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Hair Health

Topical Spironolactone for Women: 2023 Insights & Benefits

Hair loss isn’t a “male only” or “female only” issue — it’s an “everyone” issue! Most people will experience some hair loss as they age. The most common cause of hair loss for both men and women, after all, is the same condition, called androgenetic alopecia. And this hair loss disorder affects 40% of women. (01) Despite this fact, however, most hair loss treatments cater to men. Fortunately, women have their own “women only” medicated treatment in their arsenal to combat women’s hair loss — Topical Spironolactone.

What is Spironolactone?

Before discussing topical Spironolactone, we should get familiar with the oral version. Oral Spironolactone, an FDA-approved medication, is typically prescribed for blood pressure treatment. The medicine is a potassium-sparing diuretic (water pill) that prevents low potassium (which is essential for the heart). (02)

Another off-label use for Oral Spironolactone is as a women-only treatment for hair loss. Spironolactone is an excellent treatment for women’s hair loss because it blocks Testosterone and prevents Dihydrotestosterone (DHT) from forming. DHT is the culprit for both male and female pattern baldness and hair loss. Topical Spironolactone generally has fewer side effects than Oral Spironolactone.

Does oral Spironolactone have side effects?

As an oral medication, the effectiveness of Spironolactone is highly dose-dependent. This also means that the side effects of Spironolactone are dose-dependent, also. (03) So, although higher doses of oral Spironolactone are much more effective, those higher doses also result in more severe side effects. In many cases, the individuals stop treatment due to the side effects of oral spironolactone.

The possible side effects of oral spironolactone in women include: (04)

  • Painful periods
  • Painful cramping
  • Irregular periods
  • Breast tenderness
  • Breast enlargement
  • Fatigue
  • Reduced libido
  • Headaches
  • Dizziness
  • Menstrual irregularities

Hyperkalemia is likely the most concerning side-effect caused by oral spironolactone. (04) While hyperkalemia in a healthy young woman is not a significant concern, the condition may pose a danger for older women and in women with heart problems or kidney disorders.

How is topical Spironolactone different?

While oral Spironolactone is ingested, topical Spironolactone is administered onto the skin or scalp. Because topical spironolactone skips the digestive system and doesn’t enter the bloodstream, the topical version’s side effects are milder (or none) but with the same hair growth efficacy. Topical Spironolactone also acts directly on the area that needs attention the most — hair follicles. Oral Spironolactone, on the other hand, must journey all throughout the body to get to its intended destination.

How does topical Spironolactone affect hair follicles?

Hair follicles are critical to hair growth and maintenance. Healthy hair follicles produce and keep hair according to the hair’s natural growth cycle. Too much DHT, however, causes hair follicles to shrink over time until they no longer grow hair.

Spironolactone encourages hair growth by preventing the development of DHT and other androgen hormones. Topical Spironolactone also targets the DHT receptors at the hair follicles, preventing — and sometimes reversing — the shrunken follicles.

Why is topical Spironolactone for women only?

The exact process that makes Spironolactone so successful (blocking DHT and androgens) is also what makes the medication unpleasant for men. Testosterone, for example, is primarily an androgen hormone found in males. Blocking androgens like Testosterone in a healthy male may cause undesirable side effects.

To make a vital point, exceptionally high doses of spironolactone are often prescribed to men wishing to undergo gender transition into women. Therefore, oral or topical spironolactone is typically prescribed for women only.

Is spironolactone an effective treatment for women’s hair loss?

Two studies highlight the effectiveness of spironolactone for hair treatment on women. A 2015 study found that 74% percent of research participants with hair loss found an improvement in hair growth. (05) The authors concluded that spironolactone is an effective treatment for women’s hair loss, especially for those with high levels of androgen hormones.

Another study compared topical spironolactone to topical finasteride. A sample of 32 patients was treated with one of either topical solution for six months. When surveyed after treatment, 100% of participants were satisfied with their results. (06) However, topical spironolactone was a viable alternative to topical finasteride, as finasteride generated more side effects.

