I am 42 and have had acne on and off since the age of 13. I've taken EVERY medication with the exception of Accutane, but find that Spironolactone works the best (in conjunction with Tazarac and Benzaclyn). I've recently started taking a dose of 100mg/day - up from my original 50 mg -and I've noticed that my hair is coming out like crazy! If you've noticed this too, do you have any suggestions for me?
Has anyone experienced hair loss while taking spironolactone?
- Asked
- 20 Jan 2013 by nw1970
- Updated
- 13 October 2021 (4 days ago)
- Topics
- acne, spironolactone, medication
48 Answers
Margie N
4 Mar 2013
Today I had my annual visit with my cardiologist - I have cardiomyopathy. I mentioned that I had had blood tests to check that I did not have a thyroid problem as my hair was thinning dreadfully. I am 70. She immediately told me that that was caused by the 25mg daily Spironolactone dosage I take. I was extremely upset and she has taken me off the drug, which I've been on for several years, and I'm to see her again in six months time to see if the hair loss has stopped. My hair has always been fine, but at least you couldn't see my scalp, unlike how it is now. If I die earlier, at least I won't be bald - I hope.
pecosdog
20 May 2013
HOLY COW! I first started taking this med when I turned @ 40 as I was having cystic acne - my dermatologist referred to it as "hormonal acne". Initially I didn't notice hair loss. At least not enough that it bothered me greatly. Over time I began to see a slight change. My prescription ran out and I was off the med for almost a month. When I restarted it my hair began coming out in handfuls. In the shower, in my brush, in my hand, on the bed pillow... it has been unbelievable. My scalp is showing. I have been off of it for about a week. So far a little improvement, but this morning after showering it was coming out in handfuls again. I hope that this is a reversible side affect.
My dermatologist didn't confirm that the med was causing this side affect as I haven't been in for a visit, but instead I saw it as the ONLY recent change in my life. After some searching on-line I found this to be a side affect for some.
Hang in there and let me know if you see improvement after stopping use of it.
Smithie
21 Dec 2014
I saw improvement when I stopped using Spiro! Try using bicalutamide or duasteride instead of Spiro. It is more appropriate for androgenic issues than spiro is, in my opinion, but it could come with more health-risky side effects. Definitely worth a discussion with your doctor, though- hair loss is not okay.
pecosdog
19 Apr 2015
Following up after 2 years. Two - three months after I quit the medication my hair stopped falling out. The rate of hair loss slowed during that time, but it did continue. It's only now 2 years later that I truly feel like my hair is in normal cycles of loss and regrowth. I recently went to a new dermatologist to get treatment for cystic acne. When she suggested I start a course of the med I told her my observations. She absolutely poo-pooed the idea that this could cause hair loss.
Anyway. I guess some docs disagree with this, but the proof is there for me. I get facials as often as I can, invested in a Clarisonic, make sure I exfoliate and NeVer! ever try to mess with the acne. It just has to pass, but it comes up much less frequently with this regime. Hang in there!
nwierback
26 Sep 2015
I am 50 years old and have had cystic acne since my teens. I took Acutane in my 20's and it helped for a long time until the pass year or so when I hit menopause. Now it's back and I'v been on Spiro for over 6 months and I've been so stressed about what's been causing my massive hair loss and thanks to this site, I now know I was right. I even went to my dermatologist about my hair loss and she didn't say anything about the possibility of it being the Spiro. I will go on Acutane again before I ever take another Spiro again. I'm quitting as of now. Hope it doesn't take 2 years to get my hair back.
Trinitytx
6 Jun 2016
Your post comforts me some. I remember asking questions about spiro when derm decided to put me on it. She said it can help with hair thinning, acne, blood pressure, etc. And i distinctly remember replying that hair was no issue (i could pop hair ties!) Now here I am with visibly thin hair. I'm so sick over it.
Mali15
7 Nov 2016
Hi I am 42 and had some cystic acne due to stress and hormonal imbalance and was put spironolactone as a first attempt to treatment . My acne cleared within 2 weeks and I took the medicine for 6 months . I quit after 6 months and exactly 2 months post that my hair started falling in clumps . After 3 months I was put on 100 mg oh spiro by docs as they suggested it will help my hair . I constantly took vitamins and supplements along side . My hair has continued to fall over last 1 year and I have seen my hair turn to brittle dry and wispy . I had long thick lower back length hair and now I m left with unmanageable straw like thin hair . I have lost 60 percent of my volume . I have now reduced my spiro to 50 mg as I feel it's not helping me and plan to ween off . It has also caused my cycle to be every 2 weeks and major insomnia . I am very stressed and depressed . Pl suggest will my hair grow back and did you get your growth back . My hair are super fragile right now .
HEALTHISMYGOAL
6 Apr 2017
I am 39 and been on and off Spiro 100mg daily for about 1 year now and have noticed significant hair loss. My scalp is showing more as well. I talk to the dermatologist and my Primary Care doctor and they all say it's not the Spiro. I totally disagree and after reading all of this definitely know it is the Spiro. I am stopping ASAP.
Trinitytx
6 Apr 2017
Crazy how they deny it, huh? I asked a pharmacist friend snd she said yes, especially if taken a while.
Joders
13 Apr 2019
Hi can you tell me the dosage of spironolactone that you were on and for how long were you on it for I am so afraid I just figured this out today and if this hair keeps coming out I don’t have much left to lose and I had such long,beautiful full curly hair and I’m losing my mind over this any info would be greatly appreciated
ashling78
13 Dec 2014
Hello, did you ever find out if spironolactone was the cause of your hair loss? If so, did your hair grow back?
I have been taking spironolactone for 9 months now and am experiencing a huge loss of hair! Any info you have will be helpful, thank you!
Smithie
21 Dec 2014
Spiro is definitely the cause of my hair loss- within just one day of taking it my hair falls out, and it doesn't stop. Once I stopped taking the Spiro, my hair loss stopped. Unfortunately, the hair growth on my body and my acne went right back to being terrible, too.
