Spironolactone for Chronic Telogen Effluvium: Is it an option?

Is Spironolactone Helpful For CTE?

I’ve selected this question below for this week’s question of the week. It allows us to review the diagnosis and misdiagnosis of CTE.

Question

I am a 48 year old female and have chronic telogen effluvium. My doctor gave me spironolactone and it worked! My shedding stopped and my hair improved. I don’t see you mention spironolactone as a treatment for CTE. Why do you think my hair improved?

Answer.

Thanks for the question. Ideally, I would want to see your scalp and review your history to determine your exact diagnosis. I suspect that most likely spironolactone worked because you have androgenetic alopecia as the actual diagnosis and not CTE. I would only be able to confirm this suspicion once I see your scalp myself.

One of the most common conditions that gives shedding is androgenetic alopecia. It’s easy to diagnose in more advanced stages but a bit tricker to diagnose in the early stages when all that the patient has is increased hair shedding. Spironolactone works very well for 50-60 % of women with androgenetic alopecia and so this is likely the reason your shedding stopped.

Elevated levels of hair shedding can occur in so many more hair loss conditions that just telogen effluvium. Shedding can occur in androgenetic alopecia (AGA), acute telogen effluvium (TE), alopecia areata, seborrheic dermatitis, chronic telogen effluvium (CTE), folliculitis decalvans (FD), lichen planopilaris (LPP), contact dermatitis (ACD/ICD), lupus, dermatomyositis and others.

I do think that androgenetic alopecia really needs to be re-evaluated in your case with such a striking improvement. A biopsy from the mid scalp can help confirm if any amount of androgenetic alopecia is present.

Thank you.