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Spironolactone For Hair Loss: Does It Really Work 2024?

Susan Adeosun

Updated on - Written by
Medically reviewed by Kathy Shattler, MS, RDN

spironolactone for hair loss
Spironolactone for hair loss is often recommended for women. Photo: sweet_tomato/Freepik

Hair loss can be a distressing experience for many. It affects not only one’s appearance but also their self-esteem and confidence. With many treatments available in the market, finding the right solution for your specific needs can be overwhelming.

Spironolactone, initially developed as a potassium-sparing diuretic, is commonly prescribed to treat conditions such as high blood pressure, heart failure, and edema. But, as with many medications, its off-label uses have expanded. 

One such use that has gained considerable attention is its potential to treat hair loss, specifically female pattern alopecia. In this article, we will explore the potential benefits of spironolactone for hair loss, and we will see its mechanism of action for hair growth and whether it truly lives up to the hype. So, let’s dive in and uncover the truth behind spironolactone hair loss treatment and its impact on hair regrowth.

Does Spironolactone Help With Hair Loss?

Yes, Spironolactone can help with hair loss treatments, particularly in cases of androgenetic alopecia in women. It works by opposing the testosterone in the hair follicles and reducing hair loss. However, it may take up to a year to see noticeable results.

Spironolactone For Hair Loss: What Is It?

Spironolactone is a medication that belongs to a class of drugs called potassium-sparing diuretics. It was originally developed to treat conditions like high blood pressure, edema (fluid retention), and certain hormonal imbalances. It is also FDA-approved for treating heart failure and abnormally high aldosterone levels.

Oral Spironolactone primarily works by helping the body eliminate excess fluid and sodium while retaining potassium. It has also shown promise in clinical practice. This has led to its exploration as an off-label option for individuals seeking to address hair thinning and loss. It treats hair loss,[1] specifically androgenetic alopecia[2] in women.

How Does Spironolactone Work For Hair Loss? 

Does spironolactone help with hair loss? Spironolactone’s mechanism of action in addressing hair loss is primarily attributed to its anti-androgenic properties. Let’s look at the relationship between hormones and hair growth to understand how spironolactone and hair loss works.

In some instances of female pattern hair loss, hormonal imbalances and sensitivity to androgens[3] like testosterone contribute to the thinning of hair follicles and subsequent hair loss. Androgens can bind to specific receptors in hair follicles, leading to a process called miniaturization. This process causes the hair follicles to shrink over time, resulting in thinner and weaker hair strands.

Here’s where spironolactone comes into play. It is often prescribed as a last resort when medications like Minoxidil do not work. Doctors also recommend spironolactone for hair growth on the face and other unlikely places—a condition known as hirsutism.[4]

As an anti-androgen, it blocks the effects of androgens, particularly testosterone, in the body. By doing so, spironolactone aims to interrupt the miniaturization process and prevent further hair follicle damage. This can potentially lead to improved hair density, thickness, and regrowth.

Research suggests that spironolactone, alone or combined with minoxidil, can provide positive outcomes for individuals experiencing hair loss.[5] Many participants have reported improvements, such as reduced shedding, increased hair regrowth, and thicker hair.

Additionally, spironolactone can indirectly stop hair loss through its diuretic properties. It does so by promoting the excretion of excess fluid and reducing edema. Thus, it may help improve blood flow to the scalp. This enhanced circulation can deliver essential nutrients and oxygen to the hair follicles, creating a favorable environment for healthy hair growth.

Side Effects Of Spironolactone 

While spironolactone can be an effective medication for certain conditions, it is important to be aware of potential side effects[6] that may occur–especially in hair treatment. Some even wonder, “Can spironolactone cause hair loss in rare cases?”