Bicalutamide blocks androgen receptors without lowering aldosterone levels (aldosterone is not an androgen) like Spironolactone does (Spiro's effect on aldosterone and the lowering effect on blood flow to the scalp may be why hair loss happens). Bicalutamide should be a decent alternative.
Duasteride (Avodart) may also be a good alternative, because it prevents conversion of testosterone to Dihydrotestosterone (more potent than testosterone). It doesn't interfere with aldosterone levels either, so it should help.
Neither bicalutamide or duasteride interfere with blood flow, so they shouldn't cause the same problems as Spiro. I'm going to try to switch to those medications soon and see what happens. I'll let you all know when I find out!
Smithie
21 Dec 2014
My hair loss stopped when I stopped spiro and my hair growth came back... but so did the hair on my body and my acne. lol Try bicalutamide or duasteride- they are more directly effective than spironolactone, because they primarily work on androgens and androgen receptors (male hormones and the receptors in your body that use them) and don't affect other hormones like aldosterone (spiro affects aldosterone and I think that may be one of the reasons why hair loss happens on it).
Smithie
21 Dec 2014
That happened to me too. Every time I upped the dose on my Spiro, more of my hair fell out. Spironolactone mainly blocks the effects of the hormone Aldosterone, which is *not* an androgen. It just so happens to also block androgens, which is why many women find acne relief and body hair growth reduction while on it. It’s also a diuretic and lowers blood pressure.
I’m not entirely sure why it causes hair loss, but I wonder if it has to do with the effect is has on blood flow to the scalp, or the fact that it lowers Aldosterone.
Either way, you guys are not the only ones experiencing this effect; and most doctors are baffled as to why it happens- even my world renown endocrinologist doesn’t understand the mechanism.
I’m going to ask my endocrinologist to switch me either to Bicalutamide, or to Dutasteride (Avodart). Bicalutamide blocks androgen receptors (without affecting aldosterone), and Dutasteride prevents conversion of testosterone to Dihydrotestosterone (which is more potent than testosterone). Those are decent alternatives to people who don’t respond well to Spironolactone, I’ve heard.
NOLA9
12 Nov 2016
The following quotes are all explanations that I found for how spiro works. The other comments are my sense-making from the quotes.
"Spironolactone (steroid that blocks mineralocorticoid receptors, androgens, and has progesterone-like effects)".
"Spironolactone is a synthetic steroid structurally related to aldosterone. "
"Spironolactone both reduces adrenal androgen production and exerts competitive blockade on androgen receptors in target tissues."
For some of us, with less androgen action to start with, we get MPHL (male pattern hair loss) when we take spiro. (Note: no one gets FPHL [female pattern hair loss] from taking spiro.)
Less androgen action would also explains the lack of sexual interest and response in women taking spiro.
Note: "Spironolactone has been used off-label in FPHL for over 20 years."
For those women who generally have MORE androgen action to start with, their relative low female to male hormone ratio would leads to FPHL. By taking spiro, they get LESS male hormone in their bodies and thus LESS FPHL (female pattern hair loss) because these people had TOO MUCH androgen action before spiro.
For these women, their relative low female to male hormone ratio also probably lead to hirsutism (excess, male-pattern body hair). By taking spiro, they get LESS male hormone in their bodies and thus LESS hirsutism -- and LESS FPHL because these people had too much androgen action to start with.
From a study I found: "Women with early FPHL are also more likely than those with late onset FPHL to have a history of hirsutism." Aha! It is starting to make sense!
"Spironolactone is not used in male androgenetic alopecia because of the risk of feminization." Even when taken for hypertension, 10% of men who take spiro usually complain of gynecomastia (breast tissue).
"Spironolactone induces gynecomastia by decreasing testosterone production, increasing peripheral conversion of testosterone to estradiol, and displacing estradiol from sex hormone-binding globulin." "Gynecomastia is a well-described adverse effect of spironolactone and is related to dose and duration of treatment; overall prevalence is 10%." And it is just as I suspected above: “Gynecomastia develops because of alterations in the ratio of free androgen to estrogen. Usual causes include enhanced peripheral aromatization of androgen to estrogen (obesity), displacement of estrogen from sex hormone-binding globulin, or decreased metabolism.”
“Spironolactone induces gynecomastia by blocking androgen production, by blocking androgens from binding to their receptors, and by increasing both total and free estrogen levels. Production of testosterone is decreased by inhibiting 17α-hydroxylase and 17,20-desmolase, which are enzymes in the testosterone synthesis pathway. Estrogen levels are increased by enhancing the peripheral conversion of testosterone to estradiol and by displacing estradiol from sex hormone-binding globulin.”
“A selective aldosterone antagonist (eplerenone) has a lower incidence of gynecomastia, but the cost is higher.”
I think your endocrinologist could understand this, if I can! He/she probably has never taken the time to really think about spironolactone and hair loss (for those who develop MPHL while taking it) or gain (for women with FPHL). Even though I am a woman and you are a woman, we have different base levels of hormones in any given year, so we react differently to this and other medications.
Joders
13 Apr 2019
Smithie, how much was your dosage? And how long did you take it that your hair started growing right back after you stopped? I am so scared to wash my hair one more time any info would be great I am so upset
DrDonovan
11 Jan 2015
Hair shedding from spironolactone is not common but can occur. We call this "telogen effluvium". Usually it occurs within 3-4 months of starting the drug.
I always advise seeing a dermatologist before concluding a drug is the cause of hair loss. Sometimes it's easy to sort out but often it's more challenging.
Let me give you an example. Spironolactone causes irregular periods in 80 % of women and really increases the risk of developing low iron levels - which is one of the most important causes of hair loss in young women!!
In this case, raising the iron levels (by taking iron pills) and addressing the irregular periods is going to help the hair loss - not necessarily stopping the spironolactone.
