Interventions for female pattern hair loss

Abstract

Although there was a predominance of included studies at unclear to high risk of bias, there was evidence to support the efficacy and safety of topical minoxidil in the treatment of FPHL (mainly moderate to low quality evidence). Furthermore, there was no difference in effect between the minoxidil 2% and 5% with the quality of evidence rated moderate to low for most outcomes. Finasteride was no more effective than placebo (low quality evidence). There were inconsistent results in the studies that evaluated laser devices (moderate to low quality evidence), but there was an improvement in total hair count measured from baseline.Further randomised controlled trials of other widely-used treatments, such as spironolactone, finasteride (different dosages), dutasteride, cyproterone acetate, and laser-based therapy are needed.

Guidelines for the diagnosis and treatment of male‐pattern and female‐pattern hair loss, 2017 version

“…Subsequently, with regard to FPHL, a systematic review involving 1242 female subjects, with an observation period of 24-32 weeks, that analyzed eight RCT using 1%, 2% and 5% minoxidil showed the efficacy of minoxidil. 65 In the minoxidil group, the number of hairs in a 1-cm 2 area of hair loss increased by a mean of 13.18 (95% CI, 10.92-15.44) compared with the placebo group. With regard to adverse events, the results of an analysis of four RCT with 725 subjects showed that the relative risk was 1.12 (95% CI, 0.61-2.06), 1.24 (95% CI, 0.82-1.87) and 2.05 (95% CI, 0.96-4.37) for the 1%, 2% and 5% minoxidil groups, respectively.…”

“…With regard to adverse events, the results of an analysis of four RCT with 725 subjects showed that the relative risk was 1.12 (95% CI, 0.61-2.06), 1.24 (95% CI, 0.82-1.87) and 2.05 (95% CI, 0.96-4.37) for the 1%, 2% and 5% minoxidil groups, respectively. 65 In a systematic review involving 631 female subjects with an observation period of 26-52 weeks that analyzed three RCT on 2% and 5% minoxidil, the total number of hairs in a 1-cm 2 area of hair loss was smaller with a mean of 2.12 (95% CI, 5.47-1.23) in the 2% minoxidil group than the 5% minoxidil group, but no significant difference was found between the two groups. 65 With regard to adverse events, the results of an analysis of four RCT with 1006 subjects also showed that the relative risk was 1.02 (95% CI, 0.91-1.20), and no significant difference was found between the two groups.…”

“…65 In a systematic review involving 631 female subjects with an observation period of 26-52 weeks that analyzed three RCT on 2% and 5% minoxidil, the total number of hairs in a 1-cm 2 area of hair loss was smaller with a mean of 2.12 (95% CI, 5.47-1.23) in the 2% minoxidil group than the 5% minoxidil group, but no significant difference was found between the two groups. 65 With regard to adverse events, the results of an analysis of four RCT with 1006 subjects also showed that the relative risk was 1.02 (95% CI, 0.91-1.20), and no significant difference was found between the two groups. 65 However, evidence quality of these analyses on the increase in the number of hairs and adverse events is low, and further investigation is required.…”

“…Commentary: With regard to the efficacy of minoxidil, 14 RCT [40][41][42][43][44][45][46][47][48][49][50][51][52][53] and one systematic review 54 on MPHL, and 10 RCT 55-64 and one systematic review 65 on FPHL have been conducted.…”

“…65 With regard to adverse events, the results of an analysis of four RCT with 1006 subjects also showed that the relative risk was 1.02 (95% CI, 0.91-1.20), and no significant difference was found between the two groups. 65 However, evidence quality of these analyses on the increase in the number of hairs and adverse events is low, and further investigation is required.…”