Spironolactone and alopecia: How does it work and how can you get it?
Dr. Eric Howell, board-certified dermatologist, talks about the use of spironolactone for hair loss and tells you how to secure a prescription.
Table of Content:
What is spironolactone? | How does it work for hair loss? | Does it make hair grow? | What is the dose for hair loss? | How to get a prescription? | Side effects | FAQs
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The information presented in this article is based on scientific research and the professional advice of our Content Medical Reviewers, who are experts in the field of Dermatology. How we write our content →
What is spironolactone?
Dr. Eric Howell, board certified dermatologist, says that spironolactone is a medication that belongs to a class of drugs known as potassium-sparing diuretics. Besides being used in the treatment of high blood pressure, edema (swelling) and high-blood pressure, in dermatology it is used in the treatment of:
- Hair loss (female androgenetic alopecia)1
- Hormonal acne in women2
- Hirsutism (hair growth in unusual body areas, like the face)3
How does spironolactone work for alopecia?
Dr. Howell says that spironolactone works for alopecia by blocking androgen receptors and inhibiting androgen production. Androgens, such as testosterone and dihydrotestosterone (DHT), can contribute to hair loss by shrinking hair follicles and shortening the hair growth cycle. Spironolactone reduces the effects of androgens on hair follicles, which can help slow down hair loss and potentially promote hair regrowth4.
Does spironolactone work for all types of hair loss?
Dr. Howell says that spironolactone is not effective for all types of hair loss, it is mainly used to treat androgenetic alopecia (the most common type of hair loss) in women.
Can you use spironolactone and minoxidil together for hair growth?
Yes, minoxidil and spironolactone are a popular and effective combination for the treatment of female androgenetic alopecia. Combining these two medications can be more effective than using either one alone, as they work through different mechanisms. Minoxidil promotes hair growth by stimulating hair follicles, while spironolactone reduces androgen levels that contribute to hair loss. You need a prescription to get this treatment, but you can get it with a photo-consultation via Miiskin.
Does spironolactone cause hair growth?
Spironolactone can potentially cause hair regrowth in women with androgenetic alopecia by reducing the impact of androgens on hair follicles. While it may not work for everyone, some women experience noticeable improvement in hair density and a reduction in hair shedding after several months of treatment. However, it is important to note that the extent of hair regrowth can vary widely among individuals, and some may not see significant changes5.
Benefits of using spironolactone for alopecia
Using spironolactone for hair loss, offers several benefits:
- Reduction in hair shedding: Spironolactone helps decrease the rate of hair shedding by blocking the effects of androgens on hair follicles.
- Promotion of hair regrowth: Some individuals experience hair regrowth as the medication allows hair follicles to recover from androgenic damage.
- Improvement in hair density: With reduced shedding and potential regrowth, users often notice an improvement in overall hair density and thickness6.
- Non-invasive treatment: Spironolactone is an oral medication, making it a non-invasive option compared to hair transplantation or other surgical interventions7.
- Acne improvement: For women who suffer from both androgenetic alopecia and acne, spironolactone can help improve both conditions simultaneously due to its anti-androgenic properties8.
What is the spironolactone dose for hair growth?
Dr. Howell says that the dosage of spironolactone for hair growth can vary based on individual needs and the prescribing physician’s assessment. However, the starting dose for hair loss is often 50 mg per day and this may be gradually increased to 100 mg to 200 mg per day, depending on the patient’s response and tolerance to the medication.
It is essential to use spironolactone under the supervision of a healthcare provider to monitor for potential side effects and adjust the dosage as needed.
Can you buy spironolactone for alopecia over the counter?
No, you cannot buy spironolactone over the counter. Spironolactone is a prescription medication, meaning it requires a prescription from a licensed healthcare provider, which is usually a dermatologist for hair loss or acne.
How can you get a prescription for spironolactone for hair loss?
You can get a prescription for spironolactone with a board-certified dermatologist via Miiskin. The price for a photo-consultation is $59 and the prescription renewal fee is only $39.
Side effects of spironolactone
As with many medications, spironolactone can cause some side effects. The severity and occurrence of these side effects can vary among individuals. Common side effects include:
- Hyperkalemia (high potassium levels)
- Menstrual irregularities
- Breast tenderness or enlargement
- Nausea, vomiting, diarrhea, stomach cramps
- Fatigue, unusual tiredness, lack of energy
- Dizziness or lightheadedness
- Headaches
- Frequent need to urinate, especially at night9
How long does it take for spironolactone to work for hair growth?
