Medical Treatment for Androgenetic Alopecia

October 2023 in “ Facial Plastic Surgery ”

Ratchathorn Panchaprateep

androgenetic alopecia topical minoxidil oral finasteride oral dutasteride hair transplantation platelet-rich plasma adipose-derived stem cells micrograft generation exosome low-level laser therapy Rogaine Propecia PRP stem cell therapy laser therapy

TLDR New treatments for common hair loss include medications, regenerative therapies, and laser therapy, but may not work for everyone.

Androgenetic alopecia, a common type of hair loss influenced by genetic factors and systemic androgens, can cause cosmetic issues and psychological distress. Standard medical treatments include topical minoxidil 2 to 5%, oral finasteride, oral dutasteride, and hair transplantation. However, these treatments may not yield favorable results for all patients. As a result, novel treatments have been developed, such as new medications, regenerative medicines (including autologous platelet-rich plasma, adipose-derived stem cells, micrograft generation, and exosome), and low-level laser therapy.

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research Efficacy of Topical Minoxidil and Oral Spironolactone Versus Minoxidil and Finasteride in Androgenic Alopecia

August 2023 in “Journal of Cosmetic Dermatology”

Both minoxidil-spironolactone and minoxidil-finasteride treatments work for hair loss, but minoxidil-spironolactone is slightly more effective, especially in women.

research Treatment of Androgenetic Alopecia by Exosomes Secreted From Hair Papilla Cells and the Intervention Effect of LTF

August 2023 in “Journal of Cosmetic Dermatology”

Exosomes from hair papilla cells and the Chinese medicine Liao Tuo Fang can potentially promote hair growth and could be used to develop hair growth drugs.

research Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2 citations , August 2023 in “Journal of Cutaneous Medicine and Surgery”

PRP is effective and safe for increasing hair density in people with hair loss.

research Clinical Study on the Efficacy and Tolerability of a Topical Regenerative Treatment in Patients With Telogen Effluvium and Mild Androgenetic Alopecia

2 citations , July 2023 in “Journal of Cosmetic Dermatology”

The topical treatment reduced hair loss and improved hair growth in patients with certain types of hair loss.

research Systematic Review of Exosome Treatment in Hair Restoration: Preliminary Evidence, Safety, and Future Directions

1 citations , June 2023 in “Journal of Cosmetic Dermatology”

Exosome treatment for hair growth is promising but not FDA-approved and needs more research on safety and how it works.

research Efficacy of Autologous Platelet-Rich Plasma Combined With a Non-Cross-Linked Hyaluronic Acid Compound in the Treatment of Female Androgenetic Alopecia: A Retrospective, Case-Series Study

June 2023 in “Journal of Cosmetic Dermatology”

The treatment combining platelet-rich plasma and a non-cross-linked hyaluronic acid compound significantly improved hair density and reduced bald areas in women with androgenetic alopecia, and it's safe with only mild side effects.

research Combination Therapy in Female Pattern Hair Loss

June 2023 in “Journal of Cosmetic and Laser Therapy”

research Androgenetic Alopecia: Therapy Update

May 2023 in “Drugs”

There are many treatments for common hair loss, but more trials are needed to decide which are best.

research Treatment of Androgenetic Alopecia: Current Guidance and Unmet Needs

May 2023 in “Clinical, Cosmetic and Investigational Dermatology”

research Could Oral Minoxidil Be Superior to Its Topical Variant for Treatment of Female Pattern Hair Loss?

April 2023 in “PubMed”

research Adipose Mesenchymal Stromal Cell-Derived Exosomes Carrying MiR-122-5p Antagonize the Inhibitory Effect of Dihydrotestosterone on Hair Follicles by Targeting the TGF-β1/SMAD3 Signaling Pathway

March 2023 in “International Journal of Molecular Sciences”

research Efficacy of Autologous Platelet-Rich Plasma Therapy Versus Topical Minoxidil in Men With Moderate Androgenetic Alopecia: A Randomized Open-Label Trial

February 2023 in “Journal of Dermatological Treatment”

research Mesotherapy With Dutasteride for Androgenetic Alopecia: A Concise Review of the Literature

February 2023 in “European Journal of Dermatology”

The document concludes that injecting dutasteride into the skin (mesotherapy) can effectively treat common hair loss in both men and women.

research An Umbrella Review of the Use of Platelet-Rich Plasma in the Treatment of Androgenetic Alopecia

January 2023 in “Journal of Cosmetic Dermatology”

research Effect of Platelet-Rich Plasma and Other Key Factors on Hair Follicle Preservation

