Spironolactone in Female Pattern Hair Loss

Action

Spironolactone is considered in some women with pattern hair loss because of its antiandrogen properties.

Evidence

Clinical series and consensus recommendations suggest potential benefit, but randomised evidence is not equally strong across patient groups.

Adverse effects

Menstrual irregularity, breast tenderness, dizziness, hypotension and hyperkalaemia can occur. Kidney disease and interactions matter.

Pregnancy

It is not suitable during pregnancy. Pregnancy possibility and contraception should be discussed with the physician.

Before surgery

Thyroid disease, iron deficiency, hyperandrogenism and coexisting telogen effluvium should be considered before a surgical decision.

Limits of the evidence

These are selected clinical sources and expert recommendations, not a new systematic review. Formulations, participants, controls, follow-up and adverse-event reporting differ. Positive findings do not establish identical benefit or local authorisation for every patient or product.

Topic-specific questions

Scientific references

1. Rosenthal A et al. Management of androgenic alopecia: a systematic review of the literature. J Cosmet Laser Ther. 2024. DOI: 10.1080/14764172.2024.2362126. https://pubmed.ncbi.nlm.nih.gov/38852607/
2. Landells I et al. A Canadian Consensus on Androgenetic Alopecia: Approach and Management. J Cutan Med Surg. 2025. DOI: 10.1177/12034754251368849. https://pubmed.ncbi.nlm.nih.gov/40986632/
3. Vañó-Galván S et al. A Consensus Statement From the Spanish Hair Disorders Group of the Spanish Academy of Dermatology and Venereology on the Management of Androgenetic Alopecia. 2024. https://doi.org/10.1016/j.ad.2023.10.043
4. American Academy of Dermatology. Hair loss: Diagnosis and treatment. https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat