Spironolactone for Hair Loss: How It Works, Dosage, and Side Effects

Medically reviewed by Dr. Shruti Chavan, MBBS Dermatologist
Written by Ramona Sinha

Most women experience hair loss at some point in their lives. Hair loss and hair thinning is prevalent in post-menopausal women due to various underlying reasons. However, this can be treated with spironolactone. This FDA-approved anti-androgen drug can help prevent hair loss (1).

Spironolactone was mainly used to treat hypertension and fluid retention. However, it was found to reduce adrenal androgen production and minimize female pattern hair loss or androgenetic alopecia (1). In this article, we have explored how spironolactone works and how you can use it to prevent hair loss. Scroll down for more information.

What Is Spironolactone?

Spironolactone is an anti-androgen drug. It was mainly used for treating hypertension, symptoms of polycystic ovary syndrome (PCOS) and hirsutism. However, spironolactone prevents adrenal androgen production in the body and thus, minimizes PCOS hair loss or androgenetic alopecia (1). Besides treating female pattern hair loss (FPHL), it may also be beneficial in reducing hirsutism and acne. The section below delves further into how it works to prevent hair loss.

How Does Spironolactone Work?

Spironolactone slows down androgen production. Androgens are a group of male sex hormones, including testosterone. In females with PCOS, excess production of androgens may cause hair loss.  A study found that the daily consumption of spironolactone in the prescribed dosage can reduce hair loss and increase the number of hair follicles in the anagen phase (1).

The dosage of spironolactone depends on the purpose it is being used for.

How Much Of Spironolactone Is Prescribed For Hair Loss?

A study found that a dose of 200 mg of oral spironolactone effectively improved female pattern hair loss (1). Doctors generally prescribe a dosage between 50-200mg of spironolactone for hair loss. However, the dosage may vary, depending on the severity of your hair loss. The doctor may even prescribe a combination of drugs to be taken with spironolactone, such as (1):

  • Spironolactone With Oral Contraceptive: This combination is often used to prevent menstrual irregularities and improve female pattern hair loss and acne.
  • Spironolactone With Minoxidil: A 2% topical minoxidil solution improves hair growth rate and hair thickness by lengthening the anagen (growth) phase and shortening the telogen (hair fall) phase of the hair (2).

Your doctor may also prescribe topical spironolactone for treating hair loss.

Spironolactone: Topical Or Oral?

You may take spironolactone orally or apply a topical solution.

Topical treatment is preferred as it cuts down many possible side effects of oral spironolactone. Research found that 5% spironolactone gel can promote hair growth and is a good option for managing androgenic alopecia (3).

The doctor will evaluate the severity of your hair loss and other complications caused by PCOS and then prescribe either topical or oral spironolactone. Once you start taking it, you may expect results in a few months. However, the duration may vary from person to person.

How Long Does It Take For Spironolactone To Work?

Do not expect overnight results. Spironolactone may take at least six months to show results. However, it may vary, depending on the severity of the condition. You may even notice changes after a year of using the drug.

You have to follow up with your doctor after taking spironolactone for six months. They may even increase the dosage, depending on the results, or suggest a combination of medications.

Spironolactone is not prescribed for everyone. Find out next who can use the drug and who should avoid it.

Who Can Use Spironolactone For Hair Loss?

Spironolactone is mainly prescribed for women with androgenetic alopecia or female pattern hair loss. However, avoid spironolactone if you (4):

  • Have kidney-related issues
  • Have high blood potassium levels
  • Have Addison’s disease
  • Are taking eplerenone (steroid)
  • Are pregnant or nursing

Teenagers below 18 years of age should also avoid this drug. If taken in the wrong way, spironolactone may have some health risks.

What Are The Side Effects Of Spironolactone?

As spironolactone is commonly prescribed for hypertension, some people may experience low blood pressure while using this drug. This is why it is crucial to take it in the prescribed dosage. Otherwise, it may cause issues like (5):

  • Headache
  • Weight loss
  • Fatigue
  • Increased urination
  • Dry skin
  • Decreased libido
  • Drowsiness and nausea
  • Irregular periods
  • Diarrhea
  • Depression
  • Breast tenderness

Overdose of spironolactone may also cause:

  • Breathing problems
  • Rashes
  • Dizziness
  • High potassium levels

High potassium levels can be life-threatening. Visit a doctor immediately if you experience:

  • Weakness
  • Muscle fatigue
  • Abnormal heart rate
  • Paralysis


Spironolactone is an effective drug to treat hair loss caused by androgenic alopecia. However, it may take time to show results. If you are using spironolactone for hair loss, make sure to follow the prescribed dosage and talk to your doctor about any changes your may experience. Also, discuss any underlying health condition you may have with your doctor before trying this drug.

Frequently Asked Questions

Does spironolactone cause hair loss?

No, spironolactone does not cause hair loss. It prevents hair loss caused by androgenetic alopecia.

Does topical spironolactone work for hair loss?

Yes, topical spironolactone works for female pattern hair loss.

Can hair grow back from female pattern baldness?

Yes. Female pattern baldness can be reversed with drugs like spironolactone and minoxidil.

Can spironolactone be used with other treatments?

It depends on the nature of medications. Taking spironolactone with other drugs can increase the potassium levels in the body and cause health risks. Talk to your doctor before taking spironolactone.


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Ramona is a journalist-turned-content writer. She holds a Master’s degree in English Literature and has been writing for the digital world for over five years. She specializes in writing for Skin Care. She has done a certificate course titled ‘Dermatology: Trip To The Skin’, offered by Novosibirsk State University. She believes that beauty begins with a good skin care regimen and is on a mission to eliminate all toxins from her routine. She helps and guides readers in selecting products and ingredients specific to their skin type/issue. When Ramona is not working, her books and passion for music, good food, and traveling keep her busy.