1 citations , January 2023 in “International Journal of Trichology”

Platelet-rich plasma didn't increase hair length but may help keep hair follicles alive.

research Autologous Platelet-Rich Plasma Treatment for Androgenic Alopecia: A Systematic Review and Meta-Analysis of Clinical Trials on Patient Safety, Efficacy and Outcomes

December 2022 in “Plastic and Reconstructive Surgery”

research Use of Autologous Platelet-Rich Plasma in Androgenetic Alopecia in Women: A Systematic Review and Meta-Analysis

October 2022 in “Journal of Dermatological Treatment”

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

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

research Platelet-Rich Plasma Monotherapies for Androgenetic Alopecia: A Network Meta-Analysis and Meta-Regression Study

1 citations , September 2022 in “Journal of Drugs in Dermatology”

research Topical Cetirizine for Treating Androgenetic Alopecia: A Systematic Review

August 2022 in “Journal of Cosmetic Dermatology”

research Comparison of Oral Minoxidil, Finasteride, and Dutasteride for Treating Androgenetic Alopecia

1 citations , August 2022 in “Journal of Dermatological Treatment”

research There Is a Positive Dose-Dependent Association Between Low-Dose Oral Minoxidil and Its Efficacy for Androgenetic Alopecia: Findings From a Systematic Review With Meta-Regression Analyses

2 citations , June 2022 in “Skin appendage disorders”

research Exosome Therapy in Hair Regeneration: A Literature Review of the Evidence, Challenges, and Future Opportunities

12 citations , June 2022 in “Journal of cosmetic dermatology”

Exosome therapy could help with hair loss, but more research is needed to confirm its safety and effectiveness.

research Combination of Platelet-Rich Plasma and Platelet Gel in Treatment of Resistant Androgenic Alopecia: A Case Series Study

April 2022 in “Journal of Cosmetic Dermatology”

research Potential of Colostrum-Derived Exosomes for Promoting Hair Regeneration Through the Transition from Telogen to Anagen Phase

5 citations , March 2022 in “Frontiers in Cell and Developmental Biology”

research Effectiveness of Platelet-Rich Plasma Therapy in Androgenic Alopecia: A Meta-Analysis

7 citations , February 2022 in “Journal of Personalized Medicine”

Platelet-Rich Plasma therapy significantly increases hair density in people with Androgenic Alopecia, and works better with more treatments per month and in younger patients.

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”

Dutasteride is the most effective hair loss treatment after 24 weeks, but finasteride leads to the most hair growth after 48 weeks.

research Bicalutamide and the New Perspectives for Female Pattern Hair Loss Treatment: What Dermatologists Should Know

3 citations , January 2022 in “Journal of Cosmetic Dermatology”

Bicalutamide, a drug with a good safety profile, is a promising new treatment for female pattern hair loss.

research Sublingual Minoxidil for the Treatment of Male and Female Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase 1B Clinical Trial

5 citations , January 2022 in “Journal of The European Academy of Dermatology and Venereology”

Sublingual minoxidil safely promotes hair growth.

research Treatment Options for Androgenetic Alopecia: Efficacy, Side Effects, Compliance, Financial Considerations, and Ethics

17 citations , November 2021 in “Journal of Cosmetic Dermatology”

research Bicalutamide Improves Minoxidil-Induced Hypertrichosis in Female Pattern Hair Loss: A Retrospective Review of 35 Patients

4 citations , November 2021 in “Journal of The American Academy of Dermatology”

research Efficacy and Safety of Topical Finasteride Spray Solution for Male Androgenetic Alopecia: A Phase III, Randomized, Controlled Clinical Trial

11 citations , October 2021 in “Journal of The European Academy of Dermatology and Venereology”

research Meta-Analysis of Photobiomodulation for the Treatment of Androgenetic Alopecia

10 citations , August 2021 in “Journal of Dermatological Treatment”

Photobiomodulation helps hair growth safely in men and women, with laser devices working better than LED ones.

research Randomized Control Trial to Study the Efficacy and Safety of Platelet-Rich Plasma as Intraoperative Holding Solution in Hair Restoration Surgery: A Pilot Study

July 2021 in “Medical journal, Armed Forces India”

Using platelet-rich plasma in hair restoration surgery significantly improves hair density after 6 months and is safe to use.

research Combination Oral Minoxidil and Spironolactone for the Treatment of Androgenetic Alopecia in Adolescent Girls

