Use of Botulinum Toxin for Androgenic Alopecia: A Systematic Review

This systematic review evaluated the use of botulinum toxin injections for treating androgenic alopecia (AGA), a common hair loss disorder, in 165 male participants across five clinical studies. The studies reported response rates of 75 to 79.1% and hair count changes of 18 to 20.9% from intramuscular injections, with no serious adverse events. However, due to the lack of control groups, small participant numbers, and low Jadad quality scores, these results should be interpreted with caution. The exact mechanisms of botulinum toxin's effect on AGA are not yet established, but it's speculated that it could decrease TGF-β1 activity in dermal papilla cells and improve blood flow to the scalp. The authors recommend larger randomized clinical trials to confirm these findings, explore its effects on female pattern hair loss, and establish best practices for injection methodologies. Until then, botulinum toxin injections should be considered an adjunct therapy rather than a stand-alone treatment for AGA.