Melatonin in the Topical Treatment of Androgenetic Alopecia

In the search for alternative treatments to Finasteride and Minoxidil for androgenetic alopecia (AGA), melatonin was identified as a candidate from in vitro and in vivo studies due to its potent antioxidant properties and role as a growth modulator. Five clinical studies demonstrated positive effects of topical melatonin treatment on AGA in both men and women with good tolerability. One study showed no significant impact on endogenous melatonin plasma levels with once-daily evening topical application. An observational study with 30 men and women reported a significant decrease in alopecia severity after 30 and 90 days (p < 0.001). Digital phototrichogram analysis in 35 men with AGA showed a significant increase in hair density of 29% and 41% after 3 and 6 months, respectively (p < 0.001). In a study with 60 men and women, a significant reduction in hair loss was observed in women, while men's hair loss remained constant (p < 0.001). A multicenter study with over 1800 participants across 200 centers over 3 months found a decrease in patients with a 2- to 3-fold positive pull test from 61.6% to 7.8% and an increase in patients with a negative pull test from 12.2% to 61.5% (p < 0.001), along with a reduction in seborrhea and seborrheic dermatitis of the scalp. Given the safety and tolerability observed in all studies, topical application of a cosmetic melatonin solution could be a sensible treatment option or supplement for AGA.