5 citations , June 2021 in “Journal of The American Academy of Dermatology”

Minoxidil and spironolactone improve hair density and reduce shedding in girls.

research A Phase 1 Study to Investigate the Effects of Cortexolone 17α-Propionate, Also Known as Clascoterone, on the QT Interval Using the Meal Effect to Demonstrate ECG Assay Sensitivity

2 citations , May 2021 in “Clinical Pharmacology in Drug Development”

Clascoterone is safe for the heart, even at high doses.

research Extracellular Vesicles Released from Irradiated Neonatal Mouse Cheek Tissue Increased Cell Survival After Radiation

5 citations , December 2020 in “Journal of radiation research”

Vesicles from irradiated mouse cheek skin help cells survive radiation.

research Efficacy and Safety of Oral Minoxidil in Female Androgenetic Alopecia

14 citations , November 2020 in “Dermatologic Therapy”

Oral minoxidil improves hair density in women with androgenetic alopecia, with mild side effects.

research Clascoterone as a Novel Treatment for Androgenetic Alopecia

5 citations , October 2020 in “Clinical and Experimental Dermatology”

Clascoterone may be a promising treatment for hair loss.

research Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment

24 citations , September 2020 in “Dermatology and therapy”

Oral minoxidil 5 mg daily increases hair growth safely in men with hair loss, with minor side effects.

research Safety of Low-Dose Oral Minoxidil Treatment for Hair Loss: A Systematic Review and Pooled Analysis of Individual Patient Data

14 citations , September 2020 in “Dermatologic Therapy”

Low-dose oral minoxidil is a safe treatment for hair loss, with the main side effect being excessive hair growth. Other side effects like foot swelling, low blood pressure when standing, and heart rate changes are rare.

research Spironolactone for Treatment of Female Pattern Hair Loss

15 citations , July 2020 in “Journal of The American Academy of Dermatology”

Spironolactone effectively treats female pattern hair loss with few side effects.

research Topical Finasteride for the Treatment of Male Androgenetic Alopecia and Female Pattern Hair Loss: A Review of the Current Literature

13 citations , June 2020 in “Journal of Dermatological Treatment”

Topical finasteride helps regrow hair and reduce hair loss in men and women.

research Effect of Platelet-Rich Plasma Versus Saline Solution as a Preservation Solution for Hair Transplantation

13 citations , June 2020 in “Plastic and reconstructive surgery. Global open”

PRP preservation improves hair transplant results better than saline.

research Efficacy and Safety of Very-Low-Dose Oral Minoxidil 1.25 mg in Male Androgenetic Alopecia

19 citations , May 2020 in “Journal of The American Academy of Dermatology”

Low-dose oral minoxidil improves hair growth in male hair loss.

research Bicalutamide: A Potential New Oral Antiandrogenic Drug for Female Pattern Hair Loss

8 citations , April 2020 in “Journal of The American Academy of Dermatology”

Bicalutamide may be a promising alternative treatment for female pattern hair loss.

research Efficacy of Non-Surgical Treatments for Androgenetic Alopecia in Men and Women: A Systematic Review with Network Meta-Analyses and an Assessment of Evidence Quality

15 citations , April 2020 in “Journal of Dermatological Treatment”

Minoxidil and finasteride work best for hair loss; more research needed.

research Safety of Oral Bicalutamide in Female Pattern Hair Loss: A Retrospective Review of 316 Patients

16 citations , March 2020 in “Journal of The American Academy of Dermatology”

Oral bicalutamide is safe and effective for female hair loss.

research Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date

32 citations , March 2020 in “Drug Design Development and Therapy”

Finasteride shows promise for female hair loss, but more research needed.

research Low-Dose Oral Minoxidil for Female Pattern Hair Loss: A Unicenter Descriptive Study of 148 Women

12 citations , February 2020 in “Skin appendage disorders”

Low-dose oral minoxidil effectively treats female hair loss with good safety.

research Oral Minoxidil: A Possible New Therapy for Androgenetic Alopecia

8 citations , January 2020 in “Journal of Cutaneous Medicine and Surgery”

Oral minoxidil may improve hair loss in men and women, but has some side effects.

research Excellent Response to Mesotherapy as Adjunctive Treatment in Male Androgenetic Alopecia

11 citations , January 2020 in “Journal of Cosmetic Dermatology”

Mesotherapy helps treat male hair loss effectively.

research Topical Ketoconazole for the Treatment of Androgenetic Alopecia: A Systematic Review

