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
- 16 July 2018 (4 days ago)
- Topics
- acne, spironolactone, medication
Details:
Responses (27)
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.
ashling78
13 Dec 2014
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.
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."
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.
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.
beabop317
19 Apr 2015
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 :(
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.
Jackiep86
27 Mar 2016
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
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?
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.
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.
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 !
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.
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!
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.
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.)
Further Information
- Spironolactone Information for Consumers
- Spironolactone Information for Healthcare Professionals (includes dosage details)
- Side Effects of Spironolactone (detailed)
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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.
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!
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.
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.
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 .
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.
Crazy how they deny it, huh? I asked a pharmacist friend snd she said yes, especially if taken a while.