From the Guidelines
Spironolactone is commonly prescribed for female pattern hair loss at doses ranging from 50 to 200 mg daily, with a typical starting dose of 25-50 mg daily, gradually increased to an effective dose of usually 100 mg daily, taken in one or two divided doses 1.
Key Considerations
- The medication works by blocking androgens (male hormones) that contribute to hair loss in women.
- Results from using spironolactone for hair loss are not immediate, typically taking at least 6 months to notice improvement, with maximum benefits seen after 12-18 months of consistent use.
- Spironolactone is not FDA-approved specifically for hair loss but is used off-label for this purpose.
- Women who are pregnant or planning pregnancy should avoid this medication as it can cause birth defects in male fetuses.
- Regular monitoring of blood pressure and potassium levels is recommended, especially during the initial treatment period, as spironolactone is a potassium-sparing diuretic that can affect these parameters.
Dosage and Administration
- The suggested dosing for spironolactone is 25-200mg daily, typically starting 100mg daily in the evening 1.
- Contraindications include significant renal impairment, hyperkalemia, and Addison disease.
- Common side effects are menstrual irregularities, breast tenderness, dizziness, nausea, headache, polyuria, and fatigue.
- Routine monitoring is not required in young women without hypertension, renal, or cardiac disease, but potassium monitoring should be considered in older patients and those with certain medical conditions or taking specific medications 1.
From the Research
Spirolonactone for Hair Loss in Female Dosage
- The dosage of spironolactone for female pattern hair loss (FPHL) is not explicitly stated in the provided studies, but it is mentioned that spironolactone 25 mg is used in combination with low-dose oral minoxidil 0.25 mg 2.
- A study suggests that spironolactone is an effective and safe treatment option for hair loss, with an overall rate of improved hair loss of 56.60% 3.
- The use of spironolactone in FPHL is supported by its antiandrogenic properties, which can help reverse or stabilize the process of hair follicle miniaturization 4, 5.
- Treatment of FPHL should start with minoxidil (5%), adding 5α-reductase inhibitors or antiandrogens like spironolactone when there is severe hair loss or hyperandrogenism 6.
- Spironolactone has been used off-label in FPHL for over 20 years, with a long-term safety profile and significant percentage of women achieving partial hair regrowth 5.