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Need treatment for a severe hair problem on my body and face?

Jul 2012
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Practicing since : 1993
Answered : 1196 Questions
I am getting a friend to type this for me.

Background information:

I am a female in my mid-30s and need treatment for a severe hair problem on my body and face (hirsutism). This has been made worse by having laser treatment several times. I am interested in taking either or thinking of Spironolactone or Flutamide. I used to take Cyproterone Acetate 100mg for the first 14 days of the monthly cycle. It was effective, but I had to stop taking it as it was reacting badly with my lithium and giving me boils. Also my psychiatrist warned me that it could lead me to develop terminal liver cancer.

Medication I am currently on:
Sulphride 1200mg twice a day (an anti-psychotic)
Sodium valparate 500mg
Diazapan 10mg at night and 2mg at lunch time

I have also taken Llithium carbonate 600 mg a day in the evening but am not at the moment (but It hope to in the next year or so).


1. Which would would you recommend out of Spironolactone and Flutamide?
2. How long do Spironolactone and Flutamide take to work?
3. What dosage of Spironolactone and Flutamide would be the best?
4. Could either affect my chances of having a baby in the future or cause abnormality to a foetus? (please note that I am not pregnant at the moment)
5. Am I likely to need blood tests to see if either are causing damage to organs like my liver and kidney?
6. Will either medication cause my breasts to grow? (this happened when I was on Cyproterone Acetate)
7. Will either medication react badly with the current medications I am taking (listed above)?
8. Is there an alternative to Spironolactone and Flutamide that is more effective and has less side effects?
9. Will all the body/facial hair be gone if I take this medication? If so, how long would this take?
10. Can you recommend anywhere I can buy these tablets in a high dosage from the internet? (I live in the UK)
Posted Sun, 11 Nov 2012 in Skin Hair and Nails
Answered by Dr. Praveen Rodrigues 4 hours later
Hi there XXXXXXX,
I empathise with your current problem of 'hirsuitism' & understand your questions clearly.
However, please note this is a net consult & we have certain limitations & restrictions on this site & are bound by certain rules.
One of them is not to divulge any specific medication dosages et al; Second is most of these medications whether in the UK or outside are prescription based especially for a long time; Third, you seem to have some serious issues with medications esp Psychiatric medications & as such, it would not be prudent on my part to recommend medications off the cuff.
However, as you have placed your faith in us, allow me to be candid to a point.
First: Why this hirsuitism? It needs to be investigated. Is it possible you have polycystic ovarian disease & if so, it could by itself affect your chances of pregnancy.
As to the choice between spironolactone & flutamide, i would plump for the former should there be an additional case for PCOD as per the tests.
There are always drug-drug interactions but there does not seem to be any direct correlations tween the ones you are currently taking & sporonolactone. Having said this, i always recommend a complete LFT (liver function tests), Serum Creatinine & serum electrolytes as baseline tests & at monthly intervals initially & once/2-3 mths later to be on the ball & prevent unwanted side effects from creeping in . Spironolactone may have an effect on the growth of breasts (gynecomastia) but again has to be monitored clinically & variable & not as much as the cyproterone acetate!
The internet is a wide open space. While as a medical professional it would be unethical to recommend a particular site in your given scenario, please feel free to google & am sure one can find anything one wants nowadays ;-)!
I am sorry but online, this is the best i can do..point you out in the right direction.
Need of the hour: abdominal scan & hormonal analysis followed by visits to the gynecologist & the psychiatrist!
Good Luck & Godspeed!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist
Bangalore, India
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