Androgenetic Alopecia: Therapy Update
May 2023
in “Drugs”
TLDR
There are many treatments for common hair loss, but more trials are needed to decide which are best.
Androgenetic Alopecia (AGA), a common form of hair loss, affects 80% of men and 50% of women by age 70. The FDA has approved two drugs for AGA: topical minoxidil and oral finoxidil. Other treatments include topical finasteride, dutasteride, oral minoxidil, spironolactone, flutamide, bicalutamide, clascoterone, pyrilutamide, and injectable treatments like botulinum A toxin and dutasteride mesotherapy. Non-drug treatments include Platelet-Rich Plasma (PRP) treatment, Low-Level Light Therapy (LLLT), mesenchymal stem cells (MSCs), microneedling, and nutritional supplements. The document concludes that more large-scale, double-blinded, placebo-controlled randomized trials are needed to make informed decisions about AGA treatments.
View this study on link.springer.com →
Cited in this study
research A Comprehensive Review of Microneedling as a Potential Treatment Option for Androgenetic Alopecia
research Mesotherapy With Dutasteride for Androgenetic Alopecia: A Retrospective Study in Real Clinical Practice.
research A Study of Combination Unilateral Subcutaneous Botulinum Toxin A Treatment for Androgenetic Alopecia
research Nutraceuticals for Androgenetic Alopecia.
research Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients
Dutasteride is the most effective hair loss treatment after 24 weeks, but finasteride leads to the most hair growth after 48 weeks.
research Natural products for male androgenetic alopecia
Natural products like saw palmetto, caffeine, melatonin, marine extracts, rosemary oil, procyanidin, pumpkin seed oil, and cannabidiol oil could potentially treat male hair loss.
research Microneedling and Its Use in Hair Loss Disorders: A Systematic Review
research Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial
research Is Every Patient of Hair Loss a Candidate for Hair Transplant?—Deciding Surgical Candidacy in Pattern Hair Loss
research Microneedling in androgenetic alopecia; comparing two different depths of microneedles
Deeper microneedling boosts hair growth, with 0.6mm needles and minoxidil being most effective.
research Trichoscopic Findings in Androgenetic Alopecia
Trichoscopy, a hair loss evaluation technique, found that people with Androgenetic Alopecia have more thin hairs, yellow dots, and perifollicular discoloration than healthy individuals.
research Oral minoxidil treatment for hair loss: A review of efficacy and safety
Oral minoxidil promotes hair growth but may cause side effects; needs monitoring.
research
A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study
Minoxidil and spironolactone combo effectively treats androgenetic alopecia, improving hair density and diameter.
research Efficacy and safety of oral minoxidil in female androgenetic alopecia
Oral minoxidil improves hair density in women with androgenetic alopecia, with mild side effects.
research Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: A randomized controlled trial
PRP treatment improves hair density and thickness for alopecia, but needs more research.
research Efficacy of Intralesional and Oral Dutasteride in the Treatment of Androgenetic Alopecia: A Systematic Review
Oral dutasteride works better for hair loss, but has more sexual side effects; intralesional dutasteride is a possible alternative.
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
Oral minoxidil 5 mg daily increases hair growth safely in men with hair loss, with minor side effects.
research Spironolactone for treatment of female pattern hair loss
Spironolactone effectively treats female pattern hair loss with few side effects.
research The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta‐analysis
Combination therapies work better than single treatments for hair loss.
research 5‐Alpha reductase inhibitors in androgenetic alopecia: Shifting paradigms, current concepts, comparative efficacy, and safety
Dutasteride works better than finasteride for hair loss, with both being safe to use.
research At the crossroads of 2 alopecias: Androgenetic alopecia pattern of hair regrowth in patients with alopecia areata treated with oral Janus kinase inhibitors
JAK inhibitors help hair regrowth but not fully effective for androgenetic alopecia.
research The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism
Botulinum toxin injections may help treat hair loss by blocking harmful secretion in hair follicles.
research Efficacy of Topical Finasteride 0.5% vs 17α-Estradiol 0.05% in the Treatment of Postmenopausal Female Pattern Hair Loss: A Retrospective, Single-Blind Study of 119 Patients
research Safety of oral bicalutamide in female pattern hair loss: A retrospective review of 316 patients
Oral bicalutamide is safe and effective for female hair loss.
research Hair transplantation by follicular unit extraction for male androgenetic alopecia: A retrospective observational study from two centers
Hair transplantation with FUE is safe, effective, and better than FUT for male hair loss.
research
Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date
Finasteride shows promise for female hair loss, but more research needed.
research Female Androgenetic Alopecia: An Update on Diagnosis and Management
FAGA diagnosis uses blood tests and trichoscopy, with treatments like topical minoxidil, oral anti-androgens, and hormone-modulating drugs.
research Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia
Combining electrodynamic microneedle with 5% minoxidil improves hair growth and reduces hair loss in Chinese men.
research Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial
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
Bicalutamide improves hair density in women safely.
research The relationship between self‐esteem and hair transplantation satisfaction in male androgenetic alopecia patients
Hair transplant boosts self-esteem and appearance satisfaction, especially in those with high self-esteem.
research A summary of in vitro, phase I, and phase II studies evaluating the mechanism of action, safety, and efficacy of clascoterone (cortexolone 17a propionate, CB-03-01) in androgenetic alopecia
Clascoterone safely promotes hair growth similar to minoxidil.
