Hair shedding from Spironolactone

Can Shedding from Spironolactone just Continue Beyond Month 2.

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts regarding hair shedding from spironolactone.

Question

I understand the spironolactone can cause hair shedding in the first 2 months of use for women that are using it to treat androgenetic alopecia. I’m wondering if spironolactone cause hair shedding that continues beyond 2 months and does not stop? I have been on spironolactone for 2 years and I’m still shedding. Is it the spironolactone?

Answer

Yes, spironolactone can cause shedding that just continues beyond 2 months but it is not common. They key questions here is whether your shedding is 1) simply from incompletely blocked androgenetic alopecia, or 2) another cause or 3) telogen effluvium or spironolactone.

It’s rare for TE just to go on and on and on in this setting. It’s certainly not impossible - but uncommon. Often, it’s simply androgenetic hair loss that is not fully treated. A dermatologist who specializes in hair loss can sort this out.

Spironolactone can do it that is true. But it’s rare. Your doctor can track how your shedding has changed over the years since starting. If the shedding has been the same since starting then it could be. If shedding has been pretty calm some months and then picks up during other months, then it’s probably not.

Your question is a good one but I would need to know your complete story over the past 15-20 years and see your scalp and see your blood tests to better evaluate the precise cause. If you treat your AGA more aggressively and find the shedding slows even more then it’s an indication that you simply weren’t treating your AGA fully enough and that the spironolactone had nothing to do with this.

There are many causes of shedding so be sure to get a proper evaluation if anything is not clear. Androgenetic hair loss, seborrheic dermatitis, alopecia areata, scarring alopecia, stress, medications, BMI under 19, endocrine issues, mineral and vitamin deficiencies, hormonal issues all cause shedding.