All in all, hair loss is a fairly rare side effect of spironolactone - but it's certainly possible
Jeff Donovan MD PhD FRCPC FAAD
US & Canadian board-certified Dermatologist
Toronto, Canada
Smithie
11 Jan 2015
That's a valid and interesting point, but my hair loss begins the very next morning after I take the first dose of spiro, and resolves the very next day after I stop taking it; can iron levels in the body be affected that rapidly?
I don't think an iron deficiency is causing my hair loss, because when my endocrinologist prescribed Loestrin FE (which has iron in it), I got very sick the first day (debilitatingly nauseated, sweaty and shaky), and she blamed the iron content in it. So, I don't think I was deficient in iron levels from the spiro because if I was, the Loestrin FE would have (theoretically) corrected for that and it shouldn't have made me so sick.
The only thing that has resolved my hair loss while taking spiro is when I take Mircette (a birth control pill) in conjunction with it. When I'm not taking spiro and not taking birth control, I don't have hair shedding problems (but I have other intolerable PCOS symptoms, which is why I need to either take spiro or some other medication to temper those symptoms).
All things considered, the only thing left to blame would be either the spiro's lowering of blood flow to my scalp (which the BC makes up for because it increases my blood pressure to a more normal range), or the fact that spiro is blocking receptors to other hormones (aldosterone) that might have something to do with hair growth.
DrDonovan
11 Jan 2015
Thanks for this. Please note: the iron is just an example.
Hair loss due to drugs is more challenging to diagnose than most would believe. Typically hair loss starts weeks to months after the drug is taken.
SLM85
19 Aug 2015
DrDonovan
I was prescribed Spiro for my Alopecia. In the first few weeks my hair loss slowed right down it was amazing. I have been taking this drug for 6 months now and noticed in the last 2 months an increase in the loss of hair again. My dermo increased the dose to 200mg per day but it hasn't got any better in fact its getting worse. I don't know weather to stop all together or what to do. I can't get an appointment for ages... Please help :(
Jessica Misner
1 Sep 2016
My 13 year old daughter started taking Spiro 3 weeks ago. 50mg am and 50mg pm for acne and hair loss. She has PCOS. Her hair loss has severely increased to the point of tears... but her skin is looking so much better. What would you suggest?
Bebeschmebe
12 Feb 2017
Dr Donovan, I started taking spiro 9 days ago at 50mg and stopped taking it today due to fear of hair loss. What are the chances that I will lose my hair in this manner 3-4 months from now? Or does that only happen in rare cases and when people consistently use the drug that builds up to this point? Thank you
Moonsalute
10 Jun 2017
Dr. Donovan, I began 100mg of spiro for hair loss 5 months ago. Just like you had mentioned, telogen effluvium began after 3 months in. I stuck it out but it's been 2 more months of losing excessive amounts of hair. In your experience, does this end or continue? There are mixed views on this and I really cannot afford to lose more hair at this point without the chance of it stopping! Please share your experience of those who had telogen effluvium at month 3-4. Thank you.
Yamamaya
20 Jun 2017
Thank you for this answer, Doctor. And how long this "telogen effluvium" will last? Will it go away itself or I need to do something about it to get ride of it? I'm taking spiro 140mg/day for MtF HRT reason, and I notice this hair losing problem the second week I start HRT, It's the 8th week now, still losing over 500 hair per day, my androgen level is very low now(half of a 7 years old boy level low), so I think is not MPHL, what I should do? Check my blood iron level?
NOLA9
16 Sep 2018
I have never had low iron levels. My diet and genetics provides me with sufficient iron. I've had regular blood work which showed nothing abnormal. The spironolactone was the cause.
beabop317
19 Apr 2015
I started spirnolactone 3 months ago for acne and my hair recently started falling out in clumps. How long does it take for the hair to grow back after stopping spirnolactone?
rossjam
14 Apr 2016
Hi there,
How long did it take for your hair to stop coming out after stopping spiro? This is happening to me now. :(
Trinitytx
6 Jun 2016
Me too :(
Trinitytx
29 Jun 2016
Rossjam, any updates? I'm still shedding around 150 a day. I don't know if it was spiro or trazadone, which makes this harder to figure out. I stopped both a month ago and no change so far. :(
rossjam
30 Jun 2016
Trinitytx: Its been about 3 months since I stopped taking spiro and my hair continues to fall out pretty rapidly. I only wash it about once every three days or so which has benefited me emotionally (not seeing the clumps come out in the shower and after blow-drying) but I'm probably losing about 150-200 hairs each time I wash it. :( I haven't experienced new hair growth but cut my hair shorter and that has really helped me feel better about the density. Once I notice either new hair growth or when the shedding slowsI will definitely let you know! I really rely on these comment boards to give me hope :\.
Trinitytx
30 Jun 2016
I'm so sorry to hear that. I know how terribly distressing this is. I am only washing my hair twice a week too because it is just hard on my emotions. My hair doesn't even look the same. I think at this point I have lost a 3rd of it. I really hope you recover soon.
Trinitytx
19 Aug 2016
Hey rossjam,
Can you tell me which part of your hair is affected? Mine is mostly the crown, temples, and sides (which of course also describes aga sigh). This sucks
rossjam
25 Sep 2016
Hey trinityx - sorry for late reply! Mine is thinning mostly on the sides and temples as well :/. Good news is I'm coming up on 6 months since stopping the medication and I really think things have slowed down. I wash my hair once every 2-3 days now and not as much is coming out in the shower. Still haven't noticed any new hair growth yet though. Has anything changed for you?
