A Randomized Trial of 5% Minoxidil Versus Combination of 5% Minoxidil and Oral Spironolactone in Treatment of Female Pattern Hair Loss

    Nachiket Madhukarrao Palaskar, Nitin K. Chaudhari, Garima Laxminarayan Balpande, Swapna S Khatu
    TLDR Combining minoxidil and spironolactone is more effective for female hair loss, but minoxidil alone is sufficient after 6 months.
    The study compared the effectiveness and safety of 5% topical minoxidil alone versus a combination of 5% topical minoxidil and oral spironolactone in treating female pattern hair loss (FPHL) in 100 patients. Results showed that after 6 months, the combination therapy group had a significantly lower mean Sinclair grade (2.56±0.50) compared to the minoxidil-only group (2.85±0.68, p=0.02). Additionally, the combination therapy group reported a significant improvement in quality of life at 12 months (26.93±2.25 vs 23.47±2.95, p<0.001). Both treatments were well-tolerated. The study concluded that the combination therapy had an additive effect, but its effectiveness plateaued at 6 months, recommending continuation with minoxidil alone thereafter.
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