Acta Derm Venereol. 1990;70(4):342-3.
Reversal of andro-genetic alopecia in a male. A spironolactone effect?
Bou-Abboud CF, Nemec F, Toffel F.
Source
Department of Internal Medicine, University Medical Center of Southern Nevada, University of Nevada School of Medicine.
Abstract
This 73-year-old white male has been bald since the age of 28. He developed nonA-nonB-induced liver cirrhosis and had been treated with spironolactone for the last 6 years. For the last 3 months, his hair had started to regrow over the scalp. This might be related to the antiandrogenic effect of spironolactone.
Comment
Spironolactone in addition to being a potassium sparing diuretic, is a moderately potent androgen receptor blocker that is generally too anti-androgenic for systemic use in men, and is so toxic I wouldn’t give it to my dog. Spironolactone used orally almost always causes fatigue (via electrolyte depletion), reduced libido and muscle mass, breast enlargement in men and raises the risks of breast cancer in women. Oral Spironolactone is also used as a primary anti-androgenic component in male to female gender reassignment hormonal protocols. Toxicity and anti-androgenic effects notwithstanding, this guy re-grew a full head of hair after 45 years of complete horseshoe fringe slick baldness. The pictures published in the full text study are dramatic. This 73 year old man went from no hair for decades to a full Ronald Reagan like head of hair. We are not posting this abstract to recommend any one, male or female use oral Spironolactone as a treatment for hair loss. We are posting this abstract because it provides, in addition to the feedback we have gotten for years, published evidence to refute the ridiculous notion that hair follicles are somehow “dead.”
The fact is that hair follicles technically never “die”, they miniaturize to the point that they are no longer visible, over time resulting in a slick bald appearance. Once a hair follicle miniaturizes to this point it does become extremely resistant to treatment and re-generation. Researchers at L’Oreal and other academic institutions identified the culprit behind this resistance to regeneration as a progressive and long standing fibrosis (chronic inflammation induced collagen hardening) that occurs in Androgenetic Alopecia. Perifollicular Fibrosis and the resultant miniaturization occur in response to inflammation and DHT, making it almost impossible to regrow hair in completely bald areas in the short term. However as fibrosis is gradually reversed, regrowth of hair is possible, as this study shows, in the long term.