Hairlosshelp.com was able to receive an advance supply of Dr Lee's new 5% Spironolactone lotion for review. These are the initial comments:

Appearance: The lotion comes in a plastic ointment type jar. The lotion is white in color and has a consistency similar to that of a hand cream.

Smell: There is a slight odor from the jar containing the lotion, but it is not very strong or overpowering. Once applied there is no trace of any type of odor at all.

Application: The lotion is easy to apply. All you need to do is to dip your fingers into the lotion and rub a small amount into the scalp. The lotion penetrated very well and there was no greasiness left on the scalp.

Combining with other products: Per the instructions from Dr Lee I applied the Spiro lotion after an application of Xandrox and there was no reaction of any kind.

Adverse Reactions: I experienced no adverse reaction of any kind, there was no itching or discomfort from the lotion.

A. Yes. There are several anti-androgens that are effective topically. Cyproterone is a
potent anti-androgen, but is not available in the U.S. Flutamide is a very potent anti-androgen, but has not been proven safe as a topical medication. On the other hand, spironolactone has been used as a topical anti-androgen for more than fifteen years.

Q. What is spironolactone?

A. It's a medication that has been used for more than 3 decades to treat hypertension and fluid retention. We offer a 5% Spironolactone Lotion in 2 oz. jars. The pharmaceutical effects of topical spironolactone are local and there are no systemic effects from its use on the scalp.

Q. What does it have to do with male pattern baldness?

A. Spironolactone is a potent anti-androgen and it is effective applied topically. It has three modes of action. (1) It successfully competes with dihydrotestosterone (DHT) for the androgen receptor site on the hair follicles. (2) Within the skin on which it is applied it also inhibits the formation of testosterone. (3) It converts the existing testosterone in the skin to an estrogen.

Q. What are the side effects?

A. Spironolactone is quickly and extensively metabolized in the skin and does not effect any other organ system. In about 1% of patients, a rash can develop. If this happens, the patient should discontinue the use of topical spironolactone.

Q. Why haven't other doctors used topical spironolactone to treat male pattern baldness?

A. Many have with variable success, but there are inherent problems with a topical spironolactone preparation. It can have a disagreeable odor and it can be difficult to get good patient compliance for its use twice/day.

Q. Why didn't you put spironolactone directly into your minoxidil solutions, so it would have been more convenient to use?

A. When minoxidil and spironolactone are combined in the same base, they will chemically react within a few hours and degrade each other causing a particularly offensive odor and compromising the pharmacological effect of both compoments. Since this chemical reaction requires many hours, it does not happen if minoxidil and spironolactone are applied to the scalp at the same time from separate containers.

Q. Will my hair have an unpleasant smell if I use spironolactone?

A. It shouldn't if you use the Regrowth 5% Spironolactone Lotion.. We've been working with a well-known pharmacologist and a reliable biochemical laboratory to produce a 5%
Spironolactone Lotion that does not have an offensive smell and will remain stable at room temperatures. Nevertheless, do not apply spironolactone solutions before strenuous exercise, as excess body heat can degrade the spironolactone resulting in an unpleasant odor.

Q. How much should I apply?

A. Using the tip of your finger, apply the smallest amount necessary onto the areas of the scalp that shows thinning and/or recession of hair to obtain a thin film of lotion on the scalp. Gently massage the lotion into the scalp.

Q. How often should the 5% Spironolactone Lotion be applied?

A. Optimally, twice/day at least eight hours apart. But realistically, most patients do not have sufficient time or motivation to make two applications per day. In which case, it would be preferable to apply the 5% Spironolactone Lotion at night.

Q. Can I use the 5% Spironolactone Lotion with topical minoxidil preparations?

A. Definitely. In fact, it is recommended that you use the 5% Spironolactone Lotion as an adjunctive treatment for MPB in combination with Regrowth 5% minoxidil or Xandrox 5% solution.

Q. In what order should I apply the 5% Spironolactone Lotion and topical minoxidil?

A. Apply the Regrowth 5% Minoxidil solution or Xandrox 5% solution first. Allow several minutes for the alcohol/aqueous solution to partially dry. Then apply the lotion on top of the minoxidil solution. The lotion will act as an occlusive dressing and enhance the absorption of both medications. Wash your hands after each application.

Q. Do I need a prescription to buy it?

A. Yes you do.

Q. How much does it cost?

A. The 2 ounce jar costs $32.95. If bought together with Xandrox there is a $4.00 discount, and a $2 discount if bought with our 5% Minoxidil.

Q. Where can I get it from?

A. You can order it from the Regrowth clinic web site which is http://www.minoxidil.com