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Women experiencing hair loss do not have all the same options as men when it comes to treating them. Propecia, for example, is a proven hair restoration medication that does not provide the same benefit for women as it does for male patients. Fortunately, there is now a medication just for women that can help stop some types of hair loss. Spironolactone, also known as Aldactone, is a diuretic approved for treatment of hypertension and heart failure. However, when used off-label, it offers useful improvement in conditions like acne, polycystic ovarian syndrome (POS) and female hair loss.

The Science behind Spironolactone ’s Success

Spironolactone is classified as a potassium-sparing diuretic, which is designed to address fluid retention in the body. It also serves as an androgen antagonist or “anti-androgen,” which is why the medication is helpful for some women experiencing androgenetic alopecia, or hair loss caused by androgens. Androgens are primarily male hormones that are also found in the female body. When they occur at higher levels than usual, women can suffer from the same type of pattern baldness men frequently see in the middle years of life.

Dihydrotestosterone, a derivative of testosterone, is the culprit behind hair loss in both men and women. This hormone binds to the cells in the hair follicle, causing it to shrink. As the follicle grows smaller, the hair growing inside becomes thinner. Over time, the follicle becomes too small to produce any hair at all and becomes unable to function correctly. The hair growth phase diminishes, and baldness becomes noticeable.

Types of Female Hair Loss

There are different types of hair loss in women, and each one occurs for a different reason:

  • Androgenetic Alopecia – hair loss due to androgens that damage the hair follicles over time
  • Telogen Effluvium – loss of hair after a stressful event like childbirth, illness or major surgery, generally temporary although some cases may last for many years
  • Anagen Effluvium – chemotherapy-induced hair loss, temporary in most patients
  • Traction Alopecia – loss caused by trauma to the follicles due to some tight hairstyles

Best Candidates for Spironolactone

Because it’s primary purpose is to lower DHT levels in the body, Spironolactone only works on hair loss caused by androgens. In most cases, a blood test will let Dr. Maas know if hormones are the culprit in your hair loss. If so, he may recommend treatment with Spironolactone alone or in combination with a topical medication known as minoxidil or Rogaine. His experience with both male and female hair loss, as well as his range of hair restoration options, will ensure you receive the best type of treatment for your needs.

Does It Work? Research Says Yes

While Spironolactone has not been approved as a hair loss treatment at this time, there have been studies to support its efficacy in this area. A study published in the Journal of the American Academy of Dermatology in 2015 found that Spironolactone offered positive results for around three-fourths of the women that used it. A 2017 study in the International Journal of Dermatology also found that a combination of Spironolactone and minoxidil were a safe and effective treatment for female pattern hair loss. Another study published this same year in the International Journal of Women’s Dermatology found Spironolactone to be effective in stopping hair loss in 75 percent of the women included in the study.

Treatment Overview and Possible Side Effects

The dose of Spironolactone prescribed by Dr. Maas will vary from 100 to 200 mg. daily. This medication is not advised for women who are pregnant or breastfeeding due to potentially dangerous side effects on the child. Side effects for women tend to be relatively mild and include increased urination, lower blood pressure and irregular menstrual periods for some women. Side effects generally resolve once the medication is stopped. It is usually best to begin this treatment before menopause. In fact, women that start the therapy early enough may find they can stop treatment after a period without reversing the positive effects.

Hair Restoration Over Time

Results are not seen with spironolactone right away, even if it has an immediate effect on DHT levels. Women may not see noticeable changes in their hair loss for six months to one year. If the medication is combined with minoxidil, the results may become evident sooner. Some women will find that if they stop taking the Spironolactone, the follicles will shrink once again, and the hair loss may resume.

If you are worried about hair loss, Dr. Maas and the staff at The Maas ClinicTM has a wide range of treatment options that might help. Contact us today and schedule your consultation with Dr. Maas at (415) 567-7000 or contact us by email.

It is never too late, To be what you might have been.- George Eliot