phase of the hair (2).

Your doctor may also prescribe topical spironolactone for treating hair loss.

Spironolactone: Topical Or Oral?

You may take spironolactone orally or apply a topical solution.

Topical treatment is preferred as it cuts down many possible side effects of oral spironolactone. Research found that 5% spironolactone gel can promote hair growth and is a good option for managing androgenic alopecia (3).

The doctor will evaluate the severity of your hair loss and other complications caused by PCOS and then prescribe either topical or oral spironolactone. Once you start taking it, you may expect results in a few months. However, the duration may vary from person to person.

How Long Does It Take For Spironolactone To Work?

Do not expect overnight results. Spironolactone may take at least six months to show results. However, it may vary, depending on the severity of the condition. You may even notice changes after a year of using the drug.

You have to follow up with your doctor after taking spironolactone for six months. They may even increase the dosage, depending on the results, or suggest a combination of medications.

Spironolactone is not prescribed for everyone. Find out next who can use the drug and who should avoid it.

Who Can Use Spironolactone For Hair Loss?

Spironolactone is mainly prescribed for women with androgenetic alopecia or female pattern hair loss. However, avoid spironolactone if you (4):

Have kidney-related issues
Have high blood potassium levels
Have Addison’s disease
Are taking eplerenone (steroid)
Are pregnant or nursing

Teenagers below 18 years of age should also avoid this drug. If taken in the wrong way, spironolactone may have some health risks.

What Are The Side Effects Of Spironolactone?

As spironolactone is commonly prescribed for hypertension, some people may experience low blood pressure while using this drug. This is why it is crucial to take it in the prescribed dosage. Otherwise, it may cause issues like (5):

Headache
Weight loss
Fatigue
Increased urination
Dry skin
Decreased libido
Drowsiness and nausea
Irregular periods
Diarrhea
Depression
Breast tenderness

Overdose of spironolactone may also cause:

Breathing problems
Rashes
Dizziness
High potassium levels

High potassium levels can be life-threatening. Visit a doctor immediately if you experience:

Weakness
Muscle fatigue
Abnormal heart rate
Paralysis

Conclusion

Spironolactone is an effective drug to treat hair loss caused by androgenic alopecia. However, it may take time to show results. If you are using spironolactone for hair loss, make sure to follow the prescribed dosage and talk to your doctor about any changes your may experience. Also, discuss any underlying health condition you may have with your doctor before trying this drug.

Frequently Asked Questions

Does spironolactone cause hair loss?

No, spironolactone does not cause hair loss. It prevents hair loss caused by androgenetic alopecia.

Does topical spironolactone work for hair loss?

Yes, topical spironolactone works for female pattern hair loss.

Can hair grow back from female pattern baldness?

Yes. Female pattern baldness can be reversed with drugs like spironolactone and minoxidil.

Can spironolactone be used with other treatments?

It depends on the nature of medications. Taking spironolactone with other drugs can increase the potassium levels in the body and cause health risks. Talk to your doctor before taking spironolactone.

Ramona is an associate editor at StyleCraze. Prior to that, she authored over 200 articles on skin and hair care. She also did a certificate course in dermatology offered by the Novosibirsk State University and is constantly endeavoring to learn more about ingredient-specific and skin-friendly and hair-friendly routines. As a communicator, she strives to educate and guide the readers by breaking down complex scientific facts into simple language to help them understand and incorporate the knowledge into their lives. When Ramona is not working, her books and passion for music, good food, and traveling keep her busy.

Dr. Shruti Chavan is a consulting dermatologist at Dr.Sheth’s Skin and Hair Clinic since 6 years. She is a co-committee member of CDSI (Cosmetic dermatologist Society of India). She is highly skilled in non-surgical facial skin rejuvenation and face lift by the use of injection treatments and lasers. Dr. Chavan is well-versed with dermatological and aesthetic procedures. Her special interests… more

Men and women are different in many ways, including why and how they can suffer from hair loss. Similarly, there are hair loss medications which may work for men but won’t work – and can even be harmful to – women, Propecia most notably. But there is also a medication which has increasingly shown promise as a treatment exclusively for women who suffer from a hair loss condition called androgenetic alopecia.

Spironolactone is a part of a family of medications called aldosterone receptor antagonist. The “antagonist” part relates to the medication’s effectiveness at slowing down and reducing the body’s the production of androgens. These male sex hormones, also found in women, are associated with hair loss caused by androgenetic alopecia. Reducing androgen levels can put the brakes on the progression of hair loss and even can encourage hair regrowth.

But for female pattern baldness, the drug’s effectiveness has been demonstrated in multiple studies, including one in 2015 which found that 75 percent of the study’s participants with androgenetic alopecia saw a noticeable improvement in their hair loss after taking spironolactone. Another study from 2017 reported that a combination of spironolactone and minoxidil could reduce hair shedding, increase hair growth, and improve hair thickness.

“The life span of a hair consists of several successive phases. Normally, about 90% of hairs are in the stage of active growth – anagen. About 5% are in the stage of loss – cathogen, the rest – “sleep” in the telogen phase. Hair can stay in telogen from two to four months, after which it falls out, and a new one begins to grow in its place. But with telogen alopecia, about 30% of the hair goes into the sleeping phase at once, ”explains Aleksandra Bogadelnikova, dermatologist, Ph.MD, an expert of the Laboratoire SVR dermatological cosmetics brand and the Phyto brand.

Lasix is available in tablets (20 to 80 mg) and in an intravenous form. The dosage is determined by the patient’s doctor and will vary depending on how much fluid and how quickly it needs to be removed. Patients with poor renal function usually require higher doses; dosages for children depend on weight. Lasix can interact with sucralfate, cisplatin, cyclosporine, ethacrynic acid, lithium, methotrexate, phenytoin, antibiotics, heart or blood pressure medications, laxatives, salicylates such as aspirin, or steroids.Tell your doctor about all medications and supplements you are taking. Tell your doctor if you are pregnant or planning to become pregnant while using Lasix; it is unknown if this will harm the fetus. Lasix passes into breast milk and may harm a nursing baby. Lasix can also slow down the production of breast milk. Talk to your doctor before breastfeeding.

Aldactone is available in 25, 50 and 100 mg tablets.Due to tumor formation in experimental animals, use during pregnancy should be avoided unless the benefits outweigh the potential risks to the fetus; women who are breastfeeding are not advised to use Aldactone. In addition, the drug should not be used to reduce normal edema during pregnancy. The active metabolite of aldactone appears in breast milk. Breastfeeding while using Aldactone is not recommended. If the use of aldactone is deemed necessary, an alternative infant feeding method should be used.