Trinitytx
25 Sep 2016
Hey rossjam,
That's great to hear! It gives me some hope. I have been fluctuating between 150-250 strands lost. I still have bouts of sore scalp. I am about to reach 4 months since stopping in a few days. I saw my derm again last week and this time she says it is probably telogen effluvium (probably because of the drastic change since May). Granted, I am still able to hide it fairly well, but of course I notice it and have some days of intense anxiety which I am sure doesn't help. Reading your post makes me feel so much better though! :)
When did you start to see a decrease and how much do you think you're shedding now? p.s. did you ever get sore scalp? Sorry for all the questions, but like you said, I come back here because it makes me feel better ;).
rossjam
29 Sep 2016
Hi trinityx,
No worries at all - keep the questions coming! I started to notice the hair loss slowing about a month ago, so right at about 5 1/2 months. It wasn't drastic at first but I thought " wow I'm not thinking as much about my hair... why is that?" and then realized its because it wasn't falling out as much.
I too remember sore scalp in the first two months before a lot of the hair started falling out. I'd say I'm shedding maybe 100-150 per day? But I haven't counted in a while. I'll check tomorrow and report back :).
jamia39563
21 Aug 2017
Me too!!! !!!
Trelrule
29 Nov 2018
Hi I am reading ur experience and am experiencing the same things as you. I found this post in The middle of July and quit taking aldactone immediately. I have noticed that the shedding is some better but still not normal. How long did it take you to completely quit shedding and to start growing hair back? Some days I feel more positive about it like things are getting better and then I’ll have another shedding phase. I want it all to stabilize but just want to know when things stabilized for you. I also had the severe itching and soreness and also burning in my scalp after I quit the medicine. All of those symptoms have improved though but now I’ve started flaking on the scalp and my dermatologist told me I have dermatitis now. Any help or insight would be appreciated.
Joders
13 Apr 2019
I am experiencing all of the same too and just figured this out today after almost a year of my hair coming out in clumps,scalp soreness as I have barely any hair left and itching too can anyone tell me hw long after stopping will my hair stop coming out and does it grow back to normal? I had my hair dresser cut off six inches 2 months ago because long hair doesn’t look good to me when it’s so thin I’m desperate for help
JT1217
19 Apr 2015
My hair started shedding like crazy to and it's literally abt to freak me out ,not to mention that I am a hairstylist. I was suppose to be taking this medication for acne because I was scared of accutane. I stop taking spiro because I just can't deal with all this hair shedding and weight gain..gosh my hair is already fine. I wonder does it grow back after u stop taking it??? Now I know why I couldn't loss the weight after trying to start a exercise regimen!!!
Dec12
8 Mar 2016
I have been taking spironolactone for at least 10 years for adult acne. My eyelashes, eyebrows and body hair started falling out about 6 years ago. I was going through a very stressful period and the doctors thought it was from stress. 4 years ago, I went to my dermatologist and she increased my dose of spironolactone to 100mg daily to stimulate hair growth. I used some regrowth products on my eyelashes and most of them grew back. My eyebrows and body hair have not. My hairline has also receded slightly in the last few years. 2 weeks ago I saw my Primary care MD. I told him I'm terrified of going bald. He told me spironolactone can cause hair growth OR loss. He checked my thyroid levels, iron, B12 which were all normal. I immediately stopped the spiro and saw my dermatologist. She doesn't think the spiro is causing my hair loss. Did a biopsy of a hair follicle. I feel certain it is the spiro. No other explanation.
Kas00
12 Nov 2016
What did the biopsy say? I too am experiencing hair loss on spiro
VickyK
26 Feb 2017
I have experienced the same stuff .. been on Spiro for years ... loved it ... but slowly realized my eyebrows... my body hair and my hairline was going. Got diagnosed with Frontal Fibrosing Alopecia. I swear the Spiro had something to do with it.
VickyK
26 Feb 2017
I have experienced the same stuff .. been on Spiro for years ... loved it ... but slowly realized my eyebrows... my body hair and my hairline was going. Got diagnosed with Frontal Fibrosing Alopecia. I swear the Spiro had something to do with it.
Melody2175
26 Jun 2017
I have been on Spirronolactone for 2 weeks and have noticed significant hair loss. I have bald spots and didn't have this 2 weeks ago. I also take thyroid medication but have never in 19 years experienced hair loss. I'm certain it's the Spironolactone! I'm very worried it won't grow back so any advice would be appreciated.
Jackiep86
27 Mar 2016
Yes my hair is falling out like crazy! I have been taking 100 mg a day for the past 3 years. This medication accompanied with another factor that causes hair loss, such as stress, exasperated it!
Phillips1946
20 Jul 2016
I shed about 50% of my hair when taking 200mg of Spiro daily. Not only did my hair shed, what I had broke off to about 3" due to the extreme dryness that the Spiro caused. I didn't even think about it causing my hair to get dry but it makes sense as it decreases sebum in the skin. I had a beautiful complexion but almost no hair. And I never had that much to begin with. I asked my Derm if the Spiro could be causing the hair loss and she said she didn't know as that was outside of her area of expertise. But, she's the one who prescribed it. I wish I could take it as my oily skin looked perfect but not a good enough trade off. It took a good year to get my hair growing in the right cycles again. The Spiro can cause hair in the growing cycle to fall out before its time and the new hair hasn't grown far enough out. So you are sitting there with hair follicles that have no hair past the scalp.
Trinitytx
24 Jul 2016
Philips, did you stop taking it? How long dod you shed after you stopped spiro? I just hit 2 mos and still shedding. It's so awful
NOLA9
14 Oct 2016
Phillips, thank you for sharing your experience. I stopped the spiro on August 4, 2016, and I have photos showing much more fine hair around the hairline. It's good to know that it can take a year to improve. I started trying minoxidil today, but I'm wondering now if that is necessary. Perhaps I should just wait a year and see if my hair comes back like yours did.
NOLA9
13 Nov 2016
UPDATE: I only did the minoxidil for a few days. I think my hair is coming back well enough without it. I will decide in January (5 months post-spiro) whether to try it again. My derm told me it could take 4-6 months for my hair to recover after stopping spiro (or any medication).
Maybe your dose was too high. I was taking 25 mg for hypertension. It didn't even work that well. I had to add on two new meds, and together they worked ok for a while.
