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Q: First I would like to say THANK YOU for helping women with these issues. To many times we are told nothing can be done. If only there were more doctors like you.
I am 31, have experienced continued hair shedding since my daughters birth 14 years ago. Recently I started taking 150mg of Spironolactone. After about 3 months it seemed to help well. But it only helped for about 3 months. Do you know why this would happen? Where could I go from here? Thanks so much.

A: Hair shedding goes in cycles, even for women who do not have alopecia. For this reason, even when treatment is working, there will be times when shedding increases. Though this may be temporary, it can be quite upsetting.

The main thing to consider is how your hair looks in the mirror. If it is not getting thinner, then often the best thing is to hang in and continue treatment. If you do have less hair, then adjustment of treatment can be considered. This might be increasing spironolactone (the maximum is 200 mg per day) or adding other medications.

Remember though that hair changes very slowly and so 3 months is usually not enough time to see the full effects of treatment.

Sometimes women feel treatment is not working and want to stop. However it still may be slowing progression so stopping may make matters worse.

In my career, I have seen all sorts of medical problems; of those which are not fatal or debilitating, alopecia is one of the hardest to live with. Though treatment usually helps, it is a long road with many ups and downs.

The best overall advice I can give is to try not to let yourself get discouraged. There may be other things that can be done.

I cannot make specific recommendations over the web so you should speak to your physician if things are not going well.

Hope this is helpful.


Geoffrey Redmond, MD

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