Stop hair loss with an acne treatment?

Dr. Janet Zand

February 5, 2021

If you’re a woman with thinning hair, there’s a new treatment that could help.

This new treatment was initially developed as a treatment for acne. But it has also been shown to help with female pattern hair loss.

In fact, one study found that it helped almost 75% of participants grow thicker, fuller hair!

It’s been so effective that dermatologists are recommending it to female patients experiencing hair loss.

So what is it?

It’s a medication called spironolactone. And to explain how it works, first I need to quickly tell you why female pattern hair loss occurs in the first place.

Female pattern hair loss comes down to the estrogen-androgen balance.

The estrogen-androgen balance

The estrogen-androgen balance is your ratio of female sex hormones (primarily estrogen) to male sex hormones (androgens).

Yes, women have male hormones, too, like testosterone.

Our bodies need it to produce new blood cells, maintain bone health, and maintain our libido. However, we still have a lot less testosterone than men do – up to 20 times less.

The problem is that sometimes our balance of estrogen to testosterone (along with other androgens) gets out of whack. And when we have too many androgens in relation to estrogen, it can result in thinning hair.

How? Well, for one thing, estrogen is what makes hair stay on your head for longer. It does this by increasing the amount of time that your hair spends in the growing phase.

So when estrogen declines in relation to androgens, you lose estrogen’s protective effect ... and your hair falls out sooner.

This is why so many women report the fullest hair of their lives while they’re pregnant (and estrogen is sky-high) ... only to feel like they’re going bald a couple of months after giving birth (when estrogen dramatically drops).

Similarly, during menopause, estrogen levels decrease, changing your estrogen-androgen balance. That’s why by age 50, approximately 40% of women will experience female pattern hair loss.

And there’s another problem with less estrogen compared to androgens: it can lead to miniaturization of the hair follicles. Miniaturization is when hair follicles constrict, making it harder for new hairs to grow. And then follicles that once produced healthy hairs start producing thinner hairs ... with a fragile shaft that can easily fall out.

So ... how can an acne medicine help with the estrogen-androgen balance?

How it works

Spironolactone works by slowing down the production of androgens. And it does this by competitively blocking androgens from attaching to receptors in your hair follicles.

With less androgen-induced stimulation on the hair follicles, the result is stronger hair -- and more of it.

That’s what researchers found when they gave spironolactone to a group of women (up to age 88!) with female pattern hair loss. The result: 74.3% of the women noticed a remarkable improvement in their hair!

Is it right for you?

If you’re interested in spironolactone, here’s how to tell if it’s right for you...

First, it only works on female pattern hair loss, which is caused by excess testosterone and other androgens. So spironolactone won’t work for hair loss from stress, chemotherapy, and nutritional deficiencies.

Second, talk to your doctor or dermatologist. Spironolactone is generally safe, but it must be taken correctly. A doctor can prescribe the right amount ... and make sure it’s safe to take with your other medications and supplements.

When talking to your doctor, ask about these three things, as well:

• Progesterone level. Like estrogen, low levels of progesterone might cause your hair to fall out sooner and grow more slowly. Progesterone can be rebalanced with bioidentical progesterone, which is especially effective for menstruating women.

• Thyroid function. A thyroid imbalance is actually a hormone imbalance. And if your thyroid is too high or too low, it can impact your hair.

• Omega-3 status. Low essential fatty acid levels are common in women with hair loss. When you replenish those essential fatty acids, your hair is more likely to grow back.

Finally, if you really want healthier hair, consider your diet. I know you’ve probably heard that before, but the fact is, the more nutritionally dense your diet, the more antioxidants, vitamins, and nutrients you’ll get. That not only gives you healthier hair, but healthier skin, too! If you’re not sure where to start, the Mediterranean diet is a good choice.

Ultimately, the estrogen-androgen balance is exactly that — a balance. Tipping it one way or the other needs to be done carefully and on an individual basis, as what works for one woman may not work for another.

But for many women experiencing the pain of hair loss, medications like spironolactone — along with other hormone-balancing treatments — are very promising solutions for thicker, fuller hair.

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