Spironolactone for acne and hair loss - dermatologist explains
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- เผยแพร่เมื่อ 10 ก.พ. 2025
- Spironolactone is a diuretic that has been used "off label" for a variety of skin conditions. In this lecture we look at how it works as an anti-androgen in acne, hair loss, hidradenitis and hirsutism. The dosage and side effects are also discussed.
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I've been using spiro for two months now after relapsing from an accutane treatment. I've noticed clearer skin and thicker hair. No complaints. I have my follow up appointment with the dermatologist in September. I just have onc concern that I would have to take Spiro long-term which represents a load on the kidneys. I'm hoping to have a satisfying answer. I'd do anything to have clear skin after 20+ years suffering from acne and trying everything to no avail.
It is good to hear that spironolactone has been helpful. It seems to be useful in onset after our teens. In a young person with no underlying medical issues, it has no significant side effects. It does not seem to cause renal problems in a healthy person. No blood tests are recommended if younger women without underlying medical issues.
@@DiscoverDermatology Thank you. That's very reassuring.
Hello...your spiro dose for acne?
AMAZING! Tysm, I'm about to start this and it's so great having your explanation. Thank you! ❤
Glad it was helpful! Thank you for your kind comment!
Great explanation, very clear and backed by science! Thank you.
Thanks for your kind words!
Great video! I am on pill 4 and having extreme brain fog, fatigue and nausea. Will this go away? I am on 25 mg once per day
Spironolactone is usually safe and side effects are unusual. If any side effects are noted, taking the dose on alternate days could be considered. There are other medications that could also be helpful that can be considered.
#Disclaimer# Please note that this video is for education purposes. It is not meant for personal advice as your own doctor/dermatologist will be the best person to answer specific queries.
Thank you so much! I have an appt to see my derm in two weeks, but had to stop because of the side effects. I appreciate you answering my question. @@DiscoverDermatology
Thank you so much sir for providing all the wonderful specifications of spirinolactone in a very crisp and concise manner.
Glad it was helpful for you! Thanks for the kind words.
Lovely explanation, keep it up!
Thanks so much!
Hello, I used 1.25 g minoxidil between May and December. Hair loss was minimally affected. I started using spironolactone since December. It was very good for my hair loss. I'm currently using 50 milligrams. Do you think I should stop minoxidil and just continue with spironolactone? What would be your suggestion?
It is difficult to know if both medications are working or just one is. I usually tend to ask my patients to make their own decisions as they know what the body is telling them. Both doses are low, so there is no harm in continuing with both too, or stopping one.
Hello Dr Yusudian, can you help with a question which has puzzled me ever since I heard another TH-cam Dr give his response to the answer? Let's say someone is diagnosed with Androgenic Alopecia; the miniaturisation has begun and is noticeable. The patient is prescribed finasteride to block further conversion of test into DHT. What happens to the existing DHT in the scalp that was already converted from test before the patient started on finasteride? Where does it go and is it not still not circulating within the scalp causing ongoing destruction? I heard some Dr say it gets "washed away" but ho is that possible. What's your opinion? Thanks.
All hormones and cytokines (inflammatory proteins) tend to have a limited life span, sometimes just minutes, or hours or a few days. The body constantly makes more of them and there is a turnover of these chemicals in the blood. So, once the medications starts its effects, it controls the excess hormones as long as it is used. Once stopped, there is a chance that the underlying hormonal changes will recur again.
Dr. What will happen after discontinuing Spirinolactone. Will acne appear again?
There is a possibility of recurrence when the medication is stopped. Generally, we tend to use spironolactone long term,, for at least 6 to 24 months.
Hello I used spironolactone tablets for my hair 1 year back. And it stopped my hair fall. But now my hairfall has started again. I just want to know that should i start taking it again??
If it has helped before, Spironolactone may be beneficial again. Oral Minoxidil isa other option. Here is a video on it
th-cam.com/video/JurJK_sSJAY/w-d-xo.html
Thank you for responding
I have started taking spironolactone 50mg
How long should I take it?
@@farhanaushad5847 Usually medications for hair loss need to be continued for about 4 to 6 months to note any change in density.
A very useful video, thanks.
Thanks so much!
Hello Doctor. Is 100mg a day suitable for AGA combined with Minoxidil. Would Bicalutamide be helpful to include?
The dose of spironolactone varies from 50 to 200mg. Addition of bicalutamide is certainly an option. It is best to give each treatment at least 4 to 6 months before moving on to add a further treatment.
Hi doc,my derm started me on spiro 50 mg once a day for HS,last month, after making a hormonal panel..
