Topical Spironolactone
A compounded topical anti-androgen applied to the scalp, used off-label to target the hormonal driver of pattern hair thinning — clinician-guided, delivered to your door.
Topical spironolactone uses
- Designed to target the hormonal (androgen/DHT) driver of pattern hair thinning.
- Applied to the scalp — fewer systemic effects than oral spironolactone.
- Can be paired with minoxidil, which works through a different pathway, if clinically appropriate.
Good to know
- Volume. 30 mL.
- Formulation. Compounded topical spironolactone 5%; prescription-only, prescribed off-label for hair.
- Flammable until dry. The solution is alcohol-based — keep away from heat and flame until it dries.
- Not in pregnancy. Not for use in pregnancy, breastfeeding, or while trying to conceive; use effective contraception if you could become pregnant.
- Tell us your medications. Especially blood-pressure medicines (ACE inhibitors/ARBs), potassium-sparing diuretics, potassium supplements, and regular NSAID use.
- Medication guide. Read the medication guide (PDF).
Topical prescription care for thinning hair
A scalp-focused approach to hormonal hair thinning.
When thinning is driven by hormones, not just time
Not all hair thinning is the same. When it’s driven by your follicles’ sensitivity to androgens, stimulating growth is only half the picture — the hormonal driver matters too. Topical spironolactone is designed to address that side, right at the scalp.
- Targets the hormonal driver. An anti-androgen designed to address the androgen (DHT) sensitivity behind pattern thinning.
- Applied to the scalp. Works locally where thinning happens — not a systemic pill.
- Pairs with minoxidil. Often used alongside minoxidil, which works through a different pathway.
- Clinician-guided. Reviewed, prescribed, and monitored with check-ins.
Why topical, not oral spironolactone
Oral spironolactone acts throughout the whole body, which can mean effects like increased urination and the need for blood-potassium monitoring. Applied to the scalp, topical spironolactone targets the area that matters with much less systemic exposure — an option for women who want the anti-androgen approach without an oral pill.
What topical spironolactone does
Spironolactone is an anti-androgen: it’s designed to reduce the effect of androgens like DHT that shrink hair follicles in pattern (androgenetic) thinning. Applied to the scalp, it’s intended to act locally at the follicle.
- Anti-androgen. Designed to reduce DHT’s effect on scalp follicles.
- Topical, once daily. Applied to the scalp, not swallowed.
- Off-label. Spironolactone isn’t FDA-approved for hair loss; this use is off-label.
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Order a test
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Collect a sample
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See a doctor
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Get treated
Built for consistent use, not overnight
- First weeks. A brief increase in shedding early on is common and usually settles — keep going unless your clinician says otherwise.
- 3–6 months. Results typically take three to six months of consistent daily use.
- Ongoing. Continue applying once daily as prescribed; benefits fade if you stop.
Read your medication guide
Review the full medication guide for additional product and safety information.
Frequently asked questions
How does topical spironolactone work?
Spironolactone has anti-androgen properties. When used topically, it is intended to act locally on the scalp and may help reduce the effect of androgens on hair follicles in some patients. Response varies, and benefits are not guaranteed.
Is topical spironolactone FDA-approved for hair loss?
No. Topical Spironolactone is a compounded prescription medication used off-label. Your clinician will determine whether it is appropriate based on your health history and symptoms.
How long does it take to see results?
Hair growth treatments take time. Some patients may notice changes after several months of consistent use, but response varies. Your clinician may recommend follow-up check-ins to evaluate progress and tolerability.
Can I use topical spironolactone with minoxidil?
Some patients may use topical spironolactone as part of a broader hair treatment plan. Your clinician will review your current treatments and advise whether combining therapies is appropriate for you.
Can men use topical spironolactone?
Topical Spironolactone may not be appropriate for everyone. Your clinician will review your health history, symptoms, and treatment goals to determine whether it is a good fit.
Can I use it if I am pregnant or breastfeeding?
