Use of Low-Dose Spironolactone in Female Pattern Hair Loss in a Specialty Alopecia Clinic

April 2023 in “ Journal of Investigative Dermatology ”

S. Devjani, O. Ezemma, K.J. Kelley, M.M. Senna

spironolactone female pattern hair loss FPHL Sinclair scale alopecia hyperkalemia Aldactone

TLDR Low-dose spironolactone effectively treats female pattern hair loss with mild side effects.

A retrospective chart review of 14 adult women with female pattern hair loss (FPHL) treated with low-dose spironolactone (≤50mg daily) at a specialty alopecia clinic showed promising results. The average age of participants was 59 years, and the majority were Caucasian. The average Sinclair scale score decreased from 2.64 to 2.11 after approximately 1 year of treatment. Mild side effects such as breast tenderness, dizziness, nausea, and increased urination were reported but did not lead to discontinuation. No cases of hyperkalemia were observed. The study suggests that low-dose spironolactone is an effective and well-tolerated treatment for FPHL, particularly for patients who cannot tolerate higher doses. Further large-scale studies are recommended to confirm these findings.

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