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SPIRO CREAM VERSUS SPIRO SOLUTIONS [Beitrag #19785] :: Mi., 19 April 2006 18:15

weil mich das interessiert hat. die studie ist erstens schon was älter (u. sicherlich bekannt), und zweitens arg klein, und drittens mit (für meine begriffe) seltsamen resultaten (siehe schluss). vielleicht alles irreführend? oder nur anzeichen, dass man sich doch nicht zu viele hoffnungen machen sollte?

(ist von bryan aus dem hairlosstalkforum)
- - -
SPIRO CREAM VERSUS SPIRO SOLUTIONS: WHICH IS BETTER?

What originally got me interested in this subject is Chapter
18 of the book "Clinics in Dermatology", Volume 6, No. 4,
October-December 1988, with the title: "Topical Antiandrogens
in the Treatment of Male-Pattern Baldness". It was written
by Roger S. Rittmaster, MD. He is the same doctor associated
with Glaxo's dutasteride research, and other notable hairloss
investigations.

The whole thing is rather lengthy, but I'm going to quote
in full the relevant section, including the two tables which
list all the data:

-------------------------------------
Antiandrogens and Hirsutism

"The pathogenesis of hirsutism in women is similar to that
of male-pattern baldness. While monitoring small changes
in hair growth in the balding scalp can be difficult, if not
impossible, weighing shaved hairs in hirsute women
provides a sensitive means of quantitating hair growth.
Thus, hirsutism provides an excellent model for assessing
the efficacy of topical antiandrogen preparations.

"Spironolactone is a potent antiandrogen with an affinity
for human androgen receptors almost as great as dihydro-
testosterone. Numerous studies have demonstrated the
effectiveness of oral spironolactone in reducing hair growth
in hirsute women. Spironolactone, however, is rapidly
converted by the liver to canrenone, a weaker anti-
androgen. Oral spironolactone also has frequent
side effects including nausea, fatigue, menstrual
disturbances in women, and impotence and gyne-
comastia in men. In order to avoid systemic side
effects while attempting to deliver high local
concentrations of spironolactone, we used the topical
route to treat hirsutism in women. An initial study
using a canrenone cream suggested that this approach
would be successful.

"In a pilot study, nine women with idiopathic hirsutism
entered a randomized, double-blind, crossover trial using
either 1% spironolactone in a cream base alone (59.4%
water, 13% propylene glycol, 7.5% mineral oil, 6%
stearyl alcohol, 5.5% white petrolatum, 3.2% cetyl
alcohol, 2.7% sodium lauryl sulfate, 2.6% spermaceti,
and 0.1% potassium sorbate). After 3 months, patients
were switched to the alternate therapy for an additional
3 months. The patients were instructed to apply the
cream to a predetermined area of excess facial hair
growth three times daily. Hair growth rates (mg/day)
were assessed by weighing shaved hairs. The patients
were instructed to use no cosmetics on the days when
they were shaved. The skin was washed with an
alcohol-soaked gauze and then dry-shaved with a
previously unused safety razor, and the hair discarded.
The same area was shaved 2-7 days later, and the hair
weighed. The time between shavings remained constant
for each individual. Initially, each woman had two hair
growth rate determinations; the percent coefficient
of variation determined from the initial shavings was 17%.
The percent change in the hair growth rate was determined
for each treatment period by comparing hair growth
immediately before and after each period.

Table 18-2. Hair Growth During Topical Spironolactone
(SP) and Placebo (PL) Therapy in Hirsute Women
------------------------------------------------------------ -
% Change*
Patient ---------------------------------
No. 3-month 6-month
------------------------------------------------------------ -
1 +16 (PL) +12 (SP)
3 +34 (PL) - 3 (SP)
5 +30 (PL) -13 (SP)
7 +39 (PL) -48 (SP)
Mean (+/- SE) +30 +/- 4 -13 +/- 13

2 -73 (SP) +113 (PL)
4 -29 (SP) + 36 (PL)
6 -13 (SP) + 42 (PL)
8 -40 (SP) - 8 (PL)
9 -27 (SP) - 61 (PL)
Mean (+/- SE) -36 +/- 10 +49 +/- 20
------------------------------------------------------------
*The percent change refers to the difference in hair growth
weights (mg/day) immediately before and after each
treatment period.

"The changes in hair growth rates during spironolactone
and placebo therapy are shown in Table 18-2. Combining
the results after 3 and 6 months, hair growth decreased by
26 +/- 8.5% (SE) during spironolactone treatment
compared with a 40 +/- 11% increase during placebo
treatment (P<0.005 using the paired Student's t-test).
The five patients who used spironolactone during the
first treatment period, in which hair growth decreased
by 36%, had a 49% increase in hair growth during the
second (placebo) treatment period. When the data from
the placebo treatment period in these five patients were
omitted, a significant difference in hair growth persisted
(P<0.005 using the unpaired Student's t-test). Five of the
nine patients correctly identified the treatment period
during which spironolactone was given. Three of the
others were uncertain, and one patient (#8) felt she had
improved on placebo but not on spironolactone.

