Right off the bat, let’s dive into something that I know is on a lot of your minds…hair loss topicals such as minoxidil vs hair loss pills such as spironolactone. These options can seem confusing and overwhelming, and as you know, I love to lay out all the deets – the ins, the outs, the pros, and the cons – to give you the full picture.
Spironolactone,
On Jan 21, 1960 Spironolactone received FDA approval as a diuretic. In dermatology, it’s commonly used “off label” in treating female pattern hair loss (also known as androgenetic alopecia). Women with acne and women with hirsutism (increased facial hair) commonly use this medication as well. It was increasingly used in dermatology for these indications starting in the late 1970s.
Spironolactone is the oral medication that is prescribed for women with a diagnosis of Female Pattern Hair Loss (FPHL). It comes in strengths 12.5mg. 25mg, 50mg, and 100mg. Since it is a diuretic, some patients complain of having to visit the bathroom more frequently. Keep in mind if you choose to take this medication, it’s imperative that you increase your water intake so you don’t get dehydrated.
Spironolactone is an anti-androgen which means that it stops the male hormone (testosterone) from working. It does this by affecting a protein that is involved in making testosterone. Because it is blocking one entire group of hormones it can make other hormonal imbalances worse.
The efficacy and safety of Oral Spironolactone is dependent on the diagnosis. This medication will only help women who have a diagnosis of AGA, Androgenic Alopecia. It has great potential is helping women who experience AGA, but we really need to be patient when treating FPHL. Although results can be seen as early as 4-6 months, maximal results are not seen for about 1 year or more for most. This is common due to starting out with a lower dose, then changing it midway, or adding on another layer of treatment such as Minoxidil. It is imperative to start with one treatment before adding another to make sure the efficacy of one is working.
A careful review of side effects with one’s physician is essential in all individuals considering this medication. About one third of patients are going to have side effects such as fatigue, irregular periods, decreased libido, and like mentioned earlier can have you visiting the bathroom more frequently. Studies have shown that it can also cause electrolyte imbalances (low sodium, magnesium, and calcium).
Minoxidil,
Several decades ago, Topical Minoxidil earned its FDA approval as a treatment for both male and female pattern hair loss. This discovery has an interesting backstory: back in the 1970s, some sharp-eyed clinicians and scientists noticed that patients taking oral minoxidil for high blood pressure were experiencing unexpected hair growth, both on their scalps and bodies. This intriguing side effect paved the way for the development of topical minoxidil. As newer and more effective blood pressure medications came onto the scene, oral minoxidil gradually took a backseat in hypertension treatment. Meanwhile, its topical form gained traction as a popular solution for combating hair loss.
Topical Minoxidil remains the only formally FDA approved treatment for FPHL. The purpose of minoxidil is to shorten the telogen (resting) phase, and prolong the anlagen (growth) phase. Minoxidil relaxes arteriolar smooth muscle causing vasodilation by widening the blood vessels, it allows for more oxygen, blood and nutrients to the follicle.
Application of minoxidil does have its own unique set of challenges. Many patients give up after a period of time due to the routine of having to apply it everyday and how it may make the hair feel. But as a former cosmetologist with over 15 years in the industry, I have given my clients a great solution to applying the minoxidil so it doesn’t leave any residue on the hair. Not to mention, the one my clients use, doesn’t contain alcohol. This is important when choosing your topicals. The higher the alcohol content, the efficacy of the minoxidil decreases.
Realistic expectations for hair growth using topical minoxidil, it’s important to set appropriate timeframes and acknowledge individual variability. Clinical studies show that minoxidil can stimulate hair growth, but results vary significantly among users. Typically, users might start noticing some improvement in hair density and coverage within the first 3 to 6 months of consistent use. However, it’s crucial to understand that maximal results often require at least 6 months to a year of regular application. It’s also important to note that stopping the treatment can reverse its effects, leading to resumed hair loss. The variability in response is attributed to factors such as the underlying cause of hair loss, age, and the pattern of baldness.
In summary, minoxidil and spironolactone have demonstrated effectiveness in promoting hair growth for many individuals, but it’s important to recognize that these treatments are not universally effective. Individual results can vary significantly, making it crucial for users to manage their expectations realistically. Moreover, the effectiveness of these medications can be influenced by the specific diagnosis of hair loss, underlying health conditions, and concurrent use of other medications. Therefore, seeking professional medical advice before starting any treatment is essential. In some cases, a multi-therapeutic approach may be recommended, potentially combining these medications with other treatments like Low-Level Laser Therapy (LLLT) or additional topical or oral medications. This holistic approach ensures that treatment is tailored to individual needs, enhancing the likelihood of satisfactory results.
Until next week my friends,
Laura