Efficacy of Off-Label Topical Treatments for the Management of Androgenetic Alopecia: A Review

  • Aditya K. GuptaEmail author
  • Rachel R. Mays
  • Sarah G. Versteeg
  • Neil H. Shear
  • Vincent Piguet
  • Bianca Maria Piraccini
Review Article


Androgenetic alopecia (AGA) is characterized by non-scarring follicle miniaturization. Despite the success of approved therapies, commonly reported side effects and the need for continual use has led to the investigation of alternative therapies. The aim of this paper is to critically review the success of off-label, topical monotherapies for treatment of AGA in men. A literature search was conducted to obtain randomized, controlled and blinded studies that investigated off-label, topical, monotherapies in male patients. Hair density, hair diameter and hair growth were used to evaluate treatment success. Fourteen off-label topical therapies were investigated among the 16 studies that met inclusion criteria. Nine off-label therapies were reported to produce a significantly greater improvement in hair restoration parameters (e.g. mean change from hair count and hair diameter) as compared to placebo (p < 0.05 for all treatments). In two studies, procyanidin oligomers exhibited greater efficacy over vehicle with response to mean change in hair density (hairs/cm2) (ps < 0.0001 at Week 24). In conclusion, prostaglandin analogs and polyphenols, such as latanoprost and procyanidin oligomers, can improve hair restoration parameters in male AGA patients, possibly through targeting mechanisms proposed in the etiology of AGA. The current evidence suggests short-term (24 weeks) use may provide benefit for hair loss patients; however, long-term efficacy and safety data are required.


Compliance with Ethical Standards


This paper was not funded.

Conflict of interest

Dr. Piguet reports receiving educational grants in his role as Department Division Director, Dermatology, University of Toronto (on behalf of the Division of Dermatology Residency Program) from Abbvie, Celgene, Janssen, Naos, Lilly, Sanofi, Valeant, and non-financial support from La Roche-Posay, outside the submitted work.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Mediprobe Research Inc.LondonCanada
  2. 2.Division of Dermatology, Department of MedicineUniversity of Toronto School of MedicineTorontoCanada
  3. 3.Division of DermatologySunnybrook Health Sciences CentreTorontoCanada
  4. 4.Division of DermatologyWomen’s College HospitalTorontoCanada
  5. 5.Division of Infection and ImmunityCardiff University School of MedicineCardiffUK
  6. 6.Dermatology, Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly

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