Botulinum Toxin Therapy for Androgenetic Alopecia: From Mechanistic Insights to Clinical Applications

This review examines the use of botulinum toxin (BoNT) for treating androgenetic alopecia (AGA), highlighting its potential mechanisms, such as reducing TGF-β in dermal papilla cells and enhancing blood flow through muscle relaxation. While some studies report response rates as high as 79%, others show no significant improvement in hair density. Intramuscular injections are more effective than intradermal ones, and combining BoNT with finasteride or minoxidil improves outcomes. However, BoNT is less cost-effective and requires repeated injections, which may affect patient compliance. The review emphasizes the need for larger, high-quality randomized controlled trials to clarify BoNT's effectiveness in AGA treatment and to establish standardized evaluation methods.