Topical Spirolactone for Hair Loss Treatment

Q:

I am to have a hair transplant surgery with you this early July. I’ve noticed increased shedding lately and thus have been researching additional pharmacological adjuncts to add to my daily regimen. I am currently taking 1.25 mg Finasteride and shampooing with Nizoral 2% a few times a week. I’ve read online that topical Spironolactone has been used by some with some results, and wanted to know your thoughts. I’ve also found other topical medications ( especially Monoxidil) that I cannot use due to my daily use of concealer. Are there any other medications, topical, shampoos etc. that you can recommend?

Thanks ,

 

A:

Minoxidil and finasteride are the only two FDA approved medications for hair loss treatment.  Nizoral (ketoconazole 5%) is an antifungal and anti dandruff medication that can also affect hair loss in male patterned baldness.  Nizoral is not one of the FDA approved medications for hair loss treatment.  Spironolactone or Aldactone is primarily a medication for treatment of hypertension, but it has some anti-androgenic effects.  Systemic administration of spironolactone has been shown effective in some forms of female hair loss. Spironolactone in its systemic form is not recommended in men due to its side effects such as sexual dysfunction.  There have been limited studies on the topical spironolactone for treatment of acne and hair loss so we don’t recommend topical spironolactone for treatment of hair loss for androgenetic alopecia in men.

If you want to do everything possible to minimize the hair loss, you can add minoxidil to your daily regimen of finasteride.  Minoxidil is recommended to be used twice a day, but once a day could be used as well.  You can use it in the morning before you put on the concealer or at night after you wash them off.  Minoxidil does not double up the effect of finasteride but can add to it as an adjunct treatment.