Do not use topical spironolactone if you are pregnant, trying to become pregnant, or breastfeeding unless specifically approved by your clinician.
What should I do if my scalp gets irritated?
Mild dryness or irritation can happen. Stop using the medication and contact your clinician if irritation is persistent, worsening, or severe.
How does the process work?
Complete an online health questionnaire about your medical history, current medications, and treatment goals. A licensed clinician reviews your information and determines whether treatment is appropriate. If prescribed, you’ll receive treatment instructions and can complete checkout for medication delivery.
Do I need a video appointment?
Eligible patients can receive care through an online questionnaire and messaging, without scheduling a video call. Your clinician may recommend a live or in-person visit if additional evaluation is needed.
Which states are eligible for online questionnaire-based visits?
Our asynchronous visits are currently available in:
Arizona, California, Colorado, Florida, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and Wyoming.
Availability is confirmed during intake. Eligibility also depends on your medical history and the medication requested. If your state isn’t listed, asynchronous care is not currently available there.
Is a prescription guaranteed?
No. A prescription is issued only when a licensed clinician determines that treatment is appropriate for you. Completing the questionnaire does not guarantee a prescription.
What is a compounded medication?
A compounded medication is prepared by a pharmacy according to a prescription to meet an individual patient’s needs. Compounded medications are not FDA-approved, and the FDA does not review their safety, effectiveness, or quality before they are marketed.
How will I receive my medication?
After your prescription is approved and payment is completed, our licensed partner pharmacy processes your order and ships it to the address confirmed at checkout. You’ll receive tracking information by text or email once it ships. Preparation and delivery times can vary.
Can I use insurance for my medication?
Medication costs and prescription coordination fees are self-pay and are not billed to insurance. You’ll see a breakdown of these costs before confirming payment.
How do refills work?
Refills require a valid prescription and remaining authorized refills. Depending on your medication, you may need to complete a health check-in before a refill can proceed. When your prescription expires or you run out of authorized refills, a new clinical evaluation may be required.
Can I change or cancel automatic refills?
Yes. Use the “Manage refills” link in your refill notification or patient portal to manage upcoming refills, update shipping or payment details, or cancel automatic refills. Make changes before the scheduled charge date.
Who can I contact with questions?
Contact your Paloma care team with questions about your treatment or prescription. For help with orders, shipping, or refills, email contact@palomahealth.com.
Important safety information
Topical Spironolactone is compounded and used off-label. It is not FDA-approved for hair loss, androgenic alopecia, female pattern hair loss, or scalp conditions.
Do not use if you are allergic to spironolactone or any ingredients in the compounded base. Tell your clinician if you are pregnant, trying to become pregnant, breastfeeding, have kidney disease, have a history of high potassium, or are taking medications that affect potassium levels or blood pressure.
Avoid applying to broken, irritated, or infected skin. Wash hands after application and avoid contact with the eyes, mouth, or mucous membranes. Stop use and contact your clinician if you develop significant scalp irritation, rash, swelling, dizziness, or any concerning symptoms.
Active ingredients
- Spironolactone
Inactive ingredients
- Compounded topical base, as prepared by the pharmacy
- Scalp dryness or irritation
- Itching or redness
- Flaking
- Temporary greasy or sticky feeling at the application site
- Unwanted residue on hair or scalp
Store at room temperature, away from heat, moisture, and direct sunlight. Keep the container tightly closed when not in use.
Topical Spironolactone is for external use only. Do not apply to broken or irritated skin. Avoid contact with the eyes, mouth, and mucous membranes. Do not use during pregnancy, while trying to become pregnant, or while breastfeeding unless specifically approved by your clinician. Keep out of reach of children and pets.
Read your medication guide
Review the full medication guide for additional product and safety information.
Compounded medications
More options for your care.
Explore additional options for hair, skin, sexual wellness, and more—alongside the thyroid, HRT, and weight loss care we provide through live visits.
Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Rx Required.
