I have VERY thin hair, especially around my crown area. Derm did a blood workup and said I needed to take a iron and Vitamin D supplement because they were very low and also put me on spiro and recommended I do a combination therapy with 5% minoxidil. I am very skeptical on using minoxidil since it is a lifetime commitment, so I decided to just try the spiro. I also have very minaturized hair. I want to know how well spiro works for your patients? And if I really should use minoxidil (5%)
Spironolactone and Minoxidil
I have actually had decent results using Spironolactone starting at 50mg per day and increasing up to 100mg twice a day. As far as Minoxidil, I have never been a big fan. Despite being over the counter, Minoxidil should be used with caution as it can make some scalp conditions worse while doing very little for the hair.
Spironolactone and hair loss in women
Current research suggests spironolactone helps 30% of women "improve" their hair density and helps 30% of women "prevent" further loss. Spironolactone does not help all women.
It is important to understand that this medication must be used "long term." Just like minoxidil, spironolactone is a lifetime commitment. If you gain improvement with spironolactone and then stop the medication, you will lose all benefit over 9 months.
The dose required to treat female pattern hair loss is 200 mg per day. Many women take 100 mg in the morning and 100 mg in the afternoon. Doses less than 200 mg daily are less effective. Women must never get pregnant while using this medication. Side effects include mood changes, breast tenderness, decreased libido, menstrual irregularities and dizziness. It can interact with some medications so be sure to tell your physician all medications you take.
Spironolactone can work quite well for female androgenetic alopecia
Spironolactone has worked very well for my patients with androgenetic alopecia with Ludwig pattern where there is preservation of hairline along anterior scalp but with significant thinning on the crown. I typically start spironolactone 25mg 2x/day though sometimes dose may have to be increased to 100mg 2x/day. Finasteride is also a good alternative but should be prescribed by board-certified dermatologist. Concurrent use of Rogaine 5% foam also is quite helpful. For women and men who seek relatively quicker and consistent clinical results, NeoGraft hair restoration should be considered where there is no linear scarring, sutures with less downtime compared to traditional hair transplant.
EmoticonEmoticon