Total testosterone 65 ng/dL , she said it's slightly increased than normal..., she suspected hormonal issues(only getting flares a week before periods)
After one month,now she increased it to 50 mg twice a day and finasteride 5 mg once a day,
I have severe discomfort in my head and my as i checked bp went down to about 100/60..
I've missed my period now.
As i asked her, she said spiro and finasteride won't affect periods,as they are not hormonal pills..
Pls suggest if these have any connection with periods...
And what to do..
Most medications that affect the hormones may make the periods irregular. This includes spironolactone.
Dr. Can men consider taking spironolactone ? Having severe cystic acne ?
Im afraid Spironolactone is effective only in women. It is likely to cause gynaeocmastia (swollen breasts) in men.
Sir, please suggest few dermatology journal available online .
Thanks 🙏
Most of the dermatology journals that we recommend for trainees are available online - Clinical and Experimental Dermatology, British Journal of Dermatology, American Academy,y of Dermatology, International Journal of Dermatology. However, they require paid access. The free ones are International Journal of Trichology and Indian Journal or Dermatology Venereology, which are also very good.
@@DiscoverDermatology Thank you Sir
Sir i have pcod and my doctor prescribed me this for acne should i use it or not 25mg
Spironolactone is used for those with PCOS and the dose varies from 25mg to 150mg.
Hello Sir, Good Evening!!
I'm 26 years old taking spironolactone 50mg & minoxidil 5% with finasteride 0.1% & taking Autrin for iron deficiency with vb7 hair biotin will this combination works for hair fall... Please assist.
The combination used is quite a good one and needs to be sued for at least 6 months to note any change in hair density.
Good evening sir.. can u please give your opinion for the combined treatment of finasteride 5 mg and spironolactone 50 mg for androgenic alopecia and acne. I am a 41 year woman.
Spironolactone is used for alopecia in women and is commonly combined with oral minoxidil. I tend not to use finasteride in women, but that is a personal preference. Bicalutamide is an option that may be safer. Here is a video on it
th-cam.com/video/rFWNAjIQXCg/w-d-xo.html
Metformin a further option, and there is a video I did on it.
th-cam.com/video/rFWNAjIQXCg/w-d-xo.html
@@DiscoverDermatology thank you for replying sir.. u tend to not use finasteride in women bcoz of it not being effective or bcoz of the side effects. Bicalutamide can be paired with spironolactone?
I took bicalutamide for about 6 months but it did not help my acne at all though it did reduce sebum production drastically.
@@ridhimaagarwal6142 I try not to use 5 alpha reductase inhibitors in women as there are no long term safety data on it. Bicalutamide can be used with spironolactone as they have different mechanisms of actions.
Ok sir.. thanks a ton for replying .. I will speak to my doctor regarding the combination of bica and spironolactone
Hlo doctor i am 19 years old and having female androgenic alopecia .. and taking aldactone 50 once a day...and biotin tablet is it enough
It depends on the response to treatment. In many, just one medication like spironolactone may be sufficient whilst in others, other medication like minoxidil or biclutamide may be needed. here are videos on both medications
th-cam.com/video/rFWNAjIQXCg/w-d-xo.html
th-cam.com/video/JurJK_sSJAY/w-d-xo.html
can you explain the part where we have to be low potassium diet , i am working out so part of my diet includes carbs such as patato what else we should be careful of?
In normal adults who are less than 40 years without underlying medical conditions, we do not need to worry too much about potassium levels in any food.
@@DiscoverDermatology thank you!
Hii doctor
Im 23 year old girl I have severe hairfall from last 6 months my dermatologist suggest me finasteride 1mg for 1 month but from some conditions I have to change my dermatologist then he gave me minoxidil 2.5mg for 1 and half month but no result is seen than on 2nd sitting he prescribed me finasteride 1mg
I'm really tensed
Finasteride is not for girls it have several side effects what to do doctor please reply
Each dermatologist has their own favourite. Generally I tend to avoid finasteride in women and use spironolactone instead as it has more data. Some dermatologists use finasteride before Spiro though.
Can we use 50 mg spironolactone once daily for female hair loss. My dermatologist prescribed me this
Spironolactone is one of the treatments used for hair loss, so it is worth a go. Usually the dose is started at 50mg and worked up, as explained in the video.
Sir, pls do on hairloss and hair thinning and how to differentiate whether it is hormonal or nutritional primafacie.
It can be difficult to pin point the exact cause. In most, it is more than one factor. Here is a video that gives some useful information.
th-cam.com/video/IPXRxL7r4Wc/w-d-xo.html
@@DiscoverDermatology thanks doc! Watched it and was very much helpful.
Can a GP prescribe spirinolactone?
Yes they can. It is usually initiated by a dermatologist though. The GP can then continue with it.
Is it safe to as it is steriod,and does it make skin darker if i take it ??