How long does topical Spironolactone take to work?

As with most hair loss treatments, results may take time. Topical Spironolactone may take as early as three months and up to six months of consistent treatment for results to show. Sometimes, waiting for changes in hair loss is frustrating, but the results are worthwhile.

Is topical spironolactone safe for women?

Topical Spironolactone is safe if taken correctly and under a doctor’s supervision. To avoid side effects or contraindications, women should tell their doctor if they are pregnant or breastfeeding. In addition, women should inform the doctor about any history of:

  • Liver disease
  • Kidney disease
  • High potassium
  • Addison’s disease
  • Electrolyte imbalance

Individuals with kidney (renal) conditions should not take spironolactone. Because the medication is a diuretic (which causes people to urinate), it affects the kidneys and can cause dehydration. (07)

People who take spironolactone must remain hydrated, especially during hot weather. When taking spironolactone, it’s essential to be on the lookout for signs of severe dehydration like: (01)

  • Infrequent urination
  • Dark-colored urine
  • Confusion
  • Extreme thirst

Spironolactone affects the balance of the sex hormones, causing “feminizing” characteristics in men, including erectile dysfunction. In women, however, this topical spironolactone is much less likely to cause such side effects, making topical spironolactone an ideal women’s hair loss medication.

Does topical Spironolactone cause weight gain?

Because hormones play such a significant role in weight, people often wonder whether specific medications that affect hormones cause weight gain. One side-effect of spironolactone is weight loss, particularly in women who hold a significant amount of water weight.

Spironolactone is a diuretic, therefore the medication flushes out excess water. Reducing fluid retention within the body can result in weight loss. But this weight loss is not the same as healthy weight loss using diet and exercise and may not be sustainable.

How can I place an order from Happy Head?

At Happy Head, topical Spironolactone for women only is prescribed by a physician after a free consultation with purchase. The consultation consists of a short medical survey, and a physician will review your medical history. A Happy Head physician will collaborate with you to determine your eligibility and find the appropriate medication.

The topical spironolactone dosage is as follows:

  • Spironolactone 1.0%
  • Minoxidil 6.0%
  • Retinoic acid 0.01%
  • Hydrocortisone 1.0%

After approval, a Happy Head physician authorizes your prescription, sent electronically to a pharmacy. The medication is sent to you in a discreet package with FedEx’s 2-day delivery. As part of your package, you’ll also have support from our physicians and staff for any questions and concerns.

Does topical spironolactone work for hair loss?

Topical spironolactone has been studied as a potential treatment for hair loss, specifically androgenetic alopecia (male and female pattern hair loss). Spironolactone is an aldosterone antagonist, which means it blocks the effects of the hormone aldosterone. In addition to its use as a diuretic, it has been found to have anti-androgenic properties, meaning it can block the action of androgens like dihydrotestosterone (DHT), which is a key contributor to hair loss in androgenetic alopecia.

If you are considering using topical spironolactone for hair loss, it is important to consult with a dermatologist or healthcare professional. They can help you determine if this treatment is appropriate for your specific situation and provide guidance on potential side effects and monitoring.

Is there a topical version of spironolactone or only oral spironolactone?

Yes, there is a topical version of Spironolactone. Topical spironolactone is a formulation of the drug that can be applied directly to the skin. It has been studied as a potential treatment for hair loss, acne, and other skin conditions related to hormonal imbalances.

Spironolactone gel is a topical formulation of Spironolactone medication designed to be applied directly to the skin. It has been studied for treating various skin conditions related to hormonal imbalances, such as acne, hirsutism, and androgenetic alopecia (hair loss).

What are the benefits of topical spironolactone?