Dr. Howell says that the time it takes for spironolactone to show results in hair growth can vary, but it generally takes several months to see noticeable improvements. Most patients start to observe some reduction in hair shedding and initial signs of regrowth after 3 to 6 months of consistent use. Optimal results are often seen after 6 to 12 months.
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Frequently asked questions about using spironolactone for hair loss
Can you use spironolactone for female hair loss?
Yes, oral and topical spironolactone can be used for female androgenetic alopecia (female-pattern hair loss). It works by blocking the effects of androgens, which can contribute to hair thinning and loss in women.
Can you use spironolactone for hair growth if you are pregnant?
Dr. Howell says spironolactone should not be used during pregnancy. It can cause birth defects and harm to the developing fetus. Women who are pregnant or planning to become pregnant should avoid using spironolactone.
Can you use spironolactone for male hair loss?
Spironolactone is generally not recommended for male hair loss. This is because its anti-androgen effects can lead to unwanted side effects in men. Dr. Howell says that to treat hair loss in men, he usually prescribes oral finasteride or dutasteride, topical finasteride + minoxidil solution or topical dutasteride + minoxidil solution.
Is spironolactone also used for acne?
Yes, spironolactone is also used to treat hormonal acne in women. Its anti-androgen properties help reduce the production of sebum, which can contribute to acne formation.
Who can use oral spironolactone for hair loss?
- Women with androgenetic alopecia: Women experiencing hair thinning due to sensitivity to androgens.
- Women with PCOS: Women with polycystic ovary syndrome (PCOS) who may have androgen-related hair loss or hirsutism (unwanted hair growth).
Who cannot use oral spironolactone for hair loss?
- Men: Due to the risk of feminizing side effects.
- Pregnant women: Spironolactone can cause harm to a developing fetus.
- People with kidney issues: Those with significant renal impairment or hyperkalemia.
- Individuals with Addison’s disease: Due to the risk of exacerbating the condition.
- Individuals who take potassium supplements
Do you need to use spironolactone with birth control?
Dr. Howell says that he typically prescribes a birth control method for women taking spironolactone. This is because spironolactone can cause birth defects, so it’s crucial to avoid pregnancy while on the medication.
Can spironolactone cause facial hair growth?
Dr. Howell says that on the contrary, spironolactone is often used in the treatment of hirsutism (unwanted hair growth) in women by lowering androgen levels which reduces excessive facial and body hair in women with conditions like polycystic ovary syndrome (PCOS).
Does spironolactone stop hair growth?
Dr. Howell says Spironolactone does not stop hair growth; rather, it can promote hair growth on the scalp by reducing the effects of androgens that cause hair thinning and loss. However, it can reduce unwanted hair growth in other areas (such as facial hair in women) by blocking androgen effects.
Can you use topical spironolactone for hair growth?
Dr. Howell says that topical spironolactone is sometimes used off-label for hair growth, particularly for androgenetic alopecia in women. It is important to consult a healthcare provider before using any form of spironolactone for hair growth.
Can you use topical spironolactone and finasteride for female hair loss?
Dr. Howell says spironolactone and finasteride are not commonly used together for hair loss in women. Spironolactone is a medication usually prescribed for women and finasteride is a medication usually prescribed for men. Instead he recommends the combination of topical finasteride + minoxidil for men and topical spironolactone + minoxidil for women
Lee éste artículo en Español Espironolactona ¿para que sirve en mujeres?
Key points about article
- Purpose in dermatology: Spironolactone is primarily used in dermatology to treat androgenetic alopecia hormonal acne, and hirsutism in women.
- Mechanism of action: Spironolactone works by blocking androgen receptors and inhibiting their production, which helps reduce hair loss by minimizing the impact of androgens on hair follicles.
- Benefits for hair: This medication can reduce hair loss, promote hair growth, improve hair density, and additionally help improve acne in women with hormonal imbalances.
- Side effects: Side effects may include hyperkalemia (high potassium levels), menstrual irregularities, breast tenderness, nausea, fatigue, dizziness, headaches, and frequent urination.
- Pregnancy precautions: Spironolactone should not be used during pregnancy as it can cause birth defects and harm the developing fetus. Women who are pregnant or planning to become pregnant should avoid using spironolactone.
Do you suffer from hair loss problems? Consult an affordable board-certified dermatologist!
Article References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010138/
https://pubmed.ncbi.nlm.nih.gov/37192767/
https://jamanetwork.com/journals/jama/article-abstract/368969
https://www.jaad.org/article/S0190-9622%2815%2901878-2/fulltext?_ga=2.37363941.470787455.1721634186-1802352099.1721634186
https://www.mayoclinic.org/drugs-supplements/spironolactone-oral-route/side-effects/drg-20071534
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