Spironolactone and Hair Loss

    Kristin Hall, FNP
    Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 8/20/2020

    Female pattern hair loss (FPHL can affect as many as 38 percent of women at some point in their lives. But just because it’s common doesn’t make it any less anxiety-inducing. 

    Losing your hair, noticing a lack of hair growth or even beginning to experience hair thinning can be hard on a woman. 

    Maybe you’ve tried styling it differently, using new volumizing products or doing your best to just hide what’s happening, but at some point, you need to seek help. 

    A healthcare professional can help you look at medical options for your hair loss before it gets any worse. And spironolactone is just one potential solution. 

    TL;DR: What You Need to Know

    Spironolactone is a drug that affects your hormones and could slow or even reverse female pattern hair loss. While high quality research is scant, some studies show benefits in women, particularly those suffering from polycystic ovarian syndrome.   

    What Is Spironolactone? 

    Spironolactone, also sold under the brand name Aldactone®, is a drug approved by the FDA for the treatment of several types of conditions including: low potassium levels, heart failure, edema, hypertension (high blood pressure) and hyperaldosteronism (an excess of the hormone aldosterone). 

    We should also note that some providers may prescribe spiranolactone off-label in other circumstances (like early puberty, hair loss, hirutism and as a male hormone blocker in transgender women).

    How Hair Loss Happens

    There are several kinds of hair loss, but female pattern hair loss, also known as androgenic alopecia or androgenetic alopecia, is the most common among women. 

    It most commonly begins when a woman is in her reproductive years, but increases with age.

    The role of androgens (male sex hormones) in male hair loss is established, but less understood in women. 

    That said, it’s believed androgens, genetic predisposition and environmental factors can all play a role in female pattern hair loss. 

    Women with polycystic ovarian syndrome — characterized by excess androgens — seem to be at a greater risk of hair loss.

    Although FPHL is relatively common, women who suffer from it often feel social and psychological effects including a low self esteem, depression and anxiety.

    Spironolactone Effectiveness in Hair Loss Treatment 

    Spironolactone was first noticed as a potential hair treatment medication when it was prescribed to a woman with polycystic ovarian syndrome and she noticed its effects on her excess body hair, or hirsutism. 

    Although it is not currently approved by the FDA for any dermatologic conditions, spironolactone is now prescribed off-label for hair loss, with some research indicating that it’s the most prescribed drug of its kind for this purpose.

    The research on the effectiveness of spironolactone in hair loss among women isn’t overwhelming, but it is promising. 

    Several small studies have shown that the medication, sometimes used in conjunction with minoxidil, can experience slowed hair loss and even regrowth.

    Spironolactone may be most effective in women suffering from polycystic ovarian syndrome (PCOS), as the disease causes excess androgen production, and spironolactone is an anti-androgen. 

    Sprionolactone does have its share of side effects, which can include everything from lethargy and dizziness to menstrual irregularities, gastritis and many things in between.

    We cover more of spironolactone's side effects in our complete guide to spironolactone.

    Spironolactone has a category C rating from the FDA regarding its use in pregnant women. This means that in animal studies, spironolactone has been shown to potentially affect a fetus. 

    Although there hasn’t been enough research conducted on humans to know definitively, spironolactone may negatively affect the genitalia of male fetuses.

    In other words: do not take spironolactone if you’re pregnant.

    In the treatment of female hair loss, it’s said spironolactone is most effective in women whose hair loss starts before menopause. It’s generally prescribed in doses of 100mg to 200mg per day.

    The Bottom Line

    If you’re one of the 38 percent of women who experience female pattern hair loss and you want to do something about it, spironolactone may be an option for you and your healthcare provider to discuss. 

    Though it’s FDA-approved to treat medical conditions like low potassium levels, heart failure, edema, high blood pressure and hyperaldosteronism, it has shown promise in treating hair loss — particularly in women with PCOS and in conjunction with other hair loss medications like minoxidil. 

    Although, because it does have a considerable list of side effects, you should speak with your healthcare provider before using it as a treatment. If you’d like to know more about spironolactone, head on over to our spironolactone dosage guide, our complete guide to spironolactone side effects and learn more about spironolactone’s other uses.

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.