In the quest to treat male pattern baldness, also known as androgenic alopecia, men are usually familiar with the traditional FDA-approved treatments: Propecia and minoxidil. Topical spironolactone, or "spiro," is usually a less familiar treatment for hair loss. Despite its general obscurity, spiro can be a very effective hair loss treatment and perhaps more effective than the more familiar treatments.
Spironolactone is not a new drug and has actually been used for over 30 years as an orally ingested diuretic for hypertension in men and women, according to Minoxidil.com. The site notes that oral spironolactone has a potent anti-androgen effect that can reduce the male sex hormones testosterone and dihydrotestosterone. The effect is so potent that oral spiro is rarely given to males anymore because of its' "feminizing properties which can include painful gynecomastia" or formation of breast tissue from high levels of estrogen.
While ingesting oral spironolactone is not ideal for males because of the feminizing systematic effects, spironolactone's pronounced anti-androgen effects make it an ideal treatment for male pattern baldness. Male pattern hair loss is caused by DHT attacking vulnerable hair follicles. If DHT is inhibited or blocked, according to Minoxidil.com, "the follicles no longer atrophy and can mature again to their normal size."
Spironolactone when applied topically, however, does not have the systematic effects on natural hormone levels. Topical spironolactone simply inhibits DHT where it is locally applied, according to an Italian study published in a 1990 issue of the journal "Panminerva Medica." The researchers concluded, "as far as the topical use is concerned, spironolactone seems to be highly effective with absence of systemic effects."
If spironolactone is applied topically, it can inhibit DHT locally, thus preventing hair loss in the area it was applied without effecting overall hormone levels.
Topical spironolactone, like Propecia, functions to lower DHT levels and thereby prevent hair loss. Unlike Propecia, however, topical spironolactone does not have a systematic effect that can cause an overall hormonal imbalance that can lead to sexual side effects. Merck, the manufacturer of Propecia, claims on the Propecia website that sexual side effects only occur in .3 percent to 2 percent of males. There seem to be an abundance of reports speculating the understatement of this relative percentage. These potential side effects are avoided with topical spironolactone.
Spiro formulas are also generally odorless and can be topically applied with ease.
Dr. Richard Lee, hair restoration physician and expert, suggests on Minoxidil.com that a combination of minoxidil and topical spironolactone may be the best defense against hair loss. He suggests to first apply the minoxidil to areas of thinning hair and then apply the spironolactone. Regarding the minoxidil and spironolactone combination, Dr. Lee states, "whereas neither medication alone is particularly effective for the majority of patients, the success of the combination has been experimentally proven." Dr. Lee claims his patients have a 75 to 80 percent success rate with the minoxidil and spironolactone combination.