The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta‐analysis

Abstract

Androgenetic alopecia (AGA) is the most common type of baldness affecting both men and women. Studies investigating combination therapies for AGA reported greater efficacy than monotherapy but without rigorous examination. The authors performed a meta‐analysis and systemic review to further verify the evidence. To evaluate the effectiveness of three common combination therapies of minoxidil with finasteride, low‐level laser light therapy (LLLT) or microneedling versus minoxidil monotherapy. We conducted a systematic review of randomized controlled trials (RCTs) of combination therapies consisting of topical minoxidil for AGA through April 2020. Quality assessment and data analysis were performed by Review Manager 5.3. Fifteen studies met the inclusion criteria involving a total of 1172 AGA patients. We conducted meta‐analysis for three groups of combined treatment separately, and all were superior to monotherapy in terms of global photographic assessment (P < .05). Combination of LLLT or microneedling with minoxidil also showed significant increase in hair count (P < .05) compared to monotherapy. The present study suggests that combination therapy could be an effective, safe and promising option for the treatment of AGA. However, more RCTs are needed to further investigate and confirm the efficacy of combined treatment.

Platelet‐rich plasma for androgenic alopecia: A randomized, placebo‐controlled, double‐blind study and combined mice model experiment

“…29 Several clinical trials have demonstrated the positive outcome of daily application of these medications for a long period of time. 30 However, the efficacy is limited with duration of effect and several important side effects. Recently, the use of LLLT, microneedling, and autologous treatments including PRP and human follicle stem cells (HFSCs) have been suggested as promising treatments for AGA to improve hair re-growth, which may free the patient from the daily routine.…”

“…AGA is the most common type of baldness, which was reported to affect approximately 73% of men and 57% of women over the age of 80, but only two drugs, minoxidil (a vasodilator) and finasteride (a 5‐alpha reductase inhibitor) have been approved by FDA as antialopecia treatment to date 29 . Several clinical trials have demonstrated the positive outcome of daily application of these medications for a long period of time 30 . However, the efficacy is limited with duration of effect and several important side effects.…”

Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics

“…al. (2020) indicated superior efficacy of topical minoxidil with oral finasteride 153 . Another study showed an 84.44% success rate in maintaining good hair density with topical minoxidil and finasteride combination 1–12 months after discontinuation of oral finasteride 154 …”

“…Combinations with LLLT have also undergone investigation. In a meta‐analysis of 133 subjects across 3 studies treated with LLLT and topical minoxidil, combination therapy proved superior to monotherapy in global assessment ratings 153 106,161 .…”

An Uncontrolled Case Series Using a Botanically Derived, β-Cyclodextrin Inclusion Complex in Two Androgenetic Alopecia-Affected Male Subjects

“…Inasmuch as hair follicles are ectodermal appendages of the integument, they are susceptible to both local and systemic therapy. Thus, the concomitant use of oral finasteride and topical minoxidil constitutes a rational hypothesis that has been attempted with some success [17]. However, the caveat of amplified negative side effects may discourage clinicians and patients from considering the approach.…”