Topical Spironolactone for Hair Loss
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What is Topical Spironolactone for female hair loss?
Oral spironolactone is an FDA approved medication used to treat high blood pressure and has been used off-label for treating female pattern hair loss and adult hormonal acne. It is a testosterone blocker, preventing DHT formation.
Spironolactone is typically taken once a day, and results are seen in about 6 months. More powerful than the more popular Minoxidil, which is available OTC, spironolactone is the second most commonly used oral medication for female pattern hair loss and is backed up by many clinical studies. In a UCLA study assessing the effectiveness of oral spironolactone for hair loss, 74.3% of patients receiving spironolactone reported stabilization or improvement of hair loss.1 In another study of oral anti-androgen blockers that included spironolactone, 88% of female patients saw either an improvement of their female pattern hair loss or no progression of the disease.2
Since there may be side effects associated with taking oral spironolactone, Happy Head has developed an innovative topical medication that combines topical spironolactone with prescription grade minoxidil. This prescription topical medication is based on two clinical studies. In one study of topical spironolactone, 80% of patients treated with 1% topical spironolactone gel saw improvement (see photos)3. In another group where 1% topical spironolactone was combined with 5% minoxidil gel, clinical improvements were seen in 100% of the patients, with 40% of patients having excellent response, 50% having good response, and 10% of patients having fair response (see photos).
In another study comparing topical finasteride to topical spironolactone, 32 patients were enrolled in the study and some of them were treated with topical spironolactone solution 5% for six months. In a patient satisfaction survey, 100% were either satisfied or very satisfied with the results. The authors concluded that “ topical finasteride and topical spironolactone are good options for management of androgenetic alopecia but topical spironolactone is better than topical finasteride with few side effects when compared to oral administration.”
Spironolactone can be used simultaneously with other medications, such as birth control medications. Spironolactone is a diuretic, which means that it may help you make more urine. The most common side effects may include a change in blood pressure, such as dizziness or lightheadedness, breast tenderness, breast enlargement, irregular periods or spotting between periods. Topical application of spironolactone may have lower side effects than oral spironolactone, however side effects may still occur. Spironolactone may increase potassium levels in your body, so patients should avoid foods that are high in potassium, such as bananas, coconut water or avocados. Patients should avoid pregnancy on this medication. Spironolactone is a prescription medication, so a medical consultation is required. Happy Head includes the medical consultation for free!
Efficacy of spironolactone 1% for female pattern hair loss. Photos from clinical study by Hamza Abdel-Raouf et al., a novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study.3
Efficacy of spironolactone 1% + Minoxidil 5% for hair loss. Photos from clinical study by Hamza Abdel-Raouf et al., a novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study.3
How Does Topical Spironolactone Work?
Spironolactone helps female pattern hair loss by competitively inhibiting androgen binding to intracellular receptors. In other words, it blocks testosterone binding to testosterone receptors. Testosterone is the hormone responsible for hair thinning. Typically, testosterone is converted into another hormone called dihydrotestosterone, also known as DHT. DHT is responsible for shrinking hair follicles and causing thinning and baldness. Spironolactone competes with testosterone to bind to the testosterone receptors. By doing so, it prevents testosterone from converting into DHT. By effectively reducing the levels of DHT, spironolactone helps to combat female pattern hair loss.
Spironolactone 1%, Minoxidil6%, Retinoic acid 0.01, Hydrocortisone 1%
How Does Happy Head Work?
Since spironolactone is a prescription medication, it requires a doctor’s consultation and prescription. With Happy Head, the doctor’s consultation is free and included when you purchase topical spironolactone. Simply fill out the short medical survey, and a physician will review your medical history and determine your eligibility for our prescription medication. Once approved, the prescription is written, sent electronically to the pharmacy and the medication is shipped out to you in discreet packaging with FedEx 2-day delivery. You will also receive free continuous support from our physicians in case there are any questions or issues.
Disclaimer & Caution:
Results may vary per patient. Results are not guaranteed. Topical spironolactone mixed with minoxidil is a compounded prescription medication. Compounded medications are not FDA approved. Women who may become pregnant or who are pregnant or breastfeeding should avoid using spironolactone. Some side effects may include dizziness or lightheadedness, breast tenderness, breast enlargement, irregular periods, spotting between periods or elevated potassium levels. Spironolactone may increase potassium levels in your body, so patients should avoid foods that are high in potassium, such as bananas, coconut water or avocados. Please see the Drug Safety Information below for more information.
- Famenini Shannon, BS, Slaught Christa, BS, Duan Lewei, MS, and Goh Carolyn, MD. Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy, J Am Acad Dermatol. 2015 Oct; 73(4): 705–706.
- Sinclair R, Wewerinke M, Jolley D. Treatment of female pattern hair loss with oral antiandrogens. Br J Dermatol. 2005;152(3):466–73)
- Hamza Abdel-Raouf, Usama F. Aly, Walid Medhat, Shimaa S. Ahmed, Rasha T. A. Abdel-Aziz. A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study. Dermatologic Therapy. 2021;34:e14678.
- AYMAN E. YOUSEF, M.D. AHMED S. ABDELSHAFY, M.D. and MOUSA A.S. ALMABROUK, M.Sc. Topical Finasteride versus Topical Spironolactone in the Treatment of Androgenetic Alopecia. Med. J. Cairo Univ., Vol. 88, No. 3, June: 1017-1022, 2020