Egypt: Both a 5% topical solution of minoxidil and a 5% topical solution of spironolactone, might be safe to use in a twice-daily dosage for the treatment of androgenetic alopecia (AGA) in both men and women, states a study in the Journal of Cosmetic Dermatology.

Mohamed L. Elsaie, Medical and Clinical Research Institute, National Research Centre, Egypt, and associated further found that combining both medications in a single topical dose form can increase efficacy and give greater advantages.

Androgenetic alopecia (AGA) is a common chronic illness of dermatology that causes hair fall in both men and women. Dr. Elsaie and the team conducted the study with the objective of dermoscopically assessing and comparing the impact of a combination of topical spironolactone solution (5%) and topical minoxidil solution (5%) in treating AGA in both sexes.
The study included one hundred and twenty patients with a diagnosis of androgenetic alopecia. They were divided into three groups; each group comprised 40 patients. Patients in Group A were treated with 5% topical minoxidil solution, those in Group B were treated with 5% topical spironolactone solution, and Group C patients were treated with a combination of 5% topical spironolactone and minoxidil.

Study's main findings:
Following initiation of treatment and at 6 weeks (midterm), the researchers observed a reduction in all dermoscopic features in all groups however it was not statistically significant except for vellus hair reduction.
There was an insignificant increase in upright regrowing hairs in all groups.
The pattern of dermoscopic features remained to decrease insignificantly towards the end of 12 weeks of treatment (full-term) in all studied groups except for vellus hair which showed further significant reduction towards the end of the study.
"Both minoxidil as a 5% topical solution and spironolactone as a 5% topical solution might be utilized safely in a twice-daily dosage for treating androgenetic alopecia in both males and females," the researchers wrote. "Furthermore, combining them in a single topical dose form can boost efficacy and provide greater advantages."
About Minoxidil and Spironolactone
Minoxidil is a medication that can be applied directly to the scalp. It can be purchased without a prescription. It promotes hair growth by increasing the growth phase of hair follicles; causing more follicles tp produce hair. The hair, that is then produced tends to be larger and thicker.
Commercially, Minoxidil is available in 2% and 5% liquid or 5% foam. The 2% foam is used for treating women and 5% liquid or foam is used for both women and men.
Spironolactone decreases the production of hormones that contribute to androgenetic alopecia. The addition of spironolactone may be beneficial for women with androgenetic alopecia.
Reference:
Ammar AM, Elshahid AR, Abdel-Dayem HA, Mohamed AA, Elsaie ML. Dermoscopic Evaluation of the Efficacy of Combination of topical spironolactone 5% and minoxidil 5% Solutions in the Treatment of Androgenetic Alopecia: A cross sectional- comparative study. J Cosmet Dermatol. 2022 Aug 29. doi: 10.1111/jocd.15328. Epub ahead of print. PMID: 36039391.