spironolactone?

Johnny24601

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I read alot about the big 3 (which I am on) but very little about this spironolactone stuff on this forum. Normally people recommend the big 3 but few come out and recommend spironolactone though this website reports positive feedback and zero sides (for topical spironolactone).
Now I seem to have had some positive results with the big 3 after about 4-5 months but I am a little concerned with my hairline which appears to still be thin as compared with the rest of my head. Seeing how I was able to catch this early, I figure I have a good shot of maintaining what I have and that would be so great (I am most likely not a Norwood-2 yet but I have pictures that prove I am thinning and receeding), but I am afraid that I am losing (or soon could be losing) the battle with my hairline.
Should I consider adding sprio to just the hairline? Are there truly no side effects from spironolactone? Would adding spironolactone be regime overflow? What are your thoughts on the potential positive benefits of spironolactone? If there are benefits, then why are there not more people on this site who either use spironolactone or recommend it as part of a normal hairloss regime along with the finasteride/minoxidil/nizoral combo?
Any help would be appreciated.
 

Cornholio

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spironolactone is a good (possibly the best/most studied/most recommended) topical androgen blocker available. (I know, RU the "wonder cream" cooked up in small batches and mailed from behind the iron curtain and Fluradil both exist, but finding genuine RU is a problem, and finding actual studies on either is difficult to impossible.... couple that with the cost and spironolactone looks good.)

spironolactone topical has no side-effects but can stink... Dr. Lee's 2% fast drying isnt bad, and his 5% cream is supposed to be good. A generic 5% lotion has been said to give off an odor of "skunkweed." Depending on your job and neighborhood that could be bad.

There is evidence that spironolactone is an anti-androgen, blocking androgen receptors and promoting conversion of testosterone to estrogen. As with Finasteride/Dutasteride DHT does not go to zero and serum testosterone may increase there is a theoretical reason to think that further androgen blockade might help some people (who continue to thin on the big 3)... Further blockade (my theory) might help because 1)some people are more sensitive to the residual DHT with stronger predisposition to balding 2) the testosterone not addressed at all by finasteride/dutasteride continues to cause problems in predisposed people.

That being said, I cannot think of a single clinical study where topical spironolactone was studied and shown to grown hair. This may be because its an old generic, and nobody would make money proving it helps... There certainly is no study showing that it grows hair when added to "the big 3" as combination treatments are never studied.

The "big 3" were chosen based on the amount of evidence backing them up... Lack of clinical studies make it harder to strongly recommend spironolactone, as above, but there is reason to think that it might add an important piece to the puzzle if proven treatments are not working for you....

Most people would rather start small and add if needed. If the more convenient proven treatments aren't working, or if you are inclined (as I am) to try to piece together the most complete multifactorial treatment possible and take them forever (cost and convenience be damned) then spironolactone (and copper peptides) might make sense for you.

"Global" knows his facts and uses spironolactone. Search the boards and look at people's meds... You will find people who use them, but its hard to strongly recommend them without clinical studies to back up the recommendation.
 

Johnny24601

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re:

I am of the belief that finasteride does not grow hair it simply slows down the rate at which your follicles shrink and even reverses the process. This enables hair to grow thicker, darker and longer and thus it apears that one has regrown hair. As far as I am concerned, when a follicle is dead it is dead and nothing is bringing it back. If there is a tiny bit of life with very small non-pigmented hairs then these can eventually be converted to thicker normal looking hair. Therefore, because I have a decent amount of hair on my hairline, it is clear that there are many hair follicle left, but they also seem to be shrinking at a faster rate then the rest of my head.
My fear is that, if I wait, I could be losing follicles that could have been saved with the added help of spironolactone. The problem I am having is that I do not want to become a slave of either my hairloss or my techniques to battle the hairloss. I do not want to start going crazy applying every single possible cream to my head. I think to many get obsessed with both their hairloss and their regime to fight the hairloss.
 