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
Combination of 0.25% finasteride and 3% minoxidil works better than just 3% minoxidil for increasing hair thickness in women.
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
Finasteride and minoxidil mix works better for hair growth than minoxidil alone, with similar safety.
research A randomized controlled, single-observer blinded study to determine the efficacy of topical minoxidil plus microneedling versus topical minoxidil alone in the treatment of androgenetic alopecia
research A pilot split-scalp study of combined fractional radiofrequency microneedling and 5% topical minoxidil in treating male pattern hair loss
Combined microneedling and minoxidil improves hair growth more than minoxidil alone.
research The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia
research Low-level laser therapy for the treatment of androgenic alopecia: a review
Low-Level Laser Therapy (LLLT) is a safe and effective treatment for common hair loss, but more research is needed to find the best power and wavelength for treatment.
research Effectiveness of Platelet-Rich Plasma for Androgenetic Alopecia: A Review of the Literature
PRP treatment helps hair growth in most cases, but more research needed.
research Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone
Low-dose oral minoxidil and spironolactone combo effectively reduces hair loss and improves hair density in women.
research An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia
Caffeine-based liquid 0.2% is as effective as minoxidil 5% for treating male hair loss.
research Growing evidence of the beneficial effects of a marine protein-based dietary supplement for treating hair loss
A marine protein-based dietary supplement can safely boost hair growth and reduce hair loss in people with thinning hair.
research Low level light-minoxidil 5% combination versus either therapeutic modality alone in management of female patterned hair loss: A randomized controlled study
Combining low-level light therapy and minoxidil 5% is more effective for female hair loss than using either treatment alone.
research Minoxidil dose response study in female pattern hair loss patients determined to be non-responders to 5% topical minoxidil.
Increasing the dosage of minoxidil can help hair regrowth in women who didn't respond to the standard treatment.
research Androgenetic Alopecia: An Update of Treatment Options
Minoxidil is the only FDA-approved topical drug for treating male or female pattern hair loss, and other medications like finasteride and dutasteride can also increase hair growth.
research A 6-month, randomized, double-blind, placebo-controlled study evaluating the ability of a marine complex supplement to promote hair growth in men with thinning hair
research Guidelines on the use of finasteride in androgenetic alopecia
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 Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients
Finasteride and minoxidil together work best for male hair loss.
research Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy
Microneedling can effectively promote new hair growth in men with hair loss who didn't improve with traditional treatments.
research Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial.
Rosemary oil and minoxidil 2% both effectively increase hair count in people with androgenetic alopecia, but rosemary oil causes less scalp itching.
research 5% Minoxidil: treatment for female pattern hair loss.
research Effect of Pumpkin Seed Oil on Hair Growth in Men with Androgenetic Alopecia: A Randomized, Double-Blind, Placebo-Controlled Trial
Pumpkin seed oil helps hair growth in men with hair loss.
research Use of low-level laser therapy as monotherapy or concomitant therapy for male and female Androgenetic alopecia
Low-level laser therapy helps male and female hair loss alone or with other treatments.
research Androgenetic alopecia.
Androgenetic alopecia is a common hair loss condition caused by testosterone effects on hair follicles, leading to thinner, shorter, and less pigmented hair, diagnosed using scalp dermoscopy and treated with topical minoxidil, antiandrogen agents, and 5-alpha reductase inhibitors.
research Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study
Laser device increases hair density, safe for treating hair loss in men and women.
research Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Sham Device–Controlled Multicenter Trial
Low-level light therapy safely improves hair growth and thickness for androgenetic alopecia.
research New investigational drugs for androgenetic alopecia
Possible new treatments for common hair loss include drugs, stem cells, and improved transplants.
research Hair: What is New in Diagnosis and Management?
Female pattern hair loss diagnosed by scalp appearance, treated with combined therapies and targeted approaches.
research A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study
research Efficacy and safety of 3% minoxidil versus combined 3% minoxidil / 0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study.
