Use of Topical Spironolactone in Treating Male Pattern Baldness

Spironolactone (trade name Aldactone) is a diuretic causing increased amounts of sodium and water to be excreted from the body, while potassium is retained. Therefore, spironolactone is largely used to lower high blood pressure. Because of its ability to promote potassium retention in the body, its uncontrolled intake can lead to hyperkalemia. Hyperkalemia, an abnormal increase of electrolyte potassium in the blood, can profoundly affect the nervous system and heart and, when extreme, can be fatal.

Spironolactone happens to have anti-androgenic effects, which has lead to its use as a hair loss treatment. In addition, it is also applied to treat acne and hirsutism (excess body hair) in women. However, due to its feminizing effects, including breast enlargement, the oral form of this drug should not be prescribed to male patients. There are some generic topical applications available to male hair loss sufferers but empirical evidence suggests that spironolactone is not a very powerful weapon in the fight against male pattern baldness. Most consumers report no regrowth at all, whereas the most common complaint is about its weird smell. Considering the potential negative side effects and the low effectiveness of this drug, male hair loss patients should give preference to other more powerful and less harmful anti-androgens, such as finasteride or dutasteride, and consider it only as a weapon of last resort. For women, who typically have fewer options when it comes to treating baldness and due to the lower risk it presents to their health, spironolactone is an acceptable alternative to finasteride (as finasteride cannot be prescribed to female patients).

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