Topical Spironolactone has been studied for its potential benefits in treating various skin conditions related to hormonal imbalances, such as acne treatment, hirsutism, and androgenetic alopecia (hair loss). Some benefits of using a topical formulation of spironolactone may include:

  1. Targeted Hair Loss Treatment: Topical spironolactone is applied directly to the affected area, which may allow for more targeted treatment of specific skin conditions.
  2. Reduced systemic effects: Topical formulations generally have lower systemic absorption compared to oral medications. This means that the drug is less likely to cause side effects throughout the body, as it is not absorbed into the bloodstream to the same extent as oral spironolactone.
  3. Anti-androgenic properties: Topical spironolactone has been found to have anti-androgenic effects, which means it can help block the action of androgens like dihydrotestosterone (DHT). Androgens play a significant role in conditions like acne and androgenetic alopecia, so blocking their action may be beneficial in treating these conditions.
  4. Potential alternative for those who cannot tolerate oral spironolactone: Some individuals may not tolerate oral spironolactone due to side effects or contraindications. Topical spironolactone may provide an alternative treatment option for these individuals.

Can sebum production cause hair loss in women?

Sebum is an oily substance produced by the sebaceous glands in the skin. It is composed of lipids, including triglycerides, fatty acids, wax esters, and squalene. Sebum has several functions, including moisturizing and protecting the skin and hair, maintaining skin flexibility, and providing a barrier against water loss and external irritants.

Sebum production can be influenced by various factors, including hormonal fluctuations, genetics, and environmental factors. Overproduction of sebum can lead to oily skin and scalp, which may contribute to certain skin conditions such as acne. However, sebum production is not a direct cause of hair loss.

Hair loss, specifically androgenetic alopecia (male and female pattern hair loss), is primarily caused by a combination of genetic predisposition and hormonal factors, particularly dihydrotestosterone (DHT). DHT is a more potent form of testosterone that can bind to hair follicles, causing them to miniaturize and eventually stop producing hair.

While sebum itself does not cause hair loss, excessive sebum production can create an environment that might exacerbate existing hair loss conditions or make the scalp more prone to issues such as dandruff or scalp inflammation. These factors may indirectly affect hair health, but they are not the primary cause of hair loss in androgenetic alopecia.

Maintaining a healthy scalp by regularly cleansing and using hair care products formulated for your specific hair and scalp needs can help manage sebum oil production and promote overall hair health. If you are experiencing hair loss or concerned about your scalp health, it is best to consult with a dermatologist or healthcare professional for personalized advice and potential treatment options.

What is Acne Vulgaris?

Acne vulgaris, commonly known as acne, is a skin condition that occurs when hair follicles become clogged with oil (sebum) and dead skin cells. The formation of various skin lesions, including blackheads, whiteheads, pimples, papules, pustules, and nodules, characterizes it. Acne is most commonly seen on the face, chest, back, and shoulders, although it can also occur in other body areas.

Another similar type is hormonal acne which is triggered by hormonal fluctuations, often characterized by breakouts around the chin, jawline, and cheeks. It’s commonly experienced during puberty, menstruation, pregnancy, or due to conditions such as polycystic ovary syndrome (PCOS).

Primarily, acne happens by hormonal fluctuations, increased sebum production, and Propionibacterium acnes (P. acnes) on the skin. However, other factors, such as genetics, stress, and diet, may also contribute to the development of acne.

While acne vulgaris and hair loss are different conditions, they may be indirectly related in some cases:

  1. Inflammation: Inflammatory acne lesions, such as papules and pustules, can cause localized inflammation and damage to the skin and surrounding hair follicles. This inflammation may weaken hair follicles and contribute to hair loss. However, this would typically be limited to the area directly affected by acne lesions.
  2. Hairstyling and hair care products: Some hair care products, such as heavy oils and styling products, can contribute to acne if they come into contact with the skin and clog hair follicles. In these cases, hair loss might be indirectly related to acne, as hair products may cause both conditions.
  3. Psychological stress: Acne can be a source of emotional distress for many individuals, and stress has been linked to various forms of hair loss, such as telogen effluvium and alopecia areata. In this context, the relationship between acne and hair loss would be mediated by psychological factors rather than a direct effect of acne on hair follicles.


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