Oral minoxidil stimulates hair growth, but its use in female pattern hair loss (FPHL) is limited by potential adverse events including postural hypotension, fluid retention and hypertrichosis. Spironolactone, another oral antihypertensive with antiandrogen activity, may arrest hair loss in FPHL.
To investigate the use oral minoxidil and spironolactone in FPHL, 100 women with a Sinclair stage 2-5 FPHL were enrolled in a pilot study and followed for 12 months. Hair shedding was scored using a 6 point visual analogue scale.
Mean age was 48.44 years (range 18-80). Mean hair loss severity at baseline was Sinclair 2.79 (range 1-5). Mean hair shedding score at baseline was 4.82. Mean duration of diagnosis was 6.5 years (range 0.5 -30). Mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months. Mean change in blood pressure was -4.52mmHg systolic and -6.48mmHg diastolic.
Side effects were seen in 8 of women but were generally mild. Six continued treatment while 2 women who developed urticarial discontinued treatment.
In this prospective uncontrolled open label observational pilot study, once daily minoxidil 0.25mg and spironolactone 25 mg appears to be safe and effective in the treatment of FPHL. Placebo controlled studies to investigate this further are warranted.