Spironolactone and Minoxidil Dependence

Dr. Rassman,

I am a 27 year old latino male who a couple months ago noticed my hairline was receeding at the temples. 2 weeks ago I started aplying minoxidil 5% solution (2 x day) and spirolactone lotion 5% (1 x day). After ONLY 2 weeks, I`ve noticed no sheding on adjacent areas (or very little) but I have noticed an increase/thickening of vellus hairs (on the bad side, also drier scalp and incipient dandruff in adjacent scalp areas). I only apply these products to my temple areas and inmediately adjacent scalp. My questions are:

1.- Should I expect sheding if I continue use?
2.- The dependence on minoxidil, is that only for regrown or thickened hair or does healthy hair (inmediately beyond my temples) become dependant too?
3.- (a) Is it possible to avoid dependance on minoxidil by using cycles (2 weeks on, 2 weeks off, or monthly)? … (b)and still gain some benefits if done like that?
4.- Does Spirolactone topical lotion cause dependence too?

In case you are wondering, I think I`ve had a “mature” hairline for some years now and I acted only when I noticed slight but definite further receeding on my temples. Oh and I can’t get my head mapped for miniaturization yet, as I am quite poor at the moment, but I will when I can… I hope your answers help me decide on what to do at the moment.

The use of minoxidil should not cause shedding, nor I expect Spironolactone medications. Normal hair (not genetically weak) should not be affected by either Spironolactone nor minoxidil, but the dependencies that are built from these medications for genetically impacted hair is well documented. Cycling these medications may just cause them to be less effective if they are working. Although I do not have direct knowledge of Spironolactone topical lotions, I would think that it too (if working) will produce dependence. The androgenic blocking impact of Spironolactone, when administered orally, can produce impotence and breast enlargement, two side effects that are not what you may bargain for. Just because Spironolactone is in lotion form does not mean that you will not absorb it through the skin. It is a potent medication and should be used only on a doctor directed treatment plan.