Comparative study between mesotherapy and topical 5% minoxidil by dermoscopic evaluation for androgenic alopecia in male: A randomized controlled trial

Abstract

Aim: This study aims to compare efficacy and safety between mesotherapy (intralesional injection) and 5% topical minoxidil solution in male androgenic alopecia (AGA) by dermoscopic evaluation. Methodology: In a randomized active controlled trial, we enrolled 49 clinically diagnosed males of AGA and randomly allotted them into two groups – mesotherapy (A) (25) and minoxidil (B) (24). Males in Group A were given total 8 sessions of intralesional mesosolution with microneedling procedure while Group B males were prescribed topical solution of minoxidil 5% twice daily for 4 months. Results were evaluated at baseline and then monthly for 4 months with clinical photographs, dermoscopy, trichoscan, 7-point standard assessment tool, and patient-self assessment scores. Results: Grade II was the most common presentation in our study. All dermoscopic parameters such as variation of hair shaft diameter, follicular units with single and multiple hairs, yellow dots, and perifollicular halo did not show any significant difference between the groups at all time points except at 1 st month where the difference in variation of hair shaft diameter between the two group was 0.04. We observed a significant increase ( P = 0.01) in the variation of hair shaft diameter between pre- and post-treatment in mesotherapy group compared to minoxidil group. The rest of parameters failed to show any significant difference within the group in mesotherapy and minoxidil. Conclusion: In our study, we observed a significant increase in the variation of hair shaft diameter between pre- and post-treatment in Group A compared to B. Other dermoscopic, trichoscan, and subjective measurement tool failed to show significant difference between two groups. Our observation suggests that there is no significant improvement of mesotherapy in male AGA over minoxidil.

Formulation of Sodium Valproate Nanospanlastics as a Promising Approach for Drug Repurposing in the Treatment of Androgenic Alopecia

“…There is a strong correlation between family history and AGA in relation to its severity and time of onset. The pathophysiology of AGA involves shortening of the hair cycle, increasing the telogen shedding and elongation of the catagen phase duration [ 3 ].…”

Trichobiolight: A new, effective protocol in the treatment of androgenetic alopecia and telogen effluvium

“…Topical treatment are actually a valid support in the baldness therapy: lotions and/or mesotherapy with corticosteroid and/or PRP have been proposed with consistent results but also with some remarkable side effects (such as atrophic scarring after corticosteroid injection) 10‐13 …”

“…According to the literature, not so many studies have investigated the potential of mesotherapy in scalp baldness but the direct inoculation into the scalp of vitamins and growth factors and/or corticosteroids/finasteride/minoxidil/dutasteride together with the multiple trauma induced by the micro-injection increase the local release of cytokines and growth factors and resulted in a visible improvement of AGA. [9][10][11][12] Photobiostimulation by a red LED light at 630 nm is a system that has already proven to be very effective in activating the mitochondria and the ATP cycle, thus leading to an increasing cell receptivity to substances present in the vicinity. 13,14 Since baldness strongly affects self-perception and self-esteem, a psychological therapy should be considered an adjunctive support to the management of this kind of disease.…”

“…Mesotherapy is performed by multiple superficial dermal microinjections (the name “mesotherapy” means therapy in the middle layer of skin, meso = mesoderm). According to the literature, not so many studies have investigated the potential of mesotherapy in scalp baldness but the direct inoculation into the scalp of vitamins and growth factors and/or corticosteroids/finasteride/minoxidil/dutasteride together with the multiple trauma induced by the micro‐injection increase the local release of cytokines and growth factors and resulted in a visible improvement of AGA 9‐12 …”

Practice pattern and use of serum peptide formulation in patients with alopecia: results of an opinion survey among dermatologists in India

“…This practice can be supported by results of a randomized trial showing no significant improvement with mesotherapy in male AGA over topical 5% minoxidil. 17 An initial response in FPHL (AGA) may take about 12 or 24 months and needs long term treatment to maintain the effect. 15 In our survey too dermatologists reported use of long term therapy in patients with AGA as compared to those with TE.…”