The combined treatment of 3% minoxidil and 0.1% finasteride is more effective in improving hair loss than 3% minoxidil alone, with similar side effects.
research Comparitive Effectiveness and Finasteride Vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study
Finasteride works better than Serenoa repens for male hair loss.
research Depressive Symptoms and Suicidal Thoughts Among Former Users of Finasteride With Persistent Sexual Side Effects
Former finasteride users with persistent sexual side effects have higher rates of depression and suicidal thoughts.
research A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia
Latanoprost 0.1% may effectively treat hair loss.
research No improvement in male-pattern hair loss using laser hair-comb therapy: a 6-month, half-head, assessor-blinded investigation in two men
Laser hair-comb therapy doesn't improve male-pattern hair loss.
research Prostaglandin D 2 Inhibits Hair Growth and Is Elevated in Bald Scalp of Men with Androgenetic Alopecia
PGD2 stops hair growth and is higher in bald men with AGA.
research Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men
Use minoxidil for hair loss; finasteride and dutasteride for men, dutasteride for women.
research Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up
Finasteride effectively increases hair growth in men with AGA, works better for those over 30, and may cause some side effects.
research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss
Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.
research Treatment of female pattern hair loss with the androgen receptor antagonist flutamide
Flutamide improves female hair loss when other treatments fail, but may cause liver toxicity.
research Prospective Cohort Study on the Effects and Tolerability of Flutamide in Patients with Female Pattern Hair Loss
Flutamide effectively treats female pattern hair loss with low doses showing good liver tolerance.
research THERAPEUTIC HOTLINE: Treatment of androgenic alopecia with finasteride may result in a high grade prostate cancer in patients: fact or fiction?
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
Dutasteride 0.5 mg daily improves hair growth safely in men with hair loss.
research Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss.
Spironolactone helps regrow hair in women with hair loss.
research Successful treatment of female-pattern hair loss with spironolactone in a 9-year-old girl
Spironolactone successfully treated hair loss in a 9-year-old girl.
research HairMax LaserComb® Laser Phototherapy Device in the Treatment of Male Androgenetic Alopecia
HairMax LaserComb® effectively promotes hair growth and stops hair loss in males with androgenetic alopecia, with no serious side effects.
research Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss).
Finasteride 1 mg helps prevent more hair loss in men with male pattern baldness.
research Dietary supplement increases anagen hair rate in women with telogen effluvium: results of a double-blind, placebo-controlled trial
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
Dutasteride more effective for hair growth, but has more side effects than finasteride.
research Treatment of female pattern hair loss with oral antiandrogens
Oral antiandrogens effectively treat female hair loss, with better results in higher hair loss grades.
research Minoxidil: mechanisms of action on hair growth
Minoxidil boosts hair growth by opening potassium channels and increasing cell activity.
research An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia
Oral finasteride works better than topical minoxidil for hair growth, both are safe.
research Androgenetic Alopecia in Women
Androgenetic alopecia in women needs more research and better management strategies.
research Treatment of hyperandrogenic alopecia in women
research A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men
5% minoxidil works better for hair growth and density, with minor irritation.
research Comparative Efficacy of Various Treatment Regimens for Androgenetic Alopecia in Men
Best hair growth results from combining finasteride and minoxidil.
research Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial
Minoxidil works better for female hair loss, but cyproterone reduces scalp oiliness and causes menstrual issues.
research A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-α-Reductase in the Treatment of Androgenetic Alopecia
Natural 5AR inhibitors effectively improve mild to moderate hair loss in men.
research A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-α-Reductase in the Treatment of Androgenetic Alopecia
Plant extracts effectively reduce hair loss and increase growth, offering a safe alternative treatment.
research Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course
Topical finasteride helps regrow hair and reduce balding without side effects.
research The effect of cyproterone acetate on hair roots and hair shaft diameter in androgenetic alopecia in females
Cyproterone acetate effectively treats female hair loss by increasing healthy hair and decreasing unhealthy hair, but doesn't change hair thickness.
Related
research Noninvasive Hair Rejuvenation
research Androgenetic Alopecia: Therapy Update
There are many treatments for common hair loss, but more trials are needed to decide which are best.
research Edthnopharmacological Review of Medicinal Plants for the Treatment of Alopecia
Various medicinal plants like Polygonum multiflorum, Red ginseng extract, and Zizyphus jujuba can potentially treat hair loss, offering benefits like low cost and multiple ways of working. Other effective natural substances include Pygeum africanum, Seneroa, Urtica dioica, and more.
research Pediatric androgenetic alopecia: an updated review
research Relative efficacy of microneedling in the treatment of pattern hair loss: a protocol for a systematic review with network meta-analysis
research Noninvasive Hair Rejuvenation
research Micro needling: A novel therapeutic approach for androgenetic alopecia, A Review of Literature
Microneedling may help hair loss, but needs more research.
research Physiology and Medical Treatments for Alopecia
research Update on the pathogenesis, genetics and medical treatment of patterned hair loss.
research Types of Hair Loss and Treatment Options, Including the Novel Low-Level Light Therapy and Its Proposed Mechanism
Hair loss treatments include medications and new methods like low-level light therapy, which may work by boosting cell activity and blood flow.