Efficacy and safety of oral spironolactone for female pattern hair loss in premenopausal women: a randomized, double-blind, placebo-controlled, parallel-group pilot study.

Background: Oral spironolactone is widely used as an alternative treatment for female pattern hair loss, particularly in women of reproductive age. However, published data on its effects are still limited. Objective: This study aimed to evaluate the efficacy and safety of spironolactone 100 mg daily for female pattern hair loss in premenopausal women compared with placebo. Methods: Forty-eight women aged 21 to 45 years were randomly assigned to receive spironolactone 100 mg or matched placebo once daily for 24 weeks. Twice-daily minoxidil 3% solution was used for all to avoid untreated participants. Efficacy was assessed by changes in hair density and diameter using videodermoscopy and global photographic assessment. Results: After treatment, hair density and diameter increased significantly in both treatment groups (all Limitations: The sample size was small. Conclusion: Oral spironolactone 100 mg daily for 24 weeks showed an additive effect on topical minoxidil therapy in premenopausal women with mild-to-moderate female pattern hair loss. Although it was generally well-tolerated, irregular menstruation was common.