Assessment of efficacy of different botulinum toxin A concentrations in the treatment of androgenetic alopecia assessed by dermoscopy

Abstract

BackgroundAndrogenetic alopecia (AGA) is the most common type of progressive hair loss in men and women. AGA is characterized by the miniaturization of the hair follicle, leading to the transformation of terminal hair to vellus hair.ObjectiveTo evaluate the efficacy and safety of injecting two different concentrations of botulinum toxin A (BTA) for the treatment of AGA in Egyptian patients.MethodsAdult male (Hamilton–Norwood I–VII) and female (Ludwig I–III) patients (N = 32) were assigned to receive two different concentrations BTA (33.3 and 25 U/mL) on each side of the scalp; in total, there were 15 injections administered on each side, with injection volume of 0.1 mL containing 3.3 U for the right half and 2.5 U for the left half. Treatment efficiency was assessed at baseline, Month 3 and Month 6, by degree of clinical improvement and dermoscopy assessment.ResultsBy Month 6, proportion of male patients (N = 5) classified as Hamilton–Norwood Grade II increased from 0% to 60% (3/5), proportion of female patients (N = 27) classified as Ludwig Grade I also increased from 14.8% (4/27) to 70% (19/27). Dermoscopy result showed a significant increase in vellus hair density from baseline to Month 6 on the right side (33.3 U/mL), while no change was observed on the left (25 U/mL); however, vellus hair density was higher at Month 3 compared to Month 6. There were changes in yellow spots and peripilar sign more on the right side. Adverse reactions reported include irritation, headache, injections site pain, and nausea.ConclusionThe results of the present study showed that BTA is a safe and effective treatment for AGA in both genders. These findings offer a cutting‐edge conceptual structure and therapeutic strategy for the management of AGA in Egyptian population.

Efficacy and safety of botulinum toxin A in the treatment of female pattern hair loss

“…However, FPHL is a chronic and progressive alopecia process that requires long‐term treatment, and progressive hair loss occurs when treatment is stopped. The duration of patient follow‐up, according to published studies, ranges from 6 to 15 months 5–10 . We noticed that no severe adverse effects were reported in the research on therapeutic effects.…”

“…11,4 Through a review of the published literature, we found that only two articles assessing the treatment of FPHL with BTA. 10,14 One study showed that after 6 months of subcutaneous injection with BTA, the proportion of female patients (N = 27) classified as Ludwig Grade I increased from 14.8% (4/27) to 70% (19/27). 6 Another study 14 revealed that in BTA group, each patient injected with 50 units of botulinum toxin A into the muscles surrounding the scalp.…”

“…The duration of patient follow-up, according to published studies, ranges from 6 to 15 months. [5][6][7][8][9][10] We noticed that no severe adverse effects were reported in the research on therapeutic effects. It is imperative that not only efficacy but also safety should be considered.…”

“…Studies have demonstrated that Botulinum Toxin A (BTA) has been explored for the management of male AGA, showing clinical improvement after injection 5–10 . Although BTA's potential to ameliorate AGA has been observed, the exact mechanisms remain unknown.…”

“…Studies have demonstrated that Botulinum Toxin A (BTA) has been explored for the management of male AGA, showing clinical improvement after injection. 5 , 6 , 7 , 8 , 9 , 10 Although BTA's potential to ameliorate AGA has been observed, the exact mechanisms remain unknown. Possible pathogenic explanations for BTA's efficacy in treating AGA include its primary mechanism of action, which involves blocking the release of acetylcholine, a neurotransmitter that plays a crucial role in the communication between nerves and muscles.…”