Joders
13 Apr 2019
Hi Jackiep86, are you still taking the 100mg of spironolactone? I just figured this out today after almost a year of my hair coming out by the tons if you stopped taking how long after did your hair stop falling out? And how long until it came back to normal if it did I hope
Trinitytx
31 May 2016
I started 50mg last May and was upped to 100mg in August 2015. I think I started noticing some thinning about 4 months later. Recently though, I realized how quickly it accelerated and I've lost 40% of my once thick hair. My scalp burns and itches and my hair is everwhere. I'm so sad about it and now have anxiety over it.
alexk0
16 Nov 2016
I just wanted to say that I read a few of your other posts on the ACNE website and it looks like your hair as started growing back, so happy for you! :) Best wishes!
Trinitytx
22 Dec 2016
I do see some regrowth, which I am happy about, but I am still shedding abnormally (but a lot less than the amount at peak). I sure hope it continues to taper off. How are you doing?
Trinitytx
2 Jul 2018
I am Still shedding horribly. It's been two years. I stopped Spiro and after 4- 5 Mos, the shedding peaked, as did my cystic acne. Talk about a horrible combo. Although still shedding, I still get regrowth, so I'm guessing I'm stuck in a chronic telogen effluvium cycle. I no longer have cystic acne, however. I stopped eating dairy and gluten, and my face cleared up (as did my keratosis pilaris on the back of my arms). Shed also improved, but still abnormal and awful. Scalp biopsy showed TE only, so I'm going to keep hoping it will resolve with time. I've had over 50% diffuse loss, and am still able to somewhat hide it, but I miss my old hair.
Trinitytx
2 Jul 2018
P. S. If you have acne, do try eliminating dairy dairy (skim milk is especially bad for skin). It's remarkable how much that was a culprit for me.
Rexlyn
9 Sep 2018
I am experiencing hair loss at the moment from spiro. This is so scary. Wondering if you guys have updates on your hair since your posts? Please tell me this shedding stops and hair grows back in.
Ashuni
4 Aug 2016
I am in the same boat as you all. Subsequently, I was prescribed 100 mg of Spiro to start off for my acne that attacked mostly my chest, back, and face. After seeking out accutane, my new dermatologist believed that my acne was hormonal and that spirolactone was the best choice. He said the moment I get off accutane is the moment the acne will return. Putting my trust in him, we went forth. It was about a month and a half that went by in which I started to notice clumps falling out. Let's just say this affect is demoralizing. Out of all things, I was most confident about my hair. Now I have noticed that I have 'layers' from the hair breaking off at different points as well as thinning. I told my derm that it had to of been the sprio but he insists their might be a thyroid problem. This, as I can see in the past comments is usually not the case. I have been off of the medication for about 2 weeks, but constantly still notice hair falling out.
I am adding biotin to my regime and even more mousterizers to my hair. My question is, is there anyone who has had a recovery of their hair, and how long did that take?
Trinitytx
4 Aug 2016
I'm so sorry you're going through this. I've read some success stories on either this site or the acne site and theirs took 5 and six months :( , but they did recover. I'm personally still waiting. The derm denied it, but I didn't have issues until starting it. I've tried Biotin, but it does make me break out. I hope we all recover soon. It has caused me anxiety, but the recovery stories make me feel better.
HEALTHISMYGOAL
6 Apr 2017
I definitely think Spiro is the cause of my hair loss. I noticed a difference with my hair after using this maybe 6 months ago. I lose a lot in the shower and when I brush my hair and my scalp is showing more in the crown area. I have decided to stop taking it as of now after reading these comments. I hope my hair grows back though.
Trinitytx
6 Apr 2017
I hope everyone reports their experience on the fda online website. Maybe then derms will realize it happens
NOLA9
2 Jun 2017
I had my thyroid tested, as part of my normal checkup, and it was fine. Why do doctors want to see hair loss as caused by thyroid dysfunction rather than as a side effect of medication? I've also heard veiled references to "life" and "your age" (50-ish). Sorry, it's not that. When I stopped the spiro, my hair started growing back. I'm even a year OLDER now!
Dina619619
13 Aug 2016
Yes i started taking spironolactone and noticed my hair just falling out at a alarming rate. I mean just putting my fingers thru my hair it would just fall out.. I was perfectly fine untill i started those pills so as of today Aug 13,2016 im going to stop taking it and see if my hair stops falling out. I was given spironolactone for edema.. Im so scared im going to be bald!!! Its really bad...
Trinitytx
13 Aug 2016
I'm sorry about that, Dina. I know it's terrible and incredibly stressful, I hate it. How long have you been on it? I hear that Biotin or Viviscal helps with regrowth.
Dina619619
13 Aug 2016
I also noticed my hair got extremly dry and brittle!! Im so sad !
Trinitytx
13 Aug 2016
Mine too, but mostly at the top and crown. I've also noticed that when they fall out, the part closest to the bulb is quite wiry.
Dina619619
13 Aug 2016
I have been on it 1 month.. I noticed 2 weeks in my hair was so dry and brittle!! And started falling out. I changed shampoo and conditioner and it didnt help. So now i pinned it up and not washing it all all. I cant believe in 1 month my hair has fallen out this much. But today i went to pick up another medication and they gave me the refill of spironolactone i asked my pharmacist if losing hair could be a side effect of taking spironolactone and he said absoutly!! He said call your doctor and have him prescribe you something else for edema.. One other thing i also noticed and was told by several people how well my skin looked especially my face.. But i rather have my hair back. I dont even have acne. Go figure.. So im not taking it anymore see what happens in a month from now. Well keep you all updated untill than im still super depressed!!