Remember, everyone’s response to medication can vary, and not everyone will experience side effects.[7] Here are some of the most common side effects of spironolactone:

  • Increased urination: Spironolactone is a diuretic. It increases urine production. As a result, you may experience more frequent trips to the bathroom.
  • Low blood pressure: If you are using spironolactone for its antiandrogenic effects on hair loss, it might cause low blood pressure as a direct result.
  • Dizziness or lightheadedness: You may feel dizzy or lightheaded, especially when standing up quickly, often called postural hypotension. This is attributed to spironolactone’s ability to lower blood pressure.
  • Breast tenderness or enlargement: Spironolactone can affect hormone levels, leading to breast tenderness or, in some cases, breast enlargement. This side effect is more commonly observed in males.
  • Electrolyte imbalances: This drug can affect the balance of electrolytes[8] in the body, particularly potassium. Monitoring your electrolyte levels through regular blood tests is essential, as both high and low potassium levels can have adverse effects.
  • Skin reactions: Although rare, some people may develop skin reactions like rashes or hives due to taking this medication.

Additionally, spironolactone is contraindicated in certain individuals with pre-existing conditions, such as kidney dysfunction or high potassium levels in the blood. It can also interact with other medications, including certain blood pressure medications and potassium supplements. 

Therefore, it’s essential to disclose your full medical history and provide a comprehensive list of medications, supplements, and herbal remedies you are taking to your healthcare professional.

Using Spironolactone For Hair Loss Safely

Spironolactone hair growth success depends on how well you use it. Using spironolactone as directed by your doctor is crucial. In one study on low-dose therapy for female pattern alopecia, researchers prescribed a daily dosage[9] of 50 milligrams for effective hair loss treatment in women. 

Typically, 100-200 milligrams[1] are prescribed for this condition despite the effectiveness of low-dose therapy. However, to minimize the risk of side effects, doctors may advise starting with a 25-milligram daily dose and gradually increasing it as needed. 

After that, keep regular appointments with your doctor to track your progress and adjust the dosage if necessary. Your doctor may also order blood tests to monitor your potassium levels and kidney function while on Spironolactone. 

How Long Does It Take To Work?

Use it for a while before seeing results. Sometimes, it takes about six months[1] to start seeing results.

By following these guidelines and staying in close communication with your healthcare provider, you can safely use Spironolactone for hair loss treatment.

Tips For Reducing Hair Loss

Reducing hair loss involves lifestyle changes and proper hair care. In some cases, medical treatment may be needed. Here are some tips to help you minimize hair loss:

Eat A Balanced Diet

Eat A Balanced Diet
A balanced diet makes a difference in your hair’s health. Photo: master1305/Freepik

Fill your diet with vitamins, minerals, and proteins. They help promote healthy hair growth. These include foods high in vitamins A, B, C, D, and E, zinc, biotin, iron, and omega-3 fatty acids.

Avoid Tight Hairstyles

Pulling on the hair, such as tight ponytails, braids, or buns, can cause hair breakage and traction alopecia[10] over time. Opt for loose hairstyles instead.

Limit Heat Styling

Heat styling is a common fashion choice for women. But, excessive use of heat-styling tools like hairdryers, curling irons, and straighteners can weaken hair and lead to breakage. Use these tools sparingly and on the lowest heat setting possible.

Avoid Harsh Chemicals

Avoid Harsh Chemicals
Harsh chemicals are often dangerous for the hair. Photo: Anna Leshchenko/Freepik

Hair treatments like coloring, perming, and relaxing can damage hair and cause hair loss. Limit the use of these treatments or seek professional help for their application.

Manage Stress

Engaging in stress-reducing techniques can help manage the impact of stress on hair loss. Incorporating practices such as meditation, yoga, deep breathing exercises, or mindfulness can promote relaxation and reduce stress levels.

Regular exercise, which releases endorphins and promotes overall well-being, can also be beneficial. Additionally, ensuring you get enough sleep is vital, as restorative sleep aids in stress reduction.

