Quote: Dr.Lee
Spironolactone is effective in protecting the follicles from DHT because it
(1) inhibits the synthesis of DHT,
(2) converts testosterone in the scalp to estrogen, and
(3) blocks the androgen receptor sites on the hair follicles, effectively preventing even circulating DHT from attaching to the receptor sites. As a result, the follicles are protected from miniaturizing and have the potential to mature again to their normal size.
Topical spironolactone does not cause shedding. Because it metabolizes totally and rapidly in the skin where it is applied, there are no systemic effects. Although, after I used it for 2 weeks applying a moderate amount in 3 separate areas I got some worrying chest pains and trouble breathing. Consider these side effects if you decide using spironolactone.
TOPICAL SPIRONOLACTONE IN THE TREATMENT OF ALOPECIA ANDROGENETICA
Genetically, only the follicles on the top of the scalp are encoded with androgen receptor sites , which explains why hair follicles along the side of the head and in the back of the head do not atrophy. The attached DHT on the receptor sites is perceived as a foreign body and the immune system begins to destroy the hair follicle, shortening the growth phase and causing the hair shaft to become progressively finer in texture. In extreme cases, only a microscopic vellus hair remains. The good news is that these
follicles have the inherent capacity to mature to their former size and thickness.
Encouraged with the success of finasteride to reduce the amount of DHT in the scalp of patients with male pattern baldness (male pattern baldness), doctors and scientific researchers took another look at existing medications that are known to act as anti-androgens.
There have to be stringent criteria for an anti-androgen that can be used to combat or even reverse pattern alopecia. The ideal anti-androgen should have the following properties:
(1) It must have potent anti-androgen activity; (2) it should selectively prevent or successfully compete with DHT without changing testosterone levels; (3) it should be effective topically, so it can be conveniently applied with minoxidil solutions or lotions and (4), it should be easily absorbed into the skin, but should have no systemic effects.
That’s a tall order. Surprisingly, there is such a medication: spironolactone. And it’s not a new medication. For over thirty years spironolactone has been used for its anti-androgenic effects in both males and females. Taken orally, it is such a potent
anti-androgen that, although it is an effective anti-hypertensive drug, it is rarely used to treat men with hypertension because of its feminizing properties which can include painful gynecomastia .
Applied topically, however, spironolactone does not have systemic side effects . Clinical evaluators of topical applications of spironolactone concluded, "as far as the topical use is concerned, spironolactone seems to be highly effective with
absence of systemic effects". Physicians have been treating patients for male pattern baldness for well over fifteen years and there have not been any reports of systemic side effects. In my own research, the use of topical 5% spironolactone along with Xandrox 5% solution yielded improved results as compared to the use of Xandrox 5% alone. Likewise, the combination of 5% spironolactone with Regrowth's 5% minoxidil yielded improved results as compared to the use of 5% minoxidil used with daily 1 mg doses of finasteride
(with the added advantage of zero side effects).
Among its other properties as an anti-androgen, spironolactone is a potent competitive inhibitor of DHT at its androgen receptor sites . As such, spironolactone effectively prevents DHT from attaching to the receptor sites on the hair follicles.
As a result, the follicles no longer atrophy and can mature again to their normal size. And they do so without decreasing the circulating levels of DHT in the body. By comparison, finasteride inhibits the formation of systemic DHT, causing troublesome side effects in many patients.
Multiple studies in various medical centers document that spironolactone is effective when applied topically. In studying the anti-androgenic effects of topical spironolactone at the Department of Dermatology at New York University School of Medicine, researchers established that spironolactone concentrations of 0.01% to 5% produced a dose responsive decrease. When both topical 5% spironolactone and topical 5% minoxidil are used daily in the treatment of male pattern baldness, the effects of the medications are synergistic. Whereas neither medication alone is particularly effective for the majority of patients, the success of the combination has been experimentally proven. Our own success rate with this formulation has been approximately 75-80%.
Do not combine medications containing spironolactone and minoxidil in the same container. The medications slowly react with each other, resulting in a compromise of their pharmacological activities. However, since it requires many hours for spironolactone and minoxidil to chemically react with each other, they can be consecutively applied to the scalp without compromising the pharmacological action of component.
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*According to the above statement , Sprio seems like a miracle drug in treating male pattern baldness/Androgenetic Alopecia. I believe it is quite an effective treatment for male pattern baldness but it is not without it's side effects. It is claimed that there is no side effects when applied topically. Unfortuenatly after only apllying a moderate amount to my temples and crown I had trouble breathing and chest pains. I looked online to see that many others had the same side effects. Most claimed that reducing the amount applied to the head resolved these probelms. I was only using it once , nightly so reducing the frequency/amount was not really an option.
Also I highly reccomend to shave your head if possible when using spironolactone. It is quite greasy and is only effective when applied to the scalp. Wash your hands directly after applying spironolactone because you don't want to be getting any of this sh*t in your mouth.
**Many sources claim spironolactone has a bad smell. The 5% spironolactone lotion I ordered from Minoxidil.com had no smell. I imagine that the S5 cream on this site has no smell either.
---Here's an Italian study for the use of spironolactone in the treatment of male pattern baldness/Androgenetic Alopecia:
http://www.geocities.com/bryan50001/spiro2.htm
You can thank Byran for that study.
The best you can expect for spironolactone is maintenance. Although when used longterm it might enable the follicle enough time to regrow thicker and healthier.