Trinitytx
13 Aug 2016
Well the good thing is you didn't take it long! Don't worry, you won't go bald, even though you may think so. It's telogen effluvium and you will recover. I have been losing hair for 3 mos since stopping, but I took it a long time before making the connection :/. I still have a full head of hair, although I have lost a ton, and it's only really obvious to me. I had bad anxiety over it too and shed many tears, but coming to this forum makes me feel better. Btw, I shed a ton (like 300 in shower now), but I only wash my hair twice a week for my sanity so that could be why the extra strands lost, I dunno. Spiro made my skin great too, but I woukd rather have my hair. Feel free to message whenever as I know how distressing it is, especially at the start.
VickyK
26 Feb 2017
I know this is years later ... but how is your hair now ? I hope stopping Spiro helped. I have been on it for years and I am in tears looking at my receding hairline and my missing eyebrows.
mama tried
25 Sep 2016
I am dumb-founded because I started Spiro to stop hair loss and acne. Prior to Spiro-I lost over 50% of my hair. It was beyond devastating. I've been on it for 3-4 years and my hair is still thinning but slowed down quite a bit. Also, it cleared up my acne in no time. Recently, I have stopped using it bc my skin(esp on my face) has become so dry. I am hypo-thyroid so there may be a lot of things going on. Also, I wish the Spiro would stop unwanted hair growth on my face and body. It was suppossed to work for those issues but it didn't do anything. I think I'm going to lay off of it for a while and see if my hair grows in and if my acne comes back. Prior to spiro-I had very big pores or blackheads. Since taking the spiro-my pores closed and no more blackheads. So I dont know what to think.
Trinitytx
25 Sep 2016
If you truly want to stop, I would suggest tapering down. I stopped cold and I think it caused a bout of really high shedding that is only now going back down slowly. If you want to stay on it, I had good luck using Cerave Hydrating Face cleanser with it (time release emollient) to keep my face from drying out.
aralexisry
29 Sep 2016
So I just wanted to share my experience with spiro and hair loss. When I began taking spiro a little over a year ago, I had a full, thick head of hair down to the small of my back. I LOVED my hair. I had cystic acne which is why I began the spiro and at first I thought it was a miracle drug. The acne was gone almost immediately, my skin looked great, better than it had in 10 years. But then, I slowly began to notice my hair was dry, and I just kept having "bad" hair days. It just didn't seem like my hair. Then it suddenly began falling out in big clumps in the shower. Hundreds of hairs a day. I could feel the hair detaching from my scalp. This shedding has continued for months and I've lost 50% of my hair. It was also accompanied by intense itching. I've seen two dermatologists for this and had a scalp biopsy. The results of the biopsy showed chronic telogen effluvium and androgenic alopecia.
I've had to be put on topical steroids because it turns out the itching was inflammation in my scalp and it was causing the shedding. I haven't taken spiro in months but my scalp is still so sensitive that I can't even use hair products.
The topical steroids are the only reason the hair stopped shedding so profusely. I want to add that I did go through a very stressful period of my life this last year as well. I think the stress combined with the effects of spiro caused the TE. I would like to treat the androgenic alopecia with topical minoxidil but it is too harsh on my scalp and increases my shedding. I'm hoping that a good course of topical steroids will calm everything down and in a few months I can try minoxidil again. I will NEVER touch spiro again, I don't care what my dermatologist says about it NOT causing hair loss, this drug definitely did not help the hair loss and I believe it made it worse. I will deal with the cystic acne, I would rather have acne and hair than no acne and no hair. Right now I have acne and no hair, which is really depressing.
I have been taking viviscal supplements and they are making my nails grow like crazy and also my body hair. I've only been taking them for a month and a half so the verdict is still out on the hair growth.
I just wanted to put this out there for anyone else taking spiro and having hair loss and itching and burning scalp. If you stop the spiro, and it doesn't improve, ask your derm for a topical steroid. It immediately slowed my hair loss to at least 25% of what I was losing before. I wish I would have known this months ago, I could have saved a lot of my hair. I'm just hoping that eventually my scalp will return to normal and i will regrow some of what I lost. I don't feel like myself without my hair. Good luck to all of you!
NOLA9
14 Oct 2016
What was the name of the topical steroid for your scalp?
aralexisry
15 Oct 2016
I was put on Clobetasol. Topical steroids can sometimes cause folliculitis. I'm just wrapping up a bout of folliculitis. Seems like it's one thing after the other. Even with the folliculitis, the shedding isn't nearly as bad as it was before the topical steroid. So I will continue with the topical steroids once every few days and then taper down. Good luck!
aralexisry
3 Nov 2016
I wanted to give an update on my progress. My scalp has calmed down considerably since my last post. The best part is the stinging and itching feeling is completely gone. The hair loss has slowed to maybe a little bit more than my normal daily loss before spiro. I haven't noticed any regrowth yet which is a bit discouraging but I know it can take awhile. I've also restarted the rogaine. Apparently the liquid form of rogaine can be really irritating to the scalp so I switched to foam. I've also been using head and shoulders pretty religiously because it seemed very soothing and hydrating to my dry scalp and hair. My scalp is back to normal, no irritation, burning or itching, no folliculitis. I use topical steroids once or twice a week. If I notice my shed picking up I use it twice a week.
What a nightmare spiro was for me! Searching for success stories for people who lost hair due to spiro is also discouraging but I understand that people often only post when they are searching for answers and then if the situation resolves itself they may not think to go back and post updates. It would be nice if they did post those updates because it can be tough for us people actively going through this. Anyway, I'll keep you guys posted about any progress and ESPECIALLY if I start to notice regrowth. So far the scalp is calmed, tolerating rogaine foam, but no regrowth yet.
Trinitytx
8 Nov 2016
I have been off spiro for 5 months. I started seeing improvement about 3 weeks ago with fluctuations of good days and bad/higher shed days. I took antibiotics which helped with folliculitis. The stinging and burning is almost gone and now I just have soreness sometimes. From reading chemo boards, this is common in hair loss AND growth, so I really hope it's the latter. I started taking viviscal also, but I think it's making me breakout :/. I would rather have hair though. Thanks so much for posting back. It's good to have support.
