Using spironolactone for hair loss can be somewhat effective, but only when the drug is prepared in a 5% cream solution. The dosage that one would have to take in pill form would greatly increase the risk of side effects, such as hyperkalemia. This drug is typically used to treat patients who have hyperaldosteronism, low potassium or edema.
Spironolactone is a diuretic and has a long list of side effects that accompany it. It can cause drowsiness, nausea, rashes, headaches and jaundice. There are other possible side effects as well, and this makes using standard spironolactone for hair loss problematic. Spironolactone, however, has been found to be an anti-androgen, which means that it could actually reduce hair loss.
Androgens are hormones that are directly responsible for the rate of hair growth. There are many different types of androgen, and scientists found that when androgens were present around the hair follicles, the follicles got weaker. Eventually, they identified the androgen dihydrotestosterone (DHT) as the one responsible for male pattern baldness and the one that is tied to hair loss. Anti-androgens must be targeted to specific androgens to be effective. As a treatment, spironolactone for hair loss works, because it is identified as an anti-androgen.
The only thing stopping spironolactone from being an effective treatment for hair loss is the fact that the dosage of the pill that would be required to significantly reduce levels of DHT would cause adverse effects. The solution to this problem has been the use of a cream version. The concentration of the drug is only 5% in the preparation, referred to as topical spironolactone, and has been shown to produce local effects in the amount of DHT present in subjects.
Even though the cream can be used to potentially stop hair loss, the treatment cannot be used to cause the regrowth of hair. Also, when using topical spironolactone for hair loss, medical professionals might suggest combining it with a more effective anti-androgen such as finasteride. The effectiveness of spironolactone might differ from person to person, and it is advisable for one to speak with a medical professional before undergoing any treatment. Preliminary results have found, however, no side effects from using the topical spironolactone cream.