global

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From Dr. Lees website -

TOPICAL SPIRONOLACTONE IN THE TREATMENT OF ALOPECIA
AND INSTRUCTIONS FOR USE
ODORLESS 5% SPIRONOLACTONE LOTION NOW AVAILABLE
Purchase a large enough quantity of 5% Xandrox or 5% minoxidil solutions
to get your 5% Spironolactone Lotion free.
Price and discounts are explained in the Secure Order Form at:
http://www.minoxidil.com/scripts/webcar ... =minoxidil
It’s been firmly established that alopecia. androgenetica, more commonly known as male pattern baldness or just pattern baldness, is initiated by dihydrotestosterone (DHT) attaching to the receptor sites on the hair follicles [1.2.3.4.].
Genetically, only the follicles on the top of the scalp are encoded with the receptor sites [5.6.24.], 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 [6]. 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 where it is not applied.
That’s a tall order. Surprisingly, there is such a medication: spironolactone. And it’s not a new medication [7.8.]. For over thirty years spironolactone has been used for its anti-androgenic effects in both males and females [14.15.]. 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 [16.17.].
Applied topically, however, spironolactone does not have systemic side effects [12.18.19.20.]. 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"[19]. 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 receptor sites [21]. Therefore, spironolactone effectively prevents DHT from attaching to the receptor sites on the hair follicles [22].
As a result, the follicles no longer atrophy and can mature again to their normal size. And it does so without decreasing the circulating levels of DHT in the body. By comparison, finasteride inhibits the formation of DHT, causing troublesome side effects in many patients.
Multiple studies in various medical centers document that spironolactone is effective when applied topically [22].
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 [23]. 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%.
Our extensive R&D have finally produced a spironolactone lotion which almost totally eliminates the inherent disagreeable smell of spironolactone. In addition to the 5% concentration of spironolactone in the lotion, there are small (1 to 3 mm) vesicular pockets of pure, unsuspended micronized spironolactone powder. This should be spread onto the scalp with one's fingertips to optimize the effects of the application.
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 each other.
Regrowth's 5% Spironolactone Lotion has a shelf life of more than 18 months when kept at normal room temperatures.
Bibliography
1. Hamilton JB: Male hormone stimulation is prerequisite and an incitant in common baldness. Am J Anat 71:451-480, 1942
2. Rattner H: Ordinary baldness. Arch Dermatol Syph 44:201-213, 1941
3. Rook A, Dawber R: Diseases of the Hair and Scalp. Oxford, Blackwell Scientific Publications, 1982
4. Baden HP: Diseases of the Hair and Nails. Chicago, Year Book Medical Publishers, 1987
5. Lattanand A, Johnson WC: Male pattern alopecia: A histopathologic and histochemical study. J Cutan Pathol 2:58-70, 1975
6. Blauer M, Vaalasti A, Pauli SL, Ylikomi T, Joensuu T, Tuohimaa P: Location of androgen receptor in human skin. J Invest Dermatol 97:264-268, 1991
7. Menard RH, Stripp B, Gillette JR: Spironolactone and testicular cytochrome P-450: Decreased testosterone formation in several species and changes in hepatic drug metabolism. Endocrinology 1974;94:1628-1636
8. Menard RH, Martin HF, Stripp B, et al: Spironolactone and cytochrome P-450: Impairment of steroid hydroxylation in the adrenal cortex. Life Sci 1975;15:1639-1648
9. Schapiro G and Evron S. A novel use of Spironolactone:treatment of hirsutism. J Clin Endocrinol Metab. 1988;51:429-432
10. Cumming D, Yang J, Rebar R, Yen S.: Treatment of hirsutism with Spironolactone. JAMA. 1982;247:1295-8.
11. Boiselle A, Tremblay RR: Clinical usefulness of spironolactone in the treatment of acne and hirsutism, abstracted. Clin Res 1978;26:840A
12. Yamamoto A, Ito M. Topical spironolactone reduces sebum secretion rates in young adults. J Dermatol, 1996 Apr,23:4,243-6
13. Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. Int J Tissue React 10:115-119, 1988
14. Burke BM, Cunliffe WJ: Oral spironolactone therapy for female patients with acne, hirsutism or androgenetic alopecia. Br J Dermatol 112:124-125, 1985
15. Stripp B, Taylor AA, Bartter FC, et al: Effect of spironolactone on sex hormones in man. J Clin Endocrinol Metabol 1975;41:777-781
16. Mann NM: Gynecomastia during therapy with spironolactone. JAMA 190:160-162,1963
17. Rose LI, Underwood RH, Newmark SR, Kisch ES, Williams GH: Pathophysiology of spironolactone-induced gynecomastia. Ann Int Med 87:398-403, 1977
18. Corval P, Michaued A, Menard J, et al: Antiandrogenic effect of spironolactones: Mechanism of action.
Endocrinology 1975;97:52-8
19. Messina M, Manieri C, Musso MC, Pastorino R.: Oral and topical spironolactone therapies in skin androgenization. anminerva Med, 1990 Apr-Jun,32:2,49-55
20. Wendt A, Hasan SH, Heinz I, Tauber U: Systemic effects of local antiandrogen therapy. Arch Dermatol Res 273:171,1982
21. Price VH: Testosterone metabolism in the skin: A review of its function in androgenetic alopecia, acne vulgaris, and idiopathic hirsutism including recent studies with antiandrogens. Arch Dermatol 1975;111:1496-1502
22. Stoughton RB: Penetration of drugs through the skin. Dermatologica 152 (suppl): 27-36, 1976
23. Matias JR, Malloy V, Orentreich N: Synergistic antiandrogenic effects of topical combinations of 5 alpha reductase and androgen receptor inhibitors in the hamster sebaceous glands. J Invest Dermatol 91:429-433, 1988
24. Takayasu S, Wakimoto H, Itami S, Sano S: Activity of testosterone 5 alpha-reductase in various tissues of human skin. J Invest Dermatol 74:187-191,1980
25. Sawaya ME, Hoenig LS, Hsia SL: Increased androgen binding capacity in sebaceous glands in scalp of male pattern baldness. J Invest Dermatol 92:91-95, 1988, Martin HF, Stripp B, et al: SpiroH
 

