Should I discontinue Spironolactone (for acne) if my hair is falling out?

Question

This would have been my 5th month in with Spiro (100mg, once daily). I noticed beginning in the 4th month that my hair was falling out quite a bit more than usual. Recently, I completely stopped taking it in fear that I would go bald; however, I don't want my hormonal cystic acne back. This is the ONLY thing that has helped me since Accutane. What should I do? My derm says she has never heard of this happening with Spiro- but I've read otherwise. Please help.

Marla M. Klein, MD · Answer

Spironolactone is a diuretic which works by blocking testosterone receptors; it is used as a treatment for female hair issues such as hair loss from the scalp or to decrease unwanted excess hair on the face.  I would not suspect the Spironolactone of causing hair loss.Anytime a patient is experiencing acute onset of hair loss, a history looking for a large stressor such as a major surgery or death in family is needed (telogen effluvium happens 3 months later, but then grows back on its own) and typically blood tests looking for any signs of anemia or hypothyroidism.  Both of these medical causes can be successfully treated to restore the hair growth.As with any medicine, some people experience unique side effects.  The most scientific way to test this is to stop drug, and let things return to normal (if they do) then restart medicine to see if the same problem starts again.  I have been in practice as a dermatologist for 20 years, often prescribe Spironolactone for acne, and never have had a patient experience hair loss as a side effect from it.

Jennifer Ahdout, MD, FAAD · Answer

Spironolactone is actually used to treat androgenetic alopecia in females. It would be unusual to see hair loss as a result of this medication. It is important to consult with a specialist to determine if there is an alternate cause for your hair loss.

Should I discontinue Spironolactone (for acne) if my hair is falling out?

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Should I discontinue Spironolactone (for acne) if my hair is falling out?

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Everything you need to know about Spironolactone For Acne

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