It is often assumed that hair that is lost in pattern balding somehow “dies” after a certain period of time, and is therefore gone for good, rendered incapable of re-generation. This assumption is also erroneously reinforced by certain doctors, and other hair specialists. The following case study published in a reputable peer reviewed journal, along with numerous anecdotal accounts we have received over the last 10 years convincingly refute this assumption. This particular study gives an account of a 73 year old man who had been completely bald since 28 re-growing a full head of hair at age 73 ( 45 years of slick baldness) after 6 years on oral Spironolactone, effectively shattering the assumption of “dead” hair follicles. 

Acta Derm Venereol. 1990;70(4):342-3.

Reversal of andro-genetic alopecia in a male. A spironolactone effect?

Bou-Abboud CF, Nemec F, Toffel F.


Department of Internal Medicine, University Medical Center of Southern Nevada, University of Nevada School of Medicine.


This 73-year-old white male has been bald since the age of 28. He developed nonA-nonB-induced liver cirrhosis and had been treated with spironolactone for the last 6 years. For the last 3 months, his hair had started to regrow over the scalp. This might be related to the antiandrogenic effect of spironolactone.

      Spironolactone in addition to being a potassium sparing diuretic, is a moderately potent androgen receptor blocker that is generally too anti-androgenic for systemic use in men, and is so toxic I wouldn’t give it to my dog. Spironolactone used orally almost always causes fatigue (via electrolyte depletion), reduced libido and muscle mass, breast enlargement in men and raises the risks of breast cancer in women. Oral Spironolactone is also used as a primary anti-androgenic component in male to female gender reassignment hormonal protocols. Toxicity and anti-androgenic effects notwithstanding, this guy re-grew a full head of hair after 45 years of complete horseshoe fringe slick baldness. The pictures published in the full text study are dramatic. This 73 year old man went from no hair for decades to a full Ronald Reagan like head of hair. We are not posting this abstract to recommend any one, male or female use oral Spironolactone as a treatment for hair loss. We are posting this abstract because it provides, in addition to the feedback we have gotten for years, published evidence to refute the ridiculous notion that hair follicles are somehow “dead.” 

      The fact is that hair follicles technically never “die”, they miniaturize to the point that they are no longer visible, over time resulting in a slick bald appearance. Once a hair follicle miniaturizes to this point it does become extremely resistant to treatment and re-generation. Researchers at L’Oreal and other academic institutions identified the culprit behind this resistance to regeneration as a progressive and long standing fibrosis (chronic inflammation induced collagen hardening) that occurs in Androgenetic Alopecia. Perifollicular Fibrosis and the resultant miniaturization occur in response to inflammation and DHT, making it almost impossible to regrow hair in completely bald areas in the short term. However as fibrosis is gradually reversed, regrowth of hair is possible, as this study shows, in the long term. 

      Fibrosis can be reversed a number of ways. The crudest, and most feminizing, side effect prone is the usage of oral anti-androgens like Propecia, Avodart, or the stronger and even more feminizing Spironolactone,Casodex, Diane 35,and Flutamide. Fibrosis can also be gradually neutralized by countering peri-follicular inflammation with oral Resveratrol/Curcumin (fibrosis occurs in response to long standing inflammation), and the topical application of low temperature processed Emu Oil. The most direct,(and by far most cost effective) way to resolve existing fibrosis is by using oral Taurine in a dose of 250 mg or more. Taurine is the cornerstone of L’Oreal’s European oral hair loss treatments, “Hair Mass” and “Hair Mass for Men,” which combine Taurine with Green Tea Extract, Grape Seed Extract, and Beta sitosterol,(for men). 

      The study featured here underscores the treatment response possibilities when treatments are maintained long term. Because of the cross over health and anti-aging benefits of many components of our treatment recommendations that also serve as hair loss interventions, there is ample reason that go beyond hair loss to use these components indefinitely. The benefits to your long standing bald spots or hair loss can progressively manifest, often after a sustained period of time.