Kas00
12 Nov 2016
Aralexisry, I have been on spiro for 10 months and shedding is so bad. I actually was put on it for hair loss and it stopped for three months. But after those three months I can't get the shedding to stop. I was also diagnosed with TE as well as androgen alopecia. I wanted to see how you were doing with being off of spiro. I'm really contemplating on getting off of it
aralexisry
12 Nov 2016
Kas00,
I actually noticed in the last few days that I DO have regrowth. There are places on my head with about an inch of regrowth but the red to find my hair is still long so it is hard to see. I think one of the most frustrating parts about this experience has been that I've seen 3 doctors and not a single one believes that spiro can cause hair loss. In fact, my current doctor encouraged me to begin the spiro again to which I responded absolutely NOT. Almost all of the people I hear from these forums have the exact same symptoms, the shedding, the itching, the burning sensation and the spiro. I have no doubt that spiro can help SOME people with hair loss, but for some reason it makes the hair loss worse for us. Whether you stop the spiro or not is going to be completely up to you. If your hair loss is caused by the spiro you may not stop shedding immediately after stopping. It seems that the shedding continues for MONTHS after stopping for some people.
Mostly though it seems like it is reversible by discontinuing the spiro but it takes time and unfortunately not everyone regaines what they originally had. How frustrating it is to be completely dismissed when I suggest the hair loss is caused mostly by the spiro! I don't care what the doctors say! I'm not taking it again!
Trinitytx
12 Nov 2016
I agree, both derms denied it could cause it, but I had no issues prior. I seem to slooooooowly be improving. On non-was days now I lose on average of 85. Wash days went from 300 to about 70 (but I still lose another 70 throughout day after).
I am seeing fluctuations, which I believe is normal. I also have some regrowth (i part hair and put a white paper there and the little hairs are visible), it just hasn't quite kept up with the loss. The bad burning and red pimple things (folliculitis) is gone, but now I just have occasional soreness. Nizoral seems to help a bit. I also use Toppik which works great to cover the sparse areas.
P.s. i also finished 4 mos of taking doc recommended iron to raise my ferritin from 35 to 90 now (this may have helped in regards to what Dr. Donovan mentioned elsewhere in this thread).
NOLA9
12 Nov 2016
Trinitytx,
One more thing: what do you mean by this, "i part hair and put a white paper there and the little hairs are visible"? I put a white paper next to my part, but I'm not sure what I'm looking for.
NOLA9
12 Nov 2016
The following quotes are all explanations that I found for how spiro works. The other comments are my sense-making from the quotes.
"Spironolactone (steroid that blocks mineralocorticoid receptors, androgens, and has progesterone-like effects)".
"Spironolactone is a synthetic steroid structurally related to aldosterone. "
"Spironolactone both reduces adrenal androgen production and exerts competitive blockade on androgen receptors in target tissues."
For some of us, with less androgen action to start with, we get MPHL (male pattern hair loss) when we take spiro. (Note: no one gets FPHL [female pattern hair loss] from taking spiro.)
Less androgen action would also explains the lack of sexual interest and response in women taking spiro.
Note: "Spironolactone has been used off-label in FPHL for over 20 years."
For those women who generally have MORE androgen action to start with, their relative low female to male hormone ratio would leads to FPHL. By taking spiro, they get LESS male hormone in their bodies and thus LESS FPHL (female pattern hair loss) because these people had TOO MUCH androgen action before spiro.
For these women, their relative low female to male hormone ratio also probably lead to hirsutism (excess, male-pattern body hair). By taking spiro, they get LESS male hormone in their bodies and thus LESS hirsutism -- and LESS FPHL because these people had too much androgen action to start with.
From a study I found: "Women with early FPHL are also more likely than those with late onset FPHL to have a history of hirsutism." Aha! It is starting to make sense!
"Spironolactone is not used in male androgenetic alopecia because of the risk of feminization." Even when taken for hypertension, 10% of men who take spiro usually complain of gynecomastia (breast tissue).
"Spironolactone induces gynecomastia by decreasing testosterone production, increasing peripheral conversion of testosterone to estradiol, and displacing estradiol from sex hormone-binding globulin." "Gynecomastia is a well-described adverse effect of spironolactone and is related to dose and duration of treatment; overall prevalence is 10%." And it is just as I suspected above: “Gynecomastia develops because of alterations in the ratio of free androgen to estrogen. Usual causes include enhanced peripheral aromatization of androgen to estrogen (obesity), displacement of estrogen from sex hormone-binding globulin, or decreased metabolism.”
“Spironolactone induces gynecomastia by blocking androgen production, by blocking androgens from binding to their receptors, and by increasing both total and free estrogen levels. Production of testosterone is decreased by inhibiting 17α-hydroxylase and 17,20-desmolase, which are enzymes in the testosterone synthesis pathway. Estrogen levels are increased by enhancing the peripheral conversion of testosterone to estradiol and by displacing estradiol from sex hormone-binding globulin.”
“A selective aldosterone antagonist (eplerenone) has a lower incidence of gynecomastia, but the cost is higher.”
I think your endocrinologist could understand this, if I can! He/she probably has never taken the time to really think about spironolactone and hair loss (for those who develop MPHL while taking it) or gain (for women with FPHL). Even though I am a woman and you are a woman, we have different base levels of hormones in any given year, so we react differently to this and other medications.
Trinitytx
13 Nov 2016
Nola,
I have dark hair, so when I part my hair in different areas around my hair and lean a white paper to both sides of my hair in the part, i can see 1 inch hairs in some areas (not all). From what I have read on different forums, it can take follicles some time to start producing hair after a telegen effluvium. I am so ready to be over this. My mood is affected by how much I lose that day.
rossjam
22 Feb 2017
Hey trinityx,
How's your hair doing now? Last you posted you were seeing some regrowth, yay! Is that still the case?
My hair loss is slowing a lot but it's been about a year since the shedding started and I've haven't experienced any regrowth at all :(.