11 citations , January 2020 in “Dermatologic Therapy”

Ketoconazole may help regrow hair and increase follicle size, but more research needed.

research Very-Low-Dose Oral Minoxidil in Male Androgenetic Alopecia: A Study with Quantitative Trichoscopic Documentation

24 citations , January 2020 in “Journal of The American Academy of Dermatology”

Low-dose oral minoxidil improved or stabilized hair loss in some patients, but higher doses may be needed for significant effects.

research Minoxidil 1 mg Oral Versus Minoxidil 5% Topical Solution for the Treatment of Female-Pattern Hair Loss: A Randomized Clinical Trial

53 citations , January 2020 in “Journal of The American Academy of Dermatology”

Oral minoxidil and topical minoxidil 5% both effectively improve female-pattern hair loss with safe side effects.

research Oral Bicalutamide for Female Pattern Hair Loss: A Pilot Study

8 citations , November 2019 in “Dermatologic Therapy”

Bicalutamide improves hair density in women safely.

research Physiopathology and Current Treatments of Androgenetic Alopecia: Going Beyond Androgens and Anti-Androgens

45 citations , September 2019 in “Dermatologic Therapy”

Hair loss treatments work better with lifestyle changes.

research Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee

49 citations , July 2019 in “The Journal of Clinical Endocrinology and Metabolism”

Use "female pattern hair loss" term, assess androgen excess, treat with minoxidil and other medications if needed.

research Comparative Effectiveness of Low-Level Laser Therapy for Adult Androgenic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

21 citations , January 2019 in “Lasers in Medical Science”

Low-level laser therapy significantly increases hair density in adults with hair loss, with low-frequency treatment being more effective.

research The Efficacy of Platelet-Rich Plasma in Hair Restoration and Facial Aesthetics: A Systematic Review and Meta-Analysis

31 citations , January 2019 in “Journal of Cutaneous Medicine and Surgery”

Platelet-Rich Plasma (PRP) therapy can promote hair growth and improve facial aesthetics, including reducing acne scars and facial burns, and it works best with three initial monthly injections.

research A Randomized, Double-Blind Controlled Study of the Efficacy and Safety of Topical Solution of 0.25% Finasteride Admixed with 3% Minoxidil vs. 3% Minoxidil Solution in the Treatment of Male Androgenetic Alopecia

43 citations , December 2018 in “Journal of The European Academy of Dermatology and Venereology”

Finasteride and minoxidil mix works better for hair growth than minoxidil alone, with similar safety.

research Efficacy of Non-Surgical Treatments for Androgenetic Alopecia: A Systematic Review and Network Meta-Analysis

54 citations , December 2018 in “Journal of The European Academy of Dermatology and Venereology”

Low level laser therapy works best for hair loss, followed by PRP, finasteride, and minoxidil.

research Safety of 5α-Reductase Inhibitors and Spironolactone in Breast Cancer Patients Receiving Endocrine Therapies

22 citations , November 2018 in “Breast Cancer Research and Treatment”

The medications 5α-reductase inhibitors and spironolactone are generally safe for breast cancer patients on endocrine therapies and do not significantly increase breast cancer risk.

research Systematic Review of Low-Level Laser Therapy for Adult Androgenic Alopecia

13 citations , May 2018 in “Journal of Cosmetic and Laser Therapy”

Low-level laser therapy can stimulate hair growth more effectively than fake devices, but patient satisfaction is similar for both. Results should be taken with caution due to small study sizes and differences between studies. More research is needed.

research Use of Low-Level Laser Therapy in Treatment of Androgenic Alopecia: The First Systematic Review

6 citations , May 2018 in “Journal of Cosmetic and Laser Therapy”

Low-level laser therapy can improve hair density in people with androgenic alopecia, but more research is needed to find out who it works best for.

research Female Pattern Hair Loss: A Pilot Study Investigating Combination Therapy with Low-Dose Oral Minoxidil and Spironolactone

80 citations , January 2018 in “International Journal of Dermatology”

Low-dose oral minoxidil and spironolactone combo effectively reduces hair loss and improves hair density in women.

research The Effectiveness of Treatments for Androgenetic Alopecia: A Systematic Review and Meta-Analysis

178 citations , July 2017 in “Journal of The American Academy of Dermatology”

Minoxidil, finasteride, and low-level laser light therapy effectively treat hair loss.

research Mesotherapy with Dutasteride in the Treatment of Androgenetic Alopecia

24 citations , July 2017 in “International Journal of Trichology”

research Stem Cells from Human Hair Follicles: First Mechanical Isolation for Immediate Autologous Clinical Use in Androgenetic Alopecia and Hair Loss

