Spironolactone for Hair Loss: Does It Work?

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
July 15, 2022

Hair plays an important role in defining our appearance. It also helps keep our bodies clean and protected from external irritants. 

Hair loss can be an annoying problem. If you notice that you are losing hair or that your hairline is starting to thin, you may choose to seek treatment options.

Spironolactone is a medication used to treat several conditions, including hair loss.

In this article, we’ll explore what spironolactone (Aldactone) is and how it works to help with hair loss. We’ll also discuss any side effects you need to be aware of and who should not be taking the medication.

What is Spironolactone?

Spironolactone is a medication used to treat high blood pressure, heart failure, and liver and kidney diseases.

In recent years, it has been used, alongside other medications, to treat hair loss resulting from androgenic alopecia.

Healthcare providers may prescribe spironolactone off-label to treat female pattern hair loss (FPHL) or female androgenic alopecia and to help those who identify as female manage their hair loss. 

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How Does Spironolactone Work for Hair Loss?

Spironolactone is an aldosterone receptor agonist, or mineralocorticoid receptor antagonist (MRA).

This means that spironolactone slows down the production of androgens or testosterone hormones that are mainly responsible for hair loss.

Its antiandrogenic effects subdue what aldosterone does in the body; hence, it encourages hair growth. 


While the main benefit of spironolactone for hair loss is an increase in hair growth, this will depend on whether the body adapts to this medication or not.

It is used for other medical conditions, including acne, high blood pressure, and gender-affirming medication therapy.


According to the Journal of the American Academy of Dermatology, close to 40% of women or those who identify as women are affected by female pattern hair loss (FPHL) by age 50.

In the study, after using spironolactone, more than 74% of patients showed signs of improvement or stability in regard to hair loss.

Those with symptoms of hyperandrogenism especially benefited from spironolactone. 

From hormones to genetics, emotional stress to lifestyle – various internal and external factors will determine the efficacy of spironolactone.

So, it is important to remember that it might not always be the best course of treatment for you. 

Possible Side Effects

Spironolactone is a diuretic, which means that it helps your body to expel excess water, liquids, and certain minerals.

As such, you need to ensure that you drink plenty of water when taking this medication to avoid getting dehydrated.

It can also make you urinate more often.

Other possible side effects of spironolactone include:

Many side effects go away on their own once your body starts getting used to the medication.

Ask your healthcare provider for ways to manage any pain and discomfort. If any side effects become severe or unbearable, seek medical attention immediately. 

Interactions and Warnings

Spironolactone and any other similar drugs can interact with one another resulting in not only minimizing the effect you want them to have but, in some cases leading to potential damage.

Always disclose other medications you are on to your healthcare provider.

If you want to start another medication alongside spironolactone, do so only after your physician’s guidance.

Be mindful of the below drug interactions with spironolactone:

  • Aspirin
  • Captopril
  • Delapril
  • Droxicam
  • Ibuprofen
  • Lithium
  • Mefenamic Acid
  • Potassium
  • Ramipril
  • Salicylic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Licorice

Check with your medical provider about the proper dosage and when to take your medication.

You need to stick to the timings and routine of your dosage and get clear instructions on whether it needs to be accompanied by food or not.

It is also important to remember that alcohol, tobacco, and other recreational drugs can interact with your medication. 

How Quickly Does Spironolactone Work for Hair Loss?

Some studies have shown that within 24 weeks, FPHL patients notice a significant improvement after using 200mg of oral spironolactone.

When combined with other medications such as oral finasteride, minoxidil foam, and topical ketoconazole, hair growth improvement was noticeable after 14 days of use. 

As each person will react uniquely to any drug, including spironolactone, it is almost impossible for any physician to accurately determine how quickly it will help you or if it will help you at all.

It will depend on your hormones, how your additional medications react with spironolactone, and your lifestyle.

If you have any concerns regarding the efficacy of your hair growth treatment, reach out to your medical provider. 

Who Shouldn’t Take It

If you are living with a severe autoimmune disease or a chronic illness, your medical provider will advise you on whether or not you should take spironolactone for hair loss.

If you are pregnant, looking to get pregnant, are breastfeeding, or will be breastfeeding, ask your healthcare practitioner if it is advisable for you to be on this medication. 

Geriatric and pediatric patients will also need a case-by-case analysis of whether they can use spironolactone. 

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When to See a Medical Professional 

Female pattern hair loss, or female androgenic alopecia, is one of the most common causes of hair loss in people with vaginas.

However, other medical conditions may cause hair loss as well.

If you find that you are losing more hair than usual, notice any bald or thin spots or if handfuls of hair are suddenly falling out, reach out to a medical professional for advice.

They will ask you questions about your lifestyle, medical history, and family’s medical history to determine the cause of hair loss.

They may also undertake a physical examination to reach an accurate diagnosis. 

Some other causes and conditions that affect the body’s hair include:

  • Polycystic Ovary Syndrome (PCOS)
  • Types of alopecia
  • Thyroid ailments
  • Addison’s disease
  • Hodgkin’s disease
  • Celiac disease
  • Ringworm
  • Hormone imbalances before, during, and after pregnancy or menopause
  • Emotional and mental health triggers such as stress, anxiety, and depression
  • Eating disorders or lack of necessary proteins and vitamins
  • Substance abuse

You will need to consult a medical provider to know exactly what is causing your hair loss, and they can then determine the right treatment for that condition. 

If you are experiencing severe symptoms and side effects from spironolactone, seek medical help. 

Also, if you have difficulty breathing, feel lightheaded, or are extremely weak, call 911 or visit the emergency room immediately. 

How K Health Can Help

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Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

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Frequently Asked Questions

How quickly does spironolactone work for hair loss?
It can take at least six months for you to notice the effects of spironolactone on hair loss. This varies from person to person; some people notice a difference after a year. For spironolactone to work effectively, it should be taken properly and consistently as prescribed by a medical professional.
Will spironolactone help with hair loss?
Spironolactone is a medication used to treat hair loss due to androgenic alopecia. While results can take six months to a year to present, each person’s body will respond differently to spironolactone. If you are suffering from hair loss or if hair loss is causing a hindrance to your life, consult a healthcare provider for advice.
Is spironolactone used for excessive hair growth?
Spironolactone (Aldactone) may be used to treat excessive or unwanted hair growth, while in many cases, it is also taken to treat hair loss. Depending on your ailment, symptoms, and needs, you will need to consult a medical provider for an accurate diagnosis and spironolactone treatment plan.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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