From the Research
Spironolactone can promote hair growth in women with androgenic alopecia or female pattern hair loss, as evidenced by a systematic review and meta-analysis published in 2023 1. This medication, primarily used as a diuretic and to treat high blood pressure, works by blocking androgen receptors and reducing testosterone production, which can decrease the effects of androgens (male hormones) on hair follicles. For hair growth purposes, women typically take 50-200 mg daily, with many starting at 50-100 mg and gradually increasing if needed. Results usually take 3-6 months to become noticeable. However, spironolactone is not FDA-approved for hair loss and is used off-label for this purpose. It's also important to note that topical spironolactone has been shown to be effective and safer than oral administration, with significantly fewer side effects, and is suitable for both male and female patients 2. Common side effects of oral spironolactone include increased urination, menstrual irregularities, breast tenderness, and potential high potassium levels. Regular monitoring of potassium levels is recommended, especially when starting treatment or adjusting dosage. Additionally, spironolactone should not be used by men for hair loss due to potential feminizing side effects, nor by pregnant women as it can cause birth defects. The overall rate of improved hair loss was 56.60%, with a higher rate of improvement (65.80%) observed in the combined therapy group compared to the monotherapy group (43.21%) 1.
Some key points to consider when using spironolactone for hair growth include:
- The medication is not FDA-approved for hair loss and is used off-label for this purpose
- Topical spironolactone is a safer alternative to oral administration, with fewer side effects
- Regular monitoring of potassium levels is recommended, especially when starting treatment or adjusting dosage
- Spironolactone should not be used by men for hair loss due to potential feminizing side effects, nor by pregnant women as it can cause birth defects
- The medication can be used in combination with other therapies, such as minoxidil, for improved efficacy 2.
It's worth noting that while spironolactone has been shown to be effective in promoting hair growth, the response to treatment can be heterogeneous, and further research is needed to fully understand the factors that predict treatment response 1. In terms of dosage, a systematic review published in 2023 found that oral spironolactone doses ranged from 25mg to 200mg daily, with the vast majority between 80mg and 110 mg 2. Topical spironolactone dosage forms include gels of 1% and solutions of 5% twice daily 2.
Overall, spironolactone can be a useful treatment option for women with androgenic alopecia or female pattern hair loss, particularly when used in combination with other therapies and under the guidance of a healthcare professional.