Does Spironolactone Help With Hair Loss in Women? Here’s a Review of the Research

Female-pattern hair loss (FPHL), also known as androgenetic alopecia, is the most common form of hair loss in women. While the exact cause isn’t fully clear, research suggests that it usually happens as women get older and go through menopause. The hair spends less time growing, which can lead to hair thinning. Hair follicles themselves can also become smaller. Genetics can play a role, too.

More than half of women will eventually experience this type of hair loss. It usually begins after age 40, and by age 50 nearly half of women will have noticeable hair thinning. Hair loss can also contribute to social and emotional challenges.

Some hair-loss experts have explored spironolactone (Aldactone, CaroSpir) as a potential hair-loss remedy for women. This prescription medication was originally developed to treat high blood pressure and fluid retention, but some data speaks to its utility for hair growth.

Here, we’ll review the research on spironolactone's effectiveness and recommended dosages for hair loss in women. We’ll also detail the potential risks to keep in mind.

Does spironolactone help with hair loss in women?

It can. Spironolactone is sometimes prescribed off-label for FPHL. Although it’s not FDA approved for treating hair loss, your dermatologist may prescribe it anyway based on study data and past experience.

In a small study of women with FPHL, about three-fourths of participants saw their hair shedding, thickness, and regrowth improve with spironolactone. Another review of several clinical studies suggested that spironolactone may effectively treat hair loss in women when used alone or in combination with other hair-loss medicines.  

Promotion disclosure

Spironolactone

Avg retail price

$17.99(Save 69.65%)

GoodRx discount

$5.46

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

While more research is needed to confirm how well it works, spironolactone is a promising option for treating FPHL in women who haven’t found success with other treatments. If you're considering it, talk to your dermatologist to determine if it’s a good option for you.

Spironolactone’s FDA-approved uses

Spironolactone is approved to treat certain heart problems, including: 

• High blood pressure

• Heart failure

• Hormone imbalances that affect how your body handles salt and water (primary hyperaldosteronism)

• Swelling when your liver or kidneys aren't working properly (edema)

Spironolactone offers these benefits due to how it functions. It belongs to a medicine class known as aldosterone antagonists. It works in the body by blocking a hormone called aldosterone. By blocking aldosterone, this "water pill," or diuretic, stops your body from holding on to extra fluid.

How effective is spironolactone for female-pattern hair loss?

Spironolactone seems to be relatively beneficial for treating FPHL. It does this by blocking certain hormones, such as androgens like testosterone. These hormones can make hair follicles shrink, leading to hair loss or thinning. By reducing the effects of these hormones, spironolactone can help slow down hair loss and may even improve hair growth over time. 

In addition to the studies mentioned above, other small studies have shown promising results. For instance, one study published in the Journal of Cosmetic Dermatology found that 43% of women saw an improvement in hair loss after 4 months of using oral spironolactone and topical minoxidil (a common hair loss medicine) — with no serious side effects reported. 

EXPERT PICKS: WHAT TO READ NEXT

• Wondering how to tackle female-pattern hair loss? Discover science-backed treatments that can help restore your confidence and hair health.

• Medication safety: Find out what you need to know to keep yourself safe from spironolactone interactions.

• Worried about side effects? GoodRx pharmacists detail what you should know about risks linked to spironolactone — and how to manage them.

If you’re considering spironolactone for FPHL, it’s important to talk with a dermatologist to determine if it's the right treatment for your situation. 

Keep in mind: Success rates and results can vary with any medication, especially hair loss remedies. Talk to a dermatologist to find the best approach tailored to your hair loss needs.

What’s the recommended spironolactone dosage for female-pattern hair loss?

Since spironolactone isn’t approved for FPHL, there isn’t a widely accepted dosage for it. Instead, the recommended spironolactone dosage for hair loss in women depends on your overall health, hormone levels, and the extent of your hair loss. Your prescriber will decide the best dose for you and provide you with a prescription, if appropriate. 

In a study of women treated with spironolactone for FPHL, though, the average dosage was 100 mg once daily for at least 6 months. Daily doses varied from 25 mg to 200 mg.

Your dermatologist may prescribe a lower dose at first to see how well you tolerate the medicine. If all goes well, they may increase it to a target dose of 100 mg to 200 mg daily. Your prescriber will determine if you need a higher dose with careful monitoring.  

For reference, spironolactone tablets come as 25 mg, 50 mg, and 100 mg. The oral suspension comes in a 25 mg/5 mL concentration.

How long does it take to see hair growth results with spironolactone?

Hair takes time to grow, and spironolactone isn't a quick fix. 

For example, in a published case report, one woman noticed an improvement in hair growth after about 12 months (1 year) of taking spironolactone 200 mg. But these results came in stages. Early signs of regrowth, such as reduced hair shedding, appeared within the first few months, with new hair growth in thinning areas typically showing after around 6 months. Full results took up to a year or longer.

It's important to note that everyone’s body responds differently, and the timeline for visible results can vary. If you’re considering spironolactone for hair loss, make sure to ask your prescriber about the time it will likely take to see improvements.

Can you combine spironolactone with minoxidil or other hair-loss medications?

Yes, spironolactone is often used in combination with minoxidil (Rogaine) — a topical hair-loss medication that’s available over the counter (OTC). Minoxidil helps increase blood flow to the hair follicles, which can help hair grow.

Depending on the extent of your hair loss, your dermatologist or healthcare professional might suggest additional options, such as platelet-rich plasma (PRP) therapy or a hair transplant. Studies have shown that combining treatments can lead to better results. 

Before starting or combining hair-loss treatments, always talk to your prescriber to ensure they're safe and suitable for your needs.

What are the risks of taking spironolactone for hair loss as a woman?

Spironolactone has a few risks to keep in mind. It most often causes mild side effects that get better or go away as your body adjusts to the medication. These spironolactone side effects include: 

• Headaches

• Dizziness

• Breast tenderness

• Decreased sex drive

• Muscle cramps in the legs

• Low sodium levels

• Menstrual irregularities

• Stomach issues

• Electrolyte imbalances

• Fatigue

Some less common, but more serious spironolactone side effects include: 

• Stomach bleeding

• Excessive electrolyte changes

• Severe skin rashes

Always loop in your prescriber if you start to experience bothersome side effects while taking spironolactone.

Potassium-related risks

Spironolactone can increase potassium levels in your blood. This can be harmful, especially to your heart. 

If you have a history of heart or kidney problems, or take other medications that increase your potassium levels, your healthcare professional will likely want to collect routine blood work to monitor your potassium levels.

Pregnancy risks

Spironolactone is not safe to take during pregnancy. It can affect a developing fetus. If you're of childbearing age, use effective contraception while taking spironolactone. You should avoid taking spironolactone if you're pregnant or planning to become pregnant.

Does spironolactone help with hair loss in men too?

Spironolactone may help with hair loss in men. However, it's generally not recommended. Spironolactone decreases testosterone levels, which can cause unwanted side effects. It can also cause men to develop breast tissue over time, a condition called gynecomastia, which can be uncomfortable. 

Men experiencing hair loss usually benefit from medicines such as oral finasteride (Propecia) and topical or oral minoxidil.

Why trust our experts?

Written by:

Goldina Erowele, PharmD, MBA

Dr. Goldina Ikezuagu Erowele is a transformative leader in healthcare with a distinguished record of advancing medication safety, operational efficiency, and cost management.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Our editorial standards

Meet our experts