"These results were encouraging but certainly preliminary.
One disturbing feature was that the hirsutism became worse
during the 3 months when the cream base was used. The
cream caused skin dryness if used to excess, and it was
slow to vanish. Because of these features, a long-term
follow-up study was undertaken in a separate group
of hirsute patients using 1% spironolactone in an alcohol-
based vehicle (Neutrogena Vehicle/N Mild: 41.5% ethyl
alcohol, water, 6.0% isopropyl alcohol, Laureth-4).

Table 18-3. Hair Growth During Topical Spironolactone
(SP) and Placebo (PL) Therapy in Hirsute Women
------------------------------------------------------------ -
% Change*
Patient ---------------------------------
No. 3-month 6-month
------------------------------------------------------------ -
2 - 19 (PL) -19 (SP)
9 - 14 (PL) DO (SP)
10 + 47 (PL) +24 (SP)

4 + 48 (SP) DO
5 +140 (SP) +93
6 - 32 (SP) -48
8 - 8 (SP) - 5
11 - 17 (SP) -38
------------------------------------------------------------ -
DO = dropped out of study.
*The percent change refers to the difference in hair growth
weights (mg/day) before entering the study and at the end
of the treatment period. Patient #1 (PL), #7 (PL), and #3
(SP) dropped out of the study prior to the first observation.

"In this second randomized, double-blind study, hirsute
patients initially received the spironolactone solution or the
vehicle alone for the first 3 months, after which all patients
recieved the spironolactone solution. The patients were
instructed to apply the solution liberally to the affected
area (either the face or the lower abdomen) three times
daily. Hair growth rates were determined as described
above, except that three determinations were made every
3 months. The results of the study are shown in Table
18-3. At best, there was only a modest improvement
with spironolactone, and some patients actually became
worse. There was no statistical difference between
spironolactone and placebo during the first 3 months.
Subjective response was equally poor, and the dropout
rate was high.

"The long-term effectiveness of topically applied spironolac-
tone for hirsutism remains a question. The differences
observed between the alcohol-based spironolactone
solution and the cream based medication may relate
to the vehicle or perhaps small sample size."

Well, there you have it! The cream version seemed
to perform better. In fact, the alcoholic version may
not have performed AT ALL! Sad

What's interesting
is that they used a spiro concentration in both vehicles
of only 1%; and what's very strange is the fact that the
cream vehicle made the hirsutism WORSE. That's food
for thought.

Bryan

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Re: SPIRO CREAM VERSUS SPIRO SOLUTIONS [Beitrag #19817 ist eine Antwort auf Beitrag #19785] :: Mi., 19 April 2006 20:54

Ich habe jetzt keine Lust so lange zu suchen, aber was ist Hirusitim?

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Re: SPIRO CREAM VERSUS SPIRO SOLUTIONS [Beitrag #19819 ist eine Antwort auf Beitrag #19817] :: Mi., 19 April 2006 20:57

Figaro03 schrieb am Mit, 19 April 2006 20:54

Ich habe jetzt keine Lust so lange zu suchen, aber was ist Hirusitim?

Hirsutism...übermäßige behaarung...besonders bei frauen....

Die AGA-Behandlung ist individuell, eine Sache des "Trial And Error". Fasse dich kurz und kompakt bei Fragen... das ist meine Freizeit. Es besteht auch kein Verhältnis zu alopezie.de. ""Ich bin kein Arzt, sondern gebe hier lediglich meine private Meinung wieder; Art.5/GG. Auf Userfragen hin erläutere ich, wie ich persönlich vorgehen würde, wenn ich mich in der selben Lage befände. Bitte stets beachten: 1) Nachmachen auf eigene Gefahr und 2) Meine Vorschläge ersetzen keinen Arztbesuch!""

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Re: SPIRO CREAM VERSUS SPIRO SOLUTIONS [Beitrag #19829 ist eine Antwort auf Beitrag #19819] :: Mi., 19 April 2006 21:45

Zitat:

Ich habe jetzt keine Lust so lange zu suchen, aber was ist Hirusitim?

Hirsutism...übermäßige behaarung...besonders bei frauen....

Mhh vielleicht verstehe ich ja was falsch, aber was haben wir für ein Interesse an übermäßiger Behaarung bei Frauen....

Kkoo?

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Re: SPIRO CREAM VERSUS SPIRO SOLUTIONS [Beitrag #19830 ist eine Antwort auf Beitrag #19829] :: Mi., 19 April 2006 21:57

Figaro03 schrieb am Mit, 19 April 2006 21:45

Zitat:

Ich habe jetzt keine Lust so lange zu suchen, aber was ist Hirusitim?

Hirsutism...übermäßige behaarung...besonders bei frauen....

Mhh vielleicht verstehe ich ja was falsch, aber was haben wir für ein Interesse an übermäßiger Behaarung bei Frauen....

Kkoo?

Hirsutismus hat auch mit Haaren und deren Wachstum und dessen Beeinflussung zu tun, hormonell, über DHT-Beeinflussung etc. pp. Ist recht nah dran an AGA, im Großen und Ganzen...

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