The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review

This systematic review evaluated the efficacy and safety of oral and topical spironolactone in treating androgenetic alopecia (AGA) across 7 studies with 618 patients (65 men and 553 women). The review found that spironolactone, both oral and topical, showed promise in increasing hair density and diameter with manageable adverse effects. Specifically, 81% of 295 female patients on oral spironolactone reported hair growth improvement, and combined therapy with spironolactone and other treatments was effective in 94.5% of 273 patients. Adverse effects were generally mild, including menstrual disorders and headaches. The review supports spironolactone as a viable treatment for AGA, especially for those unresponsive to traditional therapies like minoxidil and finasteride, though more high-quality studies are needed to further validate these findings.