86 citations , June 2017 in “Stem cell investigation”

Stem cells from hair follicles can safely treat hair loss.

research Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia

136 citations , April 2016 in “Dermatologic Surgery”

PRP treatment helps hair growth and density in androgenetic alopecia patients.

research Guidelines on the Use of Finasteride in Androgenetic Alopecia

33 citations , March 2016 in “Indian Journal of Dermatology, Venereology and Leprology”

Taking 1 mg of finasteride daily can increase hair count and improve hair appearance, but it may have side effects on sexual function and a potential risk of prostate cancer. It may not be effective for postmenopausal women unless taken in higher doses.

research Evaluation of Wavelength-Dependent Hair Growth Effects on Low-Level Laser Therapy: An Experimental Animal Study

15 citations , June 2015 in “Lasers in Medical Science”

The 830-nm wavelength was most effective at promoting hair growth in rats using low-level laser therapy.

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

10 citations , July 2012 in “Annals of Dermatology”

Finasteride 1.25 mg showed small improvements in hair density and thickness for female pattern hair loss, but more research is needed.

research Evaluation of Efficacy and Safety of Finasteride 1 mg in 3177 Japanese Men with Androgenetic Alopecia

41 citations , January 2012 in “Journal of Dermatology”

Finasteride 1 mg effectively and safely increases hair growth in Japanese men with hair loss.

research Treatment of Postmenopausal Frontal Fibrosing Alopecia with Oral Dutasteride

64 citations , July 2009 in “Journal of The American Academy of Dermatology”

Oral dutasteride can potentially treat frontal fibrosing alopecia in postmenopausal women, with some patients showing disease arrest and hair regrowth.

research Frontal Fibrosing Alopecia: Treatment with Oral Dutasteride and Topical Pimecrolimus

69 citations , May 2009 in “Journal of The European Academy of Dermatology and Venereology”

Oral dutasteride and topical pimecrolimus can safely and effectively treat Frontal Fibrosing Alopecia, leading to significant hair regrowth.

research The Effect of 5α-Reductase Inhibition with Dutasteride and Finasteride on Semen Parameters and Serum Hormones in Healthy Men

195 citations , May 2007 in “The Journal of Clinical Endocrinology and Metabolism”

Dutasteride and finasteride may reduce sperm count and volume but don't affect movement or shape; effects are reversible after stopping.

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 , December 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Minoxidil: Mechanisms of Action on Hair Growth

397 citations , February 2004 in “British Journal of Dermatology”

Minoxidil boosts hair growth by opening potassium channels and increasing cell activity.

research A Randomized Clinical Trial of 5% Topical Minoxidil Versus 2% Topical Minoxidil and Placebo in the Treatment of Androgenetic Alopecia in Men

269 citations , September 2002 in “Journal of The American Academy of Dermatology”

5% minoxidil works better for hair growth and density, with minor irritation.

research Changes in Hair Weight and Hair Count in Men with Androgenetic Alopecia After Treatment with Finasteride, 1 mg, Daily

66 citations , April 2002 in “Journal of The American Academy of Dermatology”

Finasteride increases hair weight and count in men with hair loss.

research Chronic Treatment with Finasteride Daily Does Not Affect Spermatogenesis or Semen Production in Young Men

104 citations , October 2000 in “The Journal of Urology”

Finasteride doesn't harm male fertility or sperm quality, but may slightly reduce ejaculate volume.

4 / 4 results

research Evaluation of the Therapeutic Effects of AGA Drugs by Measuring Finasteride, Dutasteride, and Dihydrotestosterone in Hair

July 2023 in “Clinica Chimica Acta”

Finasteride and dutasteride effectively reduce DHT in hair, which may help evaluate their treatment success for hair loss.

research What Do We Know About 5-Alpha Reductase Inhibitors?

January 2018 in “Surgical and Cosmetic Dermatology”

5-alpha reductase inhibitors like finasteride and dutasteride are effective for treating enlarged prostate and male pattern hair loss.

research Dutasteride in Androgenetic Alopecia: An Update

27 citations , January 2017 in “Current Clinical Pharmacology”

Dutasteride is becoming a popular hair loss treatment, proving more effective than finasteride with similar side effects.

research Atypical Post-Finasteride Syndrome: A Pharmacological Riddle

8 citations , May 2016 in “Indian Journal of Pharmacology”