To evaluate hypertrichosis with low dose oral minoxidil and spironolactone combination therapy for alopecia

Arch Dermatol Res. 2024 Aug 12;316(8):510. doi: 10.1007/s00403-024-03261-0.

Abstract

Low dose oral minoxidil (LDOM) is an efficacious and safe treatment for alopecia, however, a notable side effect is hypertrichosis. Spironolactone, known for treating hirsutism, is also used off-label for the treatment of certain forms of alopecia and may reduce LDOM-induced hypertrichosis. We performed a retrospective review of 54 patients seen at NYU Langone Health and compared hypertrichosis rates in female alopecia patients on LDOM monotherapy versus those on combination therapy with spironolactone. Among 54 patients, 37 received LDOM alone and 17 received the combination. Hypertrichosis developed in 33.3% of patients, with lower rates in the combination group (17.6% vs. 40.5% for monotherapy). Although not statistically significant, the trend suggests spironolactone may mitigate hypertrichosis. The study highlights the potential of combination therapy to address hypertrichosis and calls for larger studies to confirm these findings.

Keywords: Alopecia; Hair; Hypertrichosis; Minoxidil; Oral minoxidil; Spironolactone.

Publication types

  • Letter

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Alopecia* / diagnosis
  • Alopecia* / drug therapy
  • Drug Therapy, Combination* / methods
  • Female
  • Humans
  • Hypertrichosis* / chemically induced
  • Hypertrichosis* / diagnosis
  • Middle Aged
  • Minoxidil* / administration & dosage
  • Minoxidil* / adverse effects
  • Retrospective Studies
  • Spironolactone* / administration & dosage
  • Spironolactone* / adverse effects
  • Treatment Outcome
  • Young Adult

Substances

  • Minoxidil
  • Spironolactone