Trinitytx
18 Mar 2017
Hey Rossjam,
Sorry, didn't get a notification. Well, I have no idea what is normal anymore. Starting in January, i have had most days under 100 loss per day, a few days over. I do have some regrowth, but it doesn't seem to be enough. I read follicles can stay dormant awhile with TE, so I am hoping it's that.
I don't lose much in the shower anymore, but if I comb or brush, that's when I start getting those higher numbers.
Part of me wants a biopsy, but apparently te recovery and AGA can look similar ugh. I hate this. Is there direct messaging? We could exchange info
maisie89
4 Jul 2017
Hi Trinixity & Rossjam, How are you ladies doing? I'm one month off spiro and still shedding:(
rachcirelli
11 Nov 2019
I just want to thank you for posting all of this! I was prescribed spiro for bad acne- it cleared it up but I had HUGE sheds and my hair is so dry and brittle. I NEVER had scalp issues and I now have an inflamed, red one that drives me nuts. I went off the spiro and got the topical you mentioned. Maybe it's helping a bit. I really would like to hear how you are doing now.. this has been an awful journey
Mindii
2 Jun 2017
I was prescribed Spiro for acne. After 3 weeks in... my hair just started falling at an alarming rate. I was like a chemo patient without d chemo. The pimples improved though. I have stopped taking it for abt 3 weeks but the hair keeps falling. I went back to the dermatologist and she says it's not the spiro and we did a scalp biopsy. Histology report isn't out yet. Went to remove stitches and for review today. Doc kept referring to it as Alopecia rather than Telogen Effluvium. This has caused me much distress over the past few weeks. I've lost at least 1/3 of my hair. I used to have a full healthy crown of hair that was Low maintenance. Now I can barely tie it up just to cover the balding patches. I'm quite certain Spiro has a part to play in it but no one has done proper research. At the end of the day, I'm d one that took the spiro meds not them. Although spiro is meant for hair growth, I have a feeling it does cause hair loss too.
The only difference was the new spiro meds in my routine. I'd rather have my hair back then have no pimples. The latter is the lesser of d two evils. The rate of hair fall is not keeping up w the hair regeneration. Devastating experience. Someone needs to do more research on this.
Trinitytx
2 Jun 2017
Mindii, they all deny it, but the proof is there. Please do the FDA online report to list this side effect. I'm glad you were not on it long. Please let us know your biopsy results. We have a telogen effluvium support group on fb btw
NOLA9
2 Jun 2017
My dermatologist agreed that the spirolactone probably caused my hair loss. In pictures, my part was soooo white and wide. I accidentally took a picture of the top of my head (long story... ) and I was shocked at the white lines (parts) on my crown area.
I stopped taking spiro in August 2016. I saw improvement within a month, and more by November. Unfortunately, I started taking HCTZ () in November, and my hair started falling out again. I stopped taking HCTZ in late March or early April 2017 (two months ago), and I noticed last weekend that my hair FEELS normal again, when I run five fingers through it on one side. I hope that means my hair is returning to its normal scalp density. (I'm afraid the "follicle miniaturization" that the spiro caused may be with me for life. My hair used to be made up of thick strands of hair; now it is so fine I can hardly see a piece of hair held between two fingers.)
On my dermatologist's suggestion, I started using generic Rogaine (MEN'S formula -- she said not to waste my time on the weaker women's version). I only use it in the front, and only once every other day. I think it helps, but be CAREFUL not to get any where you DON'T want hair. I lie down in bed and use the little dropper to draw lines from my forehead hairline back about halfway toward my crown. I don't think it's doing much, but I can only do it every other night, when I am sure I will be washing my hair first thing in the morning.
What is so frustrating is that I always ask very pointed questions about side effects in my medical visits, and all I get is "Nothing, really". Then I get hair loss, middle-of-the-night screaming foot cramps, or stabbing heartburn. The problem is that doctors don't even have good info on side effects. The drug companies minimize their own side effects and exaggerate those of their competitors.
NOLA9
2 Jun 2017
The spironolactone poison also had other effects: (1) my hair became VERY dry (no oils to lubricate it when rubbed between two fingers); (2) my scalp was dry (no real need to wash my hair as it never got oily! -- but very unhealthy looking, even when clean); and (3) I had NO sexual interest or response (listen to the crickets when I tell this to doctors... they had absolutely NO comment). Within two weeks of ending spironolactone, my hair oils had returened and I had normal sexual lubrication and response. My hair density is slowly improving.
Carpe308
31 Oct 2017
Have you noticed any changes since you’ve stopped taking the Spironolactone? I’m in the same boat as you and I’m totally freaking out! I have more hair than anyone should ever have, however, it’s receding and thinning on the top. I’ve been on Spironolactone for about 2 yrs. My derm tells me it’s not from the med. that I have AGA. No one in my family has hair loss. Help!!!
justthisonce
31 Aug 2018
I used rogaine in the past but never stuck with it. It didn't seem to do anything - probably because I didn't use it regularly. Then I went to see a specialist and decided it's now or never - before my hair is all gone. My mother went almost totally bald in her 80s. so I was given spiro and told to add back the rogaine. At first with 50mg things were going okay. I had trouble (felt really lousy) when I had to increase it to 100mg. So I did that slowly by cutting the second pill in half until I could take the whole thing without feeling awful. So now at 100mg for about three weeks and my hair is falling out all over the place - in the sink, on my bed, on my desk at work. The rogaine alone didn't have this affect so it must be the spiro. Also my thinning of my hair pattern has changed. I used to have a horseshoe shaped pattern - now the front two inches are almost bald but the back top has the thickest hair on my head now. Figure that!!! I just called the doctor to see what next. I want off of spiro - it's obviously the cause of it.
Further Information
- Spironolactone Information for Consumers
- Spironolactone Information for Healthcare Professionals (includes dosage details)
- Side Effects of Spironolactone (detailed)
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