Hair plays an important role in defining our appearance. It also helps keep our bodies clean and protected from external irritants.
Hair loss can be an annoying problem. If you notice that you are losing hair or that your hairline is starting to thin, you may choose to seek treatment options.
Spironolactone is a medication used to treat several conditions, including hair loss.
In this article, we’ll explore what spironolactone (Aldactone) is and how it works to help with hair loss. We’ll also discuss any side effects you need to be aware of and who should not be taking the medication.
What is Spironolactone?
Spironolactone is a medication used to treat high blood pressure, heart failure, and liver and kidney diseases.
In recent years, it has been used, alongside other medications, to treat hair loss resulting from androgenic alopecia.
Healthcare providers may prescribe spironolactone off-label to treat female pattern hair loss (FPHL) or female androgenic alopecia and to help those who identify as female manage their hair loss.
How Does Spironolactone Work for Hair Loss?
Spironolactone is an aldosterone receptor agonist, or mineralocorticoid receptor antagonist (MRA).
This means that spironolactone slows down the production of androgens or testosterone hormones that are mainly responsible for hair loss.
Its antiandrogenic effects subdue what aldosterone does in the body; hence, it encourages hair growth.
While the main benefit of spironolactone for hair loss is an increase in hair growth, this will depend on whether the body adapts to this medication or not.
It is used for other medical conditions, including acne, high blood pressure, and gender-affirming medication therapy.
According to the Journal of the American Academy of Dermatology, close to 40% of women or those who identify as women are affected by female pattern hair loss (FPHL) by age 50.
In the study, after using spironolactone, more than 74% of patients showed signs of improvement or stability in regard to hair loss.
Those with symptoms of hyperandrogenism especially benefited from spironolactone.
From hormones to genetics, emotional stress to lifestyle – various internal and external factors will determine the efficacy of spironolactone.
So, it is important to remember that it might not always be the best course of treatment for you.
Possible Side Effects
Spironolactone is a diuretic, which means that it helps your body to expel excess water, liquids, and certain minerals.
As such, you need to ensure that you drink plenty of water when taking this medication to avoid getting dehydrated.
It can also make you urinate more often.
Other possible side effects of spironolactone include:
- Irregular menstrual cycles
- High or low potassium levels
- Headaches, migraines, fatigue, and tiredness
- Changes in weight
- Changes in blood pressure and heart rate
- Tenderness in the breast tissues
- Changes in libido and sexual appetite
- Gastrointestinal effects such as vomiting, nausea, diarrhea, constipation, indigestion, and heartburn
- Changes in appetite
- Muscle spasms or twitching
- Depression and anxiety
- Dizziness, faintness, or lightheadedness
- Dark or bloody urine and/or stools
- Fever and chills
- Muscle aches and spasms
- Hives, itching, or skin rash
- Swelling in the limbs
Many side effects go away on their own once your body starts getting used to the medication.
Ask your healthcare provider for ways to manage any pain and discomfort. If any side effects become severe or unbearable, seek medical attention immediately.
Interactions and Warnings
Spironolactone and any other similar drugs can interact with one another resulting in not only minimizing the effect you want them to have but, in some cases leading to potential damage.
Always disclose other medications you are on to your healthcare provider.
If you want to start another medication alongside spironolactone, do so only after your physician’s guidance.
Be mindful of the below drug interactions with spironolactone:
- Mefenamic Acid
- Salicylic Acid
- Tolfenamic Acid
Check with your medical provider about the proper dosage and when to take your medication.
You need to stick to the timings and routine of your dosage and get clear instructions on whether it needs to be accompanied by food or not.
It is also important to remember that alcohol, tobacco, and other recreational drugs can interact with your medication.
How Quickly Does Spironolactone Work for Hair Loss?
Some studies have shown that within 24 weeks, FPHL patients notice a significant improvement after using 200mg of oral spironolactone.
When combined with other medications such as oral finasteride, minoxidil foam, and topical ketoconazole, hair growth improvement was noticeable after 14 days of use.
As each person will react uniquely to any drug, including spironolactone, it is almost impossible for any physician to accurately determine how quickly it will help you or if it will help you at all.
It will depend on your hormones, how your additional medications react with spironolactone, and your lifestyle.
If you have any concerns regarding the efficacy of your hair growth treatment, reach out to your medical provider.
Who Shouldn’t Take It
If you are living with a severe autoimmune disease or a chronic illness, your medical provider will advise you on whether or not you should take spironolactone for hair loss.
If you are pregnant, looking to get pregnant, are breastfeeding, or will be breastfeeding, ask your healthcare practitioner if it is advisable for you to be on this medication.
Geriatric and pediatric patients will also need a case-by-case analysis of whether they can use spironolactone.
When to See a Medical Professional
Female pattern hair loss, or female androgenic alopecia, is one of the most common causes of hair loss in people with vaginas.
However, other medical conditions may cause hair loss as well.
If you find that you are losing more hair than usual, notice any bald or thin spots or if handfuls of hair are suddenly falling out, reach out to a medical professional for advice.
They will ask you questions about your lifestyle, medical history, and family’s medical history to determine the cause of hair loss.
They may also undertake a physical examination to reach an accurate diagnosis.
Some other causes and conditions that affect the body’s hair include:
- Polycystic Ovary Syndrome (PCOS)
- Types of alopecia
- Thyroid ailments
- Addison’s disease
- Hodgkin’s disease
- Celiac disease
- Hormone imbalances before, during, and after pregnancy or menopause
- Emotional and mental health triggers such as stress, anxiety, and depression
- Eating disorders or lack of necessary proteins and vitamins
- Substance abuse
You will need to consult a medical provider to know exactly what is causing your hair loss, and they can then determine the right treatment for that condition.
If you are experiencing severe symptoms and side effects from spironolactone, seek medical help.
Also, if you have difficulty breathing, feel lightheaded, or are extremely weak, call 911 or visit the emergency room immediately.
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Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Female pattern alopecia: current perspectives. (2013).
Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. (2017).
Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss. (2010).
Spironolactone for treatment of female pattern hair loss. (2020).
Treating female pattern hair loss. (2020).