Johnny24601

Experienced Member
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re:

Dr. Lee is a salesman and therefore cannot be 100% trusted, but that was a informative little discussion. However, I would rather have the thoughts/opinions of users on this forum as they do not profit from their opinions. So I have heard what this Dr. Lee cat has to say, anyone else have something to add about their own experience?
I am starting to think about applying spironolactone once a day to the front. Global, do you think this will have any potential value? I appreciate any of the previous responses and hope for addiitonal responses. Thanks.
 

The Gardener

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I have used spironolactone, both 2% and 5%.

Here are the tradeoffs:

2% liquid
Pros: Fast Drying, easy to apply to areas where there is existing hair
Cons: Has a mild skunk smell when mixed with minoxidil on a hot day, or when you are physically exerting yourself.

5% cream
Pros: No smell
Cons: The cream is hard to apply to areas with existing hair as the cream tends to stick to the hair more than the liquid does.
 

The Gardener

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Yes, I do. I used to use 2%, did so for a long time. Then quit, and shed. Then, got back on it for a bit, then tried Xandrox for a while. Then quit Xandrox, went to Min 5% plus Retinoic Acid and restarted the spironolactone, this time spironolactone 5 on the hairline.

spironolactone works for me, I notice a difference. But, this depends on your hairloss pattern and how well the spironolactone application works for you. It's hard to explain.

On the whole, though, using the 5% as an upper temple and hairline reinforcer works well for me. I am not diffuse, I am a receeder. For me, the minoxidil growth is coming in along the periphery of my existing hairline, and in my upper temples. These hairs are new, coming in thin, then getting curly, then starting to straighten out and get a bit thicker. Putting a thin layer of spironolactone into this periphery area has accelerated things a bit.

The times I have quit the spironolactone, I have regretted it later.

I recommend 5% cream for receeders, and the 2% liquid for diffuse.
 

global

Experienced Member
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Re: re:

Johnny24601 said:
Dr. Lee is a salesman and therefore cannot be 100% trusted, but that was a informative little discussion. However, I would rather have the thoughts/opinions of users on this forum as they do not profit from their opinions. So I have heard what this Dr. Lee cat has to say, anyone else have something to add about their own experience?
I am starting to think about applying spironolactone once a day to the front. Global, do you think this will have any potential value? I appreciate any of the previous responses and hope for addiitonal responses. Thanks.

Hi, I apply 5% cream to my temples/hairline just after the shower. I do think its helped thicken the hair up a bit there so yes I do think it will have potential value for you.
 

jimmystanley

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is there also a lotion? i have a shaved head and would like to apply the 5% cream on the top of my scalp too...think it's a good idea?
 

Old Baldy

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Re: re:

Johnny24601 said:
Dr. Lee is a salesman and therefore cannot be 100% trusted, but that was a informative little discussion. However, I would rather have the thoughts/opinions of users on this forum as they do not profit from their opinions. So I have heard what this Dr. Lee cat has to say, anyone else have something to add about their own experience?
I am starting to think about applying spironolactone once a day to the front. Global, do you think this will have any potential value? I appreciate any of the previous responses and hope for addiitonal responses. Thanks.

Johnny, from all I've read, topical spironolactone. is good stuff. It isn't a great treatment but not too bad for some guys. I use it and somethng is working. (I use alot of stuff.)
 

cruiser

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so why not use the perscription poxifen? it has minoxidil, spironolactone, and copper pep. right? :lol: (other than cost)
 

Cornholio

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cruiser said:
so why not use the perscription poxifen? it has minoxidil, spironolactone, and copper pep. right? :lol: (other than cost)

1)Cost
2)The Price
3)Affordability
4)Control. Im not really sure what the concentrations of the known ingredients (minoxidil, spironolactone, copper peptides) are in Dr. Proctor's as they aren't listed... Assuming that they are included in the ideal proportion ?how is he able to mix spironolactone with minoxidil when other sources say that the two are not compatible/stable together (is spironolactone included in any significant concentration?). He lists other ingredients with SOD activity, but are they really included at more than homeopathic/placebo concentration? Are they really worth 100$/month? As there isnt evidence to back up the "extra ingredients" beyond anecdotal, and you dont really know how much of them you are getting it is difficult to justify stepping away from the simple minoxidil/spironolactone/tricomin available separately. They are at least known quantities.
5)Money.
 
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