Thank you for your question You’re asking if spironolactone damages your kidneys and is it safe to take for 6 months to a year
Well certainly, you submitted a question that is appropriate for female pattern hair loss and is a common question that is often discussed in our practice with patients with this condition A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon I have been in practice in Manhattan and Long Island for over 20 years I am also the founder of TrichoStem™ Hair Regeneration Centers, a system we developed for men and women with androgenetic alopecia using Acellular matrix and platelet-rich plasma (PRP) and we’ve doing this treatment since 2011 And we developed a system that is essentially working both with patients who are already on spironolactone as well as with most of our female patients who have never been on spironolactone
So to understand the thinking behind the use of spironolactone, when I see patients who come to me who have female pattern hair loss and typically, a dermatologist has prescribed spironolactone as a way to block testosterone with the working diagnosis that androgenetic alopecia is due to testosterone sensitive hair follicles so they suppress the testosterone Now it is known that this drug is a diuretic, it works in the kidneys And I think the way this question is most appropriately answered is to discuss the impact of spironolactone on the kidneys with your doctor It is routine to have lab tests done to check kidney function But I can tell you that I have patients who have been on spironolactone for years
In fact, it is also part of many birth control pills to have spironolactone as part of the birth control pill as a way to help, for example, patients with acne Acne is also associated with an imbalance in testosterone and testosterone blockade has certainly helped patients with acne I can tell you that from a clinical perspective that when we treat patients with Hair Regeneration and to go back to the origins of this treatment, we developed this treatment after using a material called extracellular matrix with platelet-rich plasma (PRP) to help patients with hair transplants have better healing In other words, we wanted the donor area to heal better and we wanted the hair grafts to survive And so this stem cell based technology also resulted in thinning hairs becoming thicker.
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Well, it has been a significant benefit for our patients for women who have come to us from around the world with female pattern hair loss And until this point, when we’ve taken on this challenge, there really was not much available for female pattern hair loss Besides the use of spironolactone, there was also the use of minoxidil and I can tell you that most of our patients who have tried minoxidil who were women didn't seem to find much value in it Now as far as the effectiveness of spironolactone, I can tell you just anecdotally from the feedback I get from my patients, there’s a large percentage of our patients who are on the drug who aren't sure that the drug is helping And there’s a certain percentage of patients who say that they did see an improvement being on the spironolactone
Since I don't prescribe spironolactone and I leave it up to their dermatologist to decide whether or not to continue the drug I don't interfere with that process What we do is we do our treatment of Hair Regeneration which is an injection treatment that has consistently resulted in regrowth of hair, thickening of thinning hair and prolongation of the hair growth cycle And with data now it’s going on beyond 7 years, it has had a very high rate of success essentially about 999% or more for female pattern hair loss
And this is actually interesting because it was a challenge as it was for both male and female pattern hair loss to develop an algorithm and a system of dosing and placement so that we would get good results And with women, we’ve had many challenges in the early years and ultimately, it’s become quite a really gratifying benefit to our patients to be able to help treat a condition which unfortunately, there’s no other medical intervention in contrast to men for the option of taking finasteride So I would say that there is an opportunity for you to have this discussion about your concern about kidneys with your doctor about the dosage In fact, because the drug is a diuretic, a lot of our patients would mention that they had to get up at night frequently to go to the bathroom because they're on a diuretic while others felt that they can tolerate the drug without any problem It is a discussion to have with your doctor
It’s in the context of your general medical profile and of course, with routine lab tests to see kidney function and also monitor that effect It’s important to also, in my opinion, to explore other options for the treatment of female pattern hair loss As I said, we’ve made a big impact with Hair Regeneration And with a long history of experience, I can tell you that in our practice, it is also very straightforward with the exception of some diagnostic unknowns where patients come with a presentation of female pattern hair loss and may have other conditions where we still have to do biopsies and look at other possible causes But for androgenetic alopecia, Hair Regeneration has worked out very well and has been a sustainable approach without the use of other drugs
It doesn't mean that there isn't value because I also explain to our female pattern hair loss patients that women are particularly sensitive to hormones, hormone balance where testosterone, estrogen, progesterone as well as thyroid as well as other important variables in the blood such as iron levels, Vitamin D Further, women appear to also be sensitive to stress induced hair shedding which is a distinction from genetic pattern hair loss So I always say that it’s important to have a team approach when it comes to managing hair loss That means being followed by a medical doctor, OB-GYN in terms of hormone levels and optimizing hormone therapy if appropriately, endocrinologist, dermatologist And from our end, we can stimulate hair growth with Hair Regeneration and we have a certain understanding as to the predictability based on a patient’s profile
And so essentially, spironolactone may have a value in your situation depending on your doctor’s opinion on the impact of testosterone on your hair loss So I hope that was helpful, I wish you the best of luck and thank you for your question
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