Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy

Famenini, Shannon; Slaught, Christa; Duan, Lewei; Goh, Carolyn

doi:10.1016/j.jaad.2015.06.063

Cited by 38 publications

(32 citation statements)

References 5 publications

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“…Given the structural similarity of steroid hormones, spironolactone has also some limited androgen-blocking activity. While spironolactone is not specifically approved for use for hair loss, this weak androgenblocking effect has led to the off-label use of spironolactone to minimize hair loss from polycystic ovarian syndrome (PCOS), usually in conjunction with oral contraceptive therapy [1]. As it is a weak androgen antagonist, it has not been found to be effective in treating androgenetic alopecia in males.…”

Section: Spironolactonementioning

confidence: 99%

Pharmacological Treatment of Alopecia

Gensure¹

2018

Alopecia

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In this chapter, we will explore non-surgical treatments of alopecia. Unlike many other areas of medicine, pharmacological treatments for alopecia are relatively new. There are only two treatments which are approved by the Food and Drug Administration (FDA); the rest are drugs developed for other indications which have gained popular off-label use to promote hair growth. The reasons for this are many, including the designation of alopecia by the FDA as a cosmetic disease. This designation has restricted alopecia development programs to compounds with virtually no side effects. Unfortunately, it has also led to off-label use of far more dangerous compounds as alopecia treatments, without the benefit of controlled trials. There is a growing recognition that alopecia, particularly alopecia areata and chemotherapy-induced alopecia, are disorders which significantly alter the quality of life, similar to acne vulgaris and psoriasis, and merit treatment accordingly. There have also been several recent advances in our understanding of the hair cycle, revealing new targets for developing alopecia therapies. As a result, there is a more robust slate of programs for developing new pharmacological treatments for alopecia. In this chapter, we will review current pharmacological treatments for alopecia and selected treatments under development (i.e., those with significant preclinical or clinical data which have appeared in the published literature).

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Section: Spironolactonementioning

confidence: 99%

Pharmacological Treatment of Alopecia

Gensure¹

2018

Alopecia

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“…However, the majority of women diagnosed with female-pattern hair loss have normal androgen levels, thus indicating that the cause is not solely related to androgen hormones. 1,4,[6][7][8] Several studies have indicated links between femalepattern hair loss and both body mass index and type 2 diabetes mellitus, which are associated with insulin resistance. Earlier puberty, fewer childbirths and use of the oral contraceptive pill are also found to be positively associated with developing female-pattern hair loss.…”

Section: Rebecca Mannmentioning

confidence: 99%

“…Spironolactone is generally recommended as the first choice in second-line treatment. 2,8,9 It is an aldosterone antagonist that competitively blocks androgen receptors and weakly inhibits androgen synthesis. There is a reasonably large body of data to support the efficacy of spironolactone 8 and, similar to minoxidil, it must be continued for at least six to 12 months to assess the effect on the hair.…”

Section: Second-line Therapymentioning

confidence: 99%

“…2,8,9 It is an aldosterone antagonist that competitively blocks androgen receptors and weakly inhibits androgen synthesis. There is a reasonably large body of data to support the efficacy of spironolactone 8 and, similar to minoxidil, it must be continued for at least six to 12 months to assess the effect on the hair. 7 Flutamide and cyproterone acetate are infrequently used in the UK as there is a paucity of data available and the dosing regimens are not standardised.…”

Section: Second-line Therapymentioning

confidence: 99%

“…9 Once treatment has commenced, women who begin a course of spironolactone should have their serum potassium levels checked around six weeks into the dosing regimen, as hyperkalaemia is a possible side-effect. 8 Baseline blood pressure should be checked and then routinely every six months along with a serum potassium level. Women should be counselled on the need for effective contraception while taking antiandrogenic medication as feminisation of a male foetus can occur if the woman conceives during a course of antiandrogenic medication.…”

Section: Role Of the Gpmentioning

confidence: 99%

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Management of female-pattern hair loss

Mann¹

2016

Prescriber

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Characterization of spironolactone and metabolites derivatized using Girard's reagent P using mass spectrometry and ion mobility spectrometry

Jones,

Kirkwood‐Donelson,

Alexander

et al. 2024

Rapid Comm Mass Spectrometry

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RationaleSpironolactone is a steroidal drug prescribed for a variety of medical conditions and is extensively metabolized quickly after administration. Measurement of spironolactone and its metabolites remains challenging using mass spectrometry (MS) due to in‐source fragmentation and relatively poor ionization using electrospray ionization. Therefore, improved methods of measurements are needed, particularly in the case of small sample volumes.MethodsGirard's reagent P (GP) derivatization of spironolactone was employed to improve response and provide an MS‐based solution to the measurement of spironolactone and its metabolites. We performed ultra‐high‐performance liquid chromatography‐electrospray ionization‐tandem mass spectrometry (UHPLC‐ESI‐MS/MS) and ion mobility spectrometry (IMS)–high‐resolution mass spectrometry (HRMS) to fully characterize the GP derivatization products. Analytes were studied in positive ionization mode, and MS/MS was performed using nonresonance and resonance excitation collision‐induced dissociation.ResultsWe observed the successful GP derivatization of spironolactone and its metabolites using authentic chemical standards. A signal enhancement of 1–2 orders of magnitude was observed for GP‐derivatized versions of spironolactone and its metabolites. Further, GP derivatization eliminated in‐source fragmentation. Finally, we performed GP derivatization and ultra‐high‐performance liquid chromatography–high‐resolution mass spectrometry (UHPLC–HRMS) in a small volume of murine serum (20 μL) from spironolactone‐treated and control animals and observed multiple spironolactone metabolites only in the spironolactone‐treated group.ConclusionsGP derivatization was proven to have advantageous mass spectral performance (e.g., limiting in‐source fragmentation, enhancing signals, and eliminating isobaric analytes) for spironolactone and its metabolites. This work and the detailed characterization using ultra‐high‐performance liquid chromatography–high‐resolution tandem mass spectrometry (UHPLC–HRMS/MS) and IMS serve as the foundation for future developments in reaction optimization and/or quantitative assay development.

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Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy

Cited by 38 publications

References 5 publications

Pharmacological Treatment of Alopecia

Pharmacological Treatment of Alopecia

Management of female-pattern hair loss

Characterization of spironolactone and metabolites derivatized using Girard's reagent P using mass spectrometry and ion mobility spectrometry

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