It is not a steroid and there is no evidence that it causes facial pigmentation
How many days spironolactone to be prescribed??
It is used for a minimum of 4 to 6 months but can be continued for 12 to 24 months if required.
@DiscoverDermatology thanks
Can I take it if I am experiencing thick chin hair
Yes, this is an option for hirsutism (hair growth on face) too
@@DiscoverDermatology
Thank you so much for your response
I had a pcos but not that much and my doctor prescribed me aldactone(25 mg only) also im facing major hair loss nothing is working for me do you think taking 25mg Sprinolactone everyday will help.
Spironolactoine is used for PCOS and sometimes the dose may have to be increased as mentioned in the video.
@@DiscoverDermatology but is 25mg per day still gonna work?
@@Sundaycheesy Its very hard to know what dose is required for an individual. It can work at any dose from 25mg to 150mg
For men dutasteride can it help reduce sebum since it act on enzyme 1,unlike finasterode i got very oily skin i can afford accitane at my age over 40?
Good point. Dutasteride may help to a certain extent in reducing oily skin but isotretinoin is probably superior to it. Accutane has been given in all age groups including those above the age of 40 years.
@@DiscoverDermatologysir I'm 22 years old facing receding hairline /androgenic alopecia.
Please recommend me some topical medicine or highly effective medicine
@@pkentertainmentnews9502 There are a few medications for hair loss including minoxidil. here are a couple of videos on it
th-cam.com/video/JurJK_sSJAY/w-d-xo.html
th-cam.com/video/0cqHMW7hsgM/w-d-xo.html
I am male
Doctor recommended this medicine to me
Is it beneficial for males?
There have been no studies that have been done in males Im afraid. It's only for women with acne.
Hello doctor..Plz do reply me as it is bothering me a lot..
It's been 3 years that my periods were getting delayed for months and i was experiencing excessive hairfall..This year i came to know that i have pcod after doing USG...I took medicines for five months and changed my lifestyle...My periods improved but the hairfall was same..Then i start talking minoxidil 5% and oral minoxidil..After two months,i'm having hair growth on my face,chin,neck,forehead and all over the body..Now i have started this spriro..
I'm so confused..plx help me..plx
Usually the response to treatment for hair loss takes many months to manifest. The effect of minoxidil will probably take about 6 months to show itself and similarly Spitonolactone also takes time for its effects. Here is a video on how oral minoxidil helps various hair conditions.
th-cam.com/video/0cqHMW7hsgM/w-d-xo.html
Iam having pcod ,with hairloss and no weight gain but my face is darkening why is it ???
There are various reasons for facial pigmentation. Remember that hair dyes can also cause facial pigmentation as explained in this video:
th-cam.com/video/8MxBjmE8zR8/w-d-xo.html
This video looks at ways we can reduce facial pigmentation
th-cam.com/video/nCAI4PE073k/w-d-xo.html
I have pcos and just had vertical sleeve gastrectomy over 3 months ago to help with my type 2 diabetes. I lost weight but I lost MORE HAIR than i had already lost due to my pcos. 😱😱 I was thinking about this medication. Does it ACTUALLY help with androgenic alopecia????😮 I'm about to SHAVE EVERYTHING OFF SOON I'M SO FED UP!!!
Sorry to hear about this. Sudden weight loss from surgery can result in hair loss due to telogen effluvium. Spironolactone helps in androgenic alopecia from PCOS. Minoxidil may be an option in telgogen effluvium. Here are a couple of videos on it
th-cam.com/video/JurJK_sSJAY/w-d-xo.html
th-cam.com/video/0cqHMW7hsgM/w-d-xo.html
@@DiscoverDermatology thank you!! I'll check them out 😉😉😘
Sir will 50 mg per day of spironolactone help with hair loss?
The dose of Spironolactone used for hair loss is between 50 to 100mg a day. The maximal dose is 200mg a day, though it is rarely used.
Sir my daughter is 16 years old she is facing hypothyroid and pcos hair loss. What is your advice spironolactone is safe for her should I check her testosterone level before use this medicine.
@@rayyan25khan33 Usually, acne induced by PCOS is of the indications for Spironolactone treatment. Testosterone levels are not routinely measured for Spironolactone treatment. If there are concerns about using Spironolactone for hair loss, low dose minoxidil is another option. Here is a video on it
th-cam.com/video/JurJK_sSJAY/w-d-xo.html
Can i use spironolactone if i have low bp like 100/70 mm hg
It can be used cautiously and started on a low dose as that may not have a significant effect on blood pressure.
Hello doctor when should I take it for harmonal acne
After breakfast
Can spirolactone can increase hairfall initially is it normal?
It can be a possible side effect I guess though usually not noted with this medication.