Spironolactone for Hair Loss: A Summary

spironolactone pills

While the name can be difficult to get your tongue around, understanding what spironolactone is and what it can be used for doesn’t have to be quite so tricky. Perhaps slightly confusingly however, spironolactone is commonly prescribed to treat both excessive hair growth and patterned hair loss. This article explains how that apparent contradiction actually makes sense, and looks at benefits, side effects and alternatives.

What is spironolactone?

Spironolactone is a drug with a number of applications. Its potassium-sparing diuretic effect means it has often been used for cases of heart failure and kidney disease over the past 40 years. Spironolactone is also used for cirrhosis, and less commonly as a therapy for hypertension. 

Because it reduces adrenal androgen (male sex hormone) production and binds to the androgen receptor, spironolactone has a significant anti-androgenic effect. This has led to its use in the treatment of acne and hirsutism (excessive hair growth) in women. Spironolactone is particularly used where this acne or hair growth is the result of polycystic ovary syndrome, which involves the increased production of androgen.

Does spironolactone help hair regrowth?

Spironolactone is frequently prescribed as an off-label treatment for female pattern hair loss. This means that the FDA has not approved the use of spironolactone for hair loss, but that it has passed FDA clinical trials for other indications. Off-label prescriptions are common - we’ve explained how they work in this article.

Spironolactone has been shown to stop hair loss progression in women, as well as to actually cause partial hair regrowth in a significant percentage of cases. While it might also help hair regrowth in men, spironolactone is not used for male pattern hair loss because of the risk of feminization as a result of blocking male sex hormones. We’ve covered male pattern baldness elsewhere, outlining more suitable options for men.

While some research notes that there are few ‘physician-reported outcome studies supporting its efficacy in FHPL’, there are a number of studies showing oral spironolactone to be a convenient and effective treatment for female hair loss. Some studies have also shown a combination of spironolactone with minoxidil to be an effective oral treatment.

What are the cons of taking spironolactone?

There are a number of spironolactone side effects to be aware of. There is also some evidence that taking spironolactone during pregnancy can lead to feminization of exposed male embryos.

Side effects of taking spironolactone for hair loss

The reported side effects of spironolactone range from the benign but unpleasant through to the very serious. One study looking at the side effects in hirsutism therapy reported women experiencing urticaria, which will be better known to many as hives, and another records instances of chloasma. This second study reported that 91% of the 54 patients surveyed had experienced side effects from their hirsutism or acne treatment, with 80% of these being related to spironolactone’s anti-androgenic effect. These included menstrual disturbances, though such abnormalities were less frequently seen when the contraceptive pill was used concurrently. While some of these side effects are not dangerous, women in the studies sometimes found them intolerable - 9 women experiencing metrorrhagia dropped out of one study.

Perhaps the most serious and alarming side effect is the possible feminization of male babies exposed to the drug before birth.

Spironolactone and pregnancy

The drug has been shown to cause feminization of male animals exposed before birth. As a result, use of spironolactone is not recommended during pregnancy. Despite this, the FDA has approved spironolactone for the treatment of edema in pregnant women. One paper highlights instances of males whose mothers were treated with spironolactone during pregnancy, where there was no evidence of feminization. This paper notes that more human data would be interesting, but concludes that it can’t be safely argued that spironolactone does not ‘have the potential to cause feminization in male offspring’. 

The accepted recommendation is therefore not to take spironolactone while pregnant. As a significant side effect this may make spironolactone an unappealing hair loss treatment for women who wish to have children.

Can spironolactone make hair loss worse?

As already noted, spironolactone is used to treat hirsutism. This can at first sound like a contradiction given it is also used for hair loss. How can the same drug both help hair growth and stop excess hair growth? The answer is that both excessive hair growth and hair loss can be caused by the overproduction of androgen, so the use for both indications is perfectly logical. 

Some research highlights instances of women being treated for hirsutism experiencing hair loss on the scalp. Spironolactone actually making hair loss worse is therefore not an unprecedented phenomenon.

Safe and effective spironolactone alternatives

While effective, spironolactone is clearly not appropriate for everyone. Men, pregnant women, and anyone who is concerned about the possible spironolactone side effects may want to look at other options for tackling their hair loss. It will also be necessary to look elsewhere if your hair loss is caused by something other than overproduction of male sex hormones.

One option that is appropriate for all causes of hair loss, and suitable for all hair types, is ProCelinyl. Revela’s scientists used a cutting-edge AI engine to discover this groundbreaking ingredient, scanning millions of new molecules for a solution that is effective and safe. ProCelinyl directly targets hair follicle health to reawaken dormant follicles, bringing the appearance of thicker, fuller hair in 6-8 weeks. With spironolactone bringing its best results after a year or more of use, Revela’s Hair Revival series products will be appealing to those eager for quick but lasting results.

In a six week clinical trial, 97% of women saw improvements in their hair’s appearance, 87% with tight hairstyles noticed less shedding and 82% noticed increased thickness and hair growth.

Profile photo for Avinash Boppana

Reviewed by: Avinash Boppana, BS

Avinash is a computer scientist. He completed his BS from Princeton University, concentrating in Statistics & Machine Learning. He has deep experience in computational research, working for reputable institutions, including Harvard Medical School, the Flatiron Institute, and the NIH.

Written by: Revela Editorial Team

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