Consider Medical Treatments

If your hair loss is due to a medical condition such as polycystic ovary syndrome or other hormonal imbalances, consult your healthcare provider for appropriate treatment options for increased hair growth. These may include medications like OTC minoxidil or prescription medications such as finasteride or spironolactone therapy.

The Bottom Line

In conclusion, spironolactone is a potential option for treating hair loss, particularly in female pattern hair loss with hormonal imbalances. While it is primarily prescribed as a diuretic, its anti-androgenic properties make it useful for managing hair loss. However, spironolactone should only be used under the supervision of a healthcare professional who can assess your needs and monitor your progress.

Nevertheless, like any medication, spironolactone has potential side effects and contraindications. Regular monitoring and follow-up appointments with your healthcare professional to address medical questions and achieve positive results are essential to ensure the effective and safe treatment for thinning hair or hair loss.


+ 10 sources

Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here

  1. Burns, L.J., Brianna De Souza, Flynn, E., Hagigeorges, D. and Senna, M.M. (2020). Spironolactone for treatment of female pattern hair loss. [online] 83(1), pp.276–278. doi:https://doi.org/10.1016/j.jaad.2020.03.087.
  2. Wang, C., Du, Y., Bi, L., Lin, X., Zhao, M. and Fan, W. (2023). The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review. [online] Volume 16, pp.603–612. doi:https://doi.org/10.2147/ccid.s398950.
  3. Famenini, S., Slaught, C., Duan, L. and Goh, C. (2015). Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. [online] 73(4), pp.705–706. doi:https://doi.org/10.1016/j.jaad.2015.06.063.
  4. Amer, R.I., Yassin, G.E., Reem Babiker Mohamed and Fayez, A.M. (2021). Pharmaceutical and Pharmacological Evaluation of the Effect of Nano-Formulated Spironolactone and Progesterone on Inflammation and Hormonal Levels for Managing Hirsutism Experimentally Induced in Rats. [online] 22(5). doi:https://doi.org/10.1208/s12249-021-02003-z.
  5. Sinclair, R. (2018). Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. [online] 57(1), pp.104–109. doi:https://doi.org/10.1111/ijd.13838.
  6. https://www.facebook.com/Drugscom (2022). Spironolactone Side Effects: Common, Severe, Long Term. [online] Drugs.com. Available at: https://www.drugs.com/sfx/spironolactone-side-effects.html
  7. NHS Choices (2023). Side effects of spironolactone – Brand name: Aldactone. [online] Available at: https://www.nhs.uk/medicines/spironolactone/side-effects-of-spironolactone/
  8. Abdurasool Almedeny S;Yasir Al-Mayah J;Abdulzahra MS;Hadi NR (2021). THE EFFECT OF SPIRONOLACTONE ON SERUM ELECTROLYTES AND RENAL FUNCTION TESTS IN PATIENTS WITH SEVERE CHRONIC HEART FAILURE. Wiadomosci lekarskie (Warsaw, Poland : 1960), [online] 74(10 pt 1). Available at: https://pubmed.ncbi.nlm.nih.gov/34897004/
  9. Europe PMC (2016). Europe PMC. [online] Europepmc.org. Available at: https://europepmc.org/article/med/2880814
  10. Clinical, Cosmetic and Investigational Dermatology. (2018). Traction alopecia: the root of the problem. [online] Available at: https://www.tandfonline.com/doi/full/10.2147/CCID.S137296
Susan Adeosun

Written by:

Susan Adeosun, Dr.

Medically reviewed by:

Kathy Shattler

Dr Susan Adeosun (MPH, MD) is a Medical Doctor and Public Health enthusiast. She has over five years' worth of experience in public health and preventive medicine and is a firm believer in the famous phrase by Dutch philosopher Desiderius Erasmus, “prevention is better than cure.” Her journey through public health, combined with her love for writing, has resulted in the publication of several health articles on various blogs, websites, and peer review journals. When she is not advocating for better health education, she spends her time reading, cooking, and hanging out with friends.

Medically reviewed by:

Kathy Shattler

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