Management of Androgenetic Alopecia in Men: Established Options and Emerging Therapies

June 2023 in “ Drugs & Therapy Perspectives ”

Amy Zhuang-Yan, Sheridan M. Hoy

androgenetic alopecia hair follicles 5α-reductase inhibitors dutasteride vasodilators topical minoxidil low-level laser therapy botulinum toxin AGA hair loss 5-alpha-reductase inhibitors Rogaine LLLT Botox

From the encyclopedia

Dutasteride →

Heavy duty finasteride that comes with higher risks

Botox →

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Studysummary This study discusses treatment options for androgenetic alopecia, highlighting that while available therapies include approved and off-label pharmacological agents and non-pharmacological treatments, there is still limited evidence-based guidance on managing this common hair loss disorder. Our plain-language summary of this paper — not a Tressless recommendation.

Androgenetic alopecia (AGA), the most common type of hair loss disorder, is characterized by the progressive miniaturization of hair follicles in androgenetic areas of the scalp, leading to a decrease in hair density. The management options for AGA have increased over time, but evidence-based information and guidelines are limited. Current treatments include approved and off-label use of pharmacological agents such as oral 5α-reductase inhibitors (e.g., dutasteride) and vasodilators (e.g., topical minoxidil), non-pharmacological treatments like low-level laser therapy, and emerging investigational therapies such as botulinum toxin.

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Research cited in this study

13 / 13 results

research What's New in Therapy for Male Androgenetic Alopecia?

2 citations , September 2022 in “American Journal of Clinical Dermatology”

research Guidelines for the Diagnosis and Treatment of Male-Pattern and Female-Pattern Hair Loss, 2017 Version

36 citations , June 2018 in “Journal of Dermatology”

This article updates Japanese guidelines for diagnosing and treating male and female-pattern hair loss, recommending specific drugs and therapies while advising against certain treatments for female-pattern hair loss.

research Scalp Threading with Polydioxanone Monofilament Threads: A Novel, Effective, and Safe Modality for Hair Restoration

11 citations , May 2017 in “Journal of The European Academy of Dermatology and Venereology”

Results are not reported in this letter to the editor on the use of scalp threading with polydioxanone monofilament threads for hair restoration.

research A Pilot Study to Evaluate Effectiveness of Botulinum Toxin in Treatment of Androgenetic Alopecia in Males

24 citations , January 2017 in “Journal of Cutaneous and Aesthetic Surgery”

In this pilot study, botulinum toxin was found to be a safe and effective treatment for androgenetic alopecia in most participants, though larger studies are needed to confirm these findings.

Effects of a Novel Finasteride 0.25% Topical Solution on Scalp and Serum Dihydrotestosterone in Healthy Men with Androgenetic Alopecia

research Effects of a Novel Finasteride 0.25% Topical Solution on Scalp and Serum Dihydrotestosterone in Healthy Men with Androgenetic Alopecia

42 citations , December 2015 in “International Journal of Clinical Pharmacology and Therapeutics”

This study found that applying a novel 0.25% finasteride solution to the scalp can effectively reduce scalp DHT levels in men with androgenetic alopecia, potentially reducing systemic side-effects.

research Topical Minoxidil Fortified with Finasteride: Maintenance of Hair Density After Replacing Oral Finasteride

32 citations , January 2015 in “Indian Dermatology Online Journal”

This study found that a combination of topical minoxidil and finasteride helped maintain hair density in patients with androgenetic alopecia after initial oral finasteride treatment.

A Novel Finasteride 0.25% Topical Solution for Androgenetic Alopecia: Pharmacokinetics and Effects on Plasma Androgen Levels in Healthy Male Volunteers

research A Novel Finasteride 0.25% Topical Solution for Androgenetic Alopecia: Pharmacokinetics and Effects on Plasma Androgen Levels in Healthy Male Volunteers

50 citations , July 2014 in “International Journal of Clinical Pharmacology and Therapeutics”

This study found that both topical and oral finasteride significantly reduced plasma DHT after one week, with lower finasteride plasma exposure for the topical formulation.

A Randomized, Active- and Placebo-Controlled Study of the Efficacy and Safety of Different Doses of Dutasteride Versus Placebo and Finasteride in the Treatment of Male Subjects with Androgenetic Alopecia

research A Randomized, Active- and Placebo-Controlled Study of the Efficacy and Safety of Different Doses of Dutasteride Versus Placebo and Finasteride in the Treatment of Male Subjects with Androgenetic Alopecia

97 citations , January 2014 in “Journal of The American Academy of Dermatology”

This study found that dutasteride increased hair growth and restoration in men with androgenetic alopecia more effectively than finasteride and was well tolerated over 24 weeks.

research Evaluation of the Effect of Injection of Dutasteride as a Mesotherapeutic Tool in the Treatment of Androgenetic Alopecia in Males

17 citations , January 2013 in “Our Dermatology Online”

This study concluded that mesotherapy with a dutasteride-containing solution was the most effective option for treating androgenetic alopecia in males, promoting hair growth and reducing hair loss.

research Treatment of Male Pattern Baldness with Botulinum Toxin: A Pilot Study

50 citations , November 2010 in “Plastic and Reconstructive Surgery”

This study suggests that Botox injections may increase hair count and reduce hair loss in men with androgenetic alopecia, potentially through increased blood flow and oxygen to the scalp.

research S1 Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women, and Adolescents

151 citations , August 2010 in “British Journal of Dermatology”

This guideline reviews the diagnosis of androgenetic alopecia and offers expert consensus recommendations tailored to males, females, and adolescents, but reports no new clinical results.

Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

research Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

92 citations , June 2010 in “Journal of The American Academy of Dermatology”

This study found that 0.5 mg of dutasteride significantly improved hair growth compared to placebo and was well tolerated over six months in men with male pattern hair loss.

The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

research The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

215 citations , November 2006 in “Journal of The American Academy of Dermatology”

This study found that dutasteride increased scalp hair growth in men with male pattern hair loss, particularly at a 2.5 mg dose, and was more effective than finasteride over 24 weeks.