The Relative Effect of Monotherapy with 5-Alpha Reductase Inhibitors and Minoxidil for Female Pattern Hair Loss: A Network Meta-Analysis Study

June 2023 in “ Journal of Cosmetic Dermatology ”

Aditya K. Gupta, Tong Wang, Mary A Bamimore, Milton Talukder

5-alpha reductase inhibitors minoxidil finasteride pattern hair loss topical minoxidil oral minoxidil oral finasteride 5-ARIs Rogaine Propecia PHL

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This research highlights that while minoxidil and 5-alpha reductase inhibitors are commonly used for treating pattern hair loss, there is limited evidence supporting their relative effectiveness in women compared to men.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

A network meta-analysis study analyzed data from 13 trials to compare the efficacy of minoxidil and 5-alpha reductase inhibitors (5-ARIs) in treating adult women with pattern hair loss (PHL). The study found that the most effective treatment was 5mg finasteride taken once a day for 24 weeks, followed by 5% topical minoxidil solution applied twice a day for 24 weeks, and 1mg minoxidil taken once a day for 24 weeks. The least effective treatment was 1mg finasteride taken once a day for 24 weeks. The study also suggested a possible dose-dependent effect for oral finasteride, and oral and topical minoxidil, with higher doses showing more efficacy. However, there was no significant difference between 3% and 2% topical minoxidil solution applied twice a day for 24 weeks.

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Research cited in this study

13 / 13 results

research Efficacy and Safety of 5% Minoxidil Alone, Minoxidil Plus Oral Spironolactone, and Minoxidil Plus Microneedling on Female Pattern Hair Loss: A Prospective, Single-Center, Parallel-Group, Evaluator-Blinded, Randomized Trial

2 citations , July 2022 in “Frontiers in Medicine”

This study found that combining topical minoxidil with microneedling improved hair density more than either minoxidil alone or with spironolactone for women with mild-to-moderate female pattern hair loss.

research Relative Efficacy of Minoxidil and the 5-Alpha Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients

13 citations , February 2022 in “JAMA Dermatology”

This meta-analysis reported that 0.5 mg/d of dutasteride significantly increased total hair count at 24 weeks compared to finasteride and minoxidil in men with androgenetic alopecia.

research Randomized Clinical Trial of Low-Dose Oral Minoxidil for the Treatment of Female Pattern Hair Loss: 0.25 mg Versus 1 mg

3 citations , January 2022 in “Journal of The American Academy of Dermatology”

This study found that 1 mg/day low-dose oral minoxidil significantly increased hair count compared to 0.25 mg/day over 24 weeks in women with female pattern hair loss, though no differences were observed in hair-shedding and quality-of-life scores between the two doses.

research A Randomized Clinical Trial on Therapeutic Effects of 0.25 mg Oral Minoxidil Tablets on Treatment of Female Pattern Hair Loss

5 citations , September 2021 in “Dermatologic Therapy”

In this triple-blind randomized clinical trial, researchers found that oral minoxidil 0.25 mg tablets were as effective as 2% topical minoxidil for increasing hair diameter and density in women with female pattern hair loss, with similarly minor side effects.

research Male and Female Pattern Hair Loss: Treatable and Worth Treating

11 citations , March 2021 in “Cleveland Clinic Journal of Medicine”

In this overview, the authors note that both pharmacologic and nonpharmacologic treatments are effective for pattern hair loss, emphasizing early detection and intervention to maintain hair.

research Comparison of Low-Level Light Therapy and Combination Therapy of 5% Minoxidil in the Treatment of Female Pattern Hair Loss

5 citations , October 2020 in “Lasers in Medical Science”

This study found that combination therapy with LLLT and 5% minoxidil improved hair diameter and density more effectively than each treatment alone in women with female pattern hair loss.

Evaluation of the Efficacy and Safety of Cow Placenta Extract Lotion Versus Minoxidil 2% in the Treatment of Female Pattern Androgenetic Alopecia

research Evaluation of the Efficacy and Safety of Cow Placenta Extract Lotion Versus Minoxidil 2% in the Treatment of Female Pattern Androgenetic Alopecia

4 citations , May 2020 in “International Journal of Women's Dermatology”

In this double-blind, randomized controlled trial, researchers found that cow placenta extract lotion was as effective as topical minoxidil 2% in increasing hair count for women with androgenetic alopecia over six months, though the mean increases in hair count were similar for both treatments.

research Accelerated Hair Growth by Combining Thread Monofilament and Minoxidil in Female Androgenetic Alopecia

4 citations , December 2019 in “Journal of Cosmetic Dermatology”

This study found that combining poly-l-lactic acid microthread therapy with minoxidil improved hair density and appearance more effectively than minoxidil alone in women with androgenetic alopecia.

Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study

research Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study

36 citations , September 2018 in “American Journal of Clinical Dermatology”

This study found that a topical combination of 0.25% finasteride and 3% minoxidil may increase hair diameter more effectively than 3% minoxidil alone in postmenopausal women with female pattern hair loss.

research Efficacy of Finasteride 1.25 mg on Female Pattern Hair Loss: Pilot Study

10 citations , January 2012 in “Annals of Dermatology”

In this study, 1.25 mg daily finasteride for 28 weeks showed minimal increase in hair density and thickness in normoandrogenic female pattern hair loss, but no significant clinical improvement was observed.

research 5 mg/Day Finasteride Treatment for Normoandrogenic Asian Women with Female Pattern Hair Loss

64 citations , June 2010 in “Journal of The European Academy of Dermatology and Venereology”

This study suggests that 5 mg/day oral finasteride may increase hair density and thickness in normoandrogenic Asian women with female pattern hair loss over 12 months.

Comparison of the Efficacy and Safety of Topical Minoxidil and Topical Alfatradiol in the Treatment of Androgenetic Alopecia in Women

research Comparison of the Efficacy and Safety of Topical Minoxidil and Topical Alfatradiol in the Treatment of Androgenetic Alopecia in Women

56 citations , April 2007 in “Journal der Deutschen Dermatologischen Gesellschaft”

This study found that 12 months of minoxidil treatment increased hair density and thickness in women with androgenetic alopecia, while alfatradiol primarily stabilized hair loss.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations , November 2000 in “Journal of The American Academy of Dermatology”

In this study, finasteride 1 mg/day for 12 months did not improve hair growth or slow hair thinning in postmenopausal women with androgenetic alopecia compared to placebo.