Skip to main content
Log in

Androgenetic Alopecia: An Evidence-Based Treatment Update

American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

Androgenetic alopecia (AGA) is one of the most common chronic problems seen by dermatologists worldwide. It is characterized by progressive hair loss, especially of scalp hair, and has distinctive patterns of loss in women versus men, but in both genders the central scalp is most severely affected. It often begins around puberty and is known to effect self-esteem and the individual’s quality of life. In contrast to the high prevalence of AGA, approved therapeutic options are limited. In addition to the scarce pharmacologic treatments, there are numerous nonprescription products claimed to be effective in restoring hair in androgenetic alopecia.

Objectives

The purpose of this paper is to review published medical and non-medical treatments for male and female AGA using the American College of Physicians evidence assessment methods. MEDLINE, EMBASE and Cochrane Library were searched for systematic reviews, randomized controlled trials, open studies, case reports and relevant studies of the treatment of male and female AGA. The relevant articles were classified according to grade and level of evidence.

Results

The medical treatments with the best level of evidence classification for efficacy and safety for male AGA are oral finasteride and topical minoxidil solution. For female AGA, topical minoxidil solution appears to be the most effective and safe treatment. The medical treatments corresponding to the next level of evidence quality are some commonly used therapeutic non-FDA-approved options including oral and topical anti-hormonal treatments. Surgical treatment of follicular unit hair transplantation is an option in cases that have failed medical treatment although there is high variation in outcomes.

Limitations

Some articles, especially those concerning traditional herbs claimed to promote hair regrowth, were published in non-English, local journals.

Conclusions

An assessment of the evidence quality of current publications indicates that oral finasteride (for men only) and topical minoxidil (for men and women) are the best treatments of AGA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hamilton JB. Patterned loss of hair in man: types and incidence. Ann N Y Acad Sci. 1951;53:708–28.

    Article  CAS  PubMed  Google Scholar 

  2. Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005;10:184–9.

    Article  PubMed  Google Scholar 

  3. Han SH, Byun JW, Lee WS, et al. Quality of life assessment in male patients with androgenetic alopecia: result of a prospective, multicenter study. Ann Dermatol. 2012;24:311–8.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Qaseem A, Snow V, Owens DK, Shekelle P. Clinical Guidelines Committee of the American College of Physicians. The development of clinical practice guidelines and guidance statements of the American College of Physicians: summary of methods. Ann Intern Med. 2010;153:194–9.

    Article  PubMed  Google Scholar 

  5. Mella JM, Perret MC, Manzotti M, Catalano HN, Guyatt G. Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review. Arch Dermatol. 2010;146:1141–50.

    Article  PubMed  Google Scholar 

  6. Blumeyer A, Tosti A, Messenger A, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges. 2011;9(Suppl 6):S1–57.

    Article  PubMed  Google Scholar 

  7. Bergstrom KG. What’s new in androgenetic alopecia: approvals, long-term safety data, cancer risk and treatment options for women. J Drugs Dermatol. 2011;10:98–101.

    PubMed  Google Scholar 

  8. Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011;8:1747–53.

    Article  PubMed  Google Scholar 

  9. Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5alpha-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med. 2011;8:872–84.

    Article  CAS  PubMed  Google Scholar 

  10. Irwig MS. Persistent sexual side effects of finasteride: could they be permanent? J Sex Med. 2012;9:2927–32.

    Article  PubMed  Google Scholar 

  11. Irwig MS. Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects. J Clin Psychiatry. 2012;73:1220–3.

    Article  CAS  PubMed  Google Scholar 

  12. Lynn R, Krunic A. Therapeutic hotline. Treatment of androgenic alopecia with finasteride may result in a high grade prostate cancer in patients: fact or fiction? Dermatol Ther. 2010;23:544–6.

    Article  PubMed  Google Scholar 

  13. D’Amico AV, Roehrborn CG. Effect of 1 mg/day finasteride on concentrations of serum prostate-specific antigen in men with androgenic alopecia: a randomised controlled trial. Lancet Oncol. 2007;8:21–5.

    Article  PubMed  CAS  Google Scholar 

  14. Rathnayake D, Sinclair R. Male androgenetic alopecia. Expert Opin Pharmacother. 2010;11:1295–304.

    Article  CAS  PubMed  Google Scholar 

  15. Shenoy NK, Prabhakar SM. Finasteride and male breast cancer: does the MHRA report show a link? J Cutan Aesthet Surg. 2010;3:102–5.

    PubMed Central  PubMed  Google Scholar 

  16. Bird ST, Brophy JM, Hartzema AG, Delaney JA, Etminan M. Male breast cancer and 5alpha-reductase inhibitors finasteride and dutasteride. J Urol. 2013;190:1811–4.

    Article  CAS  PubMed  Google Scholar 

  17. Atanaskova Mesinkovska N, Bergfeld WF. Hair: what is new in diagnosis and management? Female pattern hair loss update: diagnosis and treatment. Dermatol Clin. 2013;31:119–27.

    CAS  PubMed  Google Scholar 

  18. Price VH, Roberts JL, Hordinsky M, et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol. 2000;43:768–76.

    Article  CAS  PubMed  Google Scholar 

  19. Whiting DA, Waldstreicher J, Sanchez M, Kaufman KD. Measuring reversal of hair miniaturization in androgenetic alopecia by follicular counts in horizontal sections of serial scalp biopsies: results of finasteride 1 mg treatment of men and postmenopausal women. J Investig Dermatol Symp Proc. 1999;4:282–4.

    Article  CAS  PubMed  Google Scholar 

  20. Iorizzo M, Vincenzi C, Voudouris S, Piraccini BM, Tosti A. Finasteride treatment of female pattern hair loss. Arch Dermatol. 2006;142:298–302.

    Article  CAS  PubMed  Google Scholar 

  21. Shum KW, Cullen DR, Messenger AG. Hair loss in women with hyperandrogenism: four cases responding to finasteride. J Am Acad Dermatol. 2002;47:733–9.

    Article  PubMed  Google Scholar 

  22. Bowman CJ, Barlow NJ, Turner KJ, Wallace DG, Foster PM. Effects of in utero exposure to finasteride on androgen-dependent reproductive development in the male rat. Toxicol Sci. 2003;74:393–406.

    Article  CAS  PubMed  Google Scholar 

  23. Olsen EA, Hordinsky M, Whiting D, et al. The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride. J Am Acad Dermatol. 2006;55:1014–23.

    Article  PubMed  Google Scholar 

  24. Eun HC, Kwon OS, Yeon JH, et al. Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study. J Am Acad Dermatol. 2010;63:252–8.

    Article  CAS  PubMed  Google Scholar 

  25. Gupta AK, Charrette A. The efficacy and safety of 5alpha-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatol Treat. 2014;25(2):156–61.

  26. Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol. 2009;75:47–51.

    Article  PubMed  Google Scholar 

  27. Olszewska M, Rudnicka L. Effective treatment of female androgenic alopecia with dutasteride. J Drugs Dermatol. 2005;4:637–40.

    PubMed  Google Scholar 

  28. Moftah N, Moftah N, Abd-Elaziz G, et al. Mesotherapy using dutasteride-containing preparation in treatment of female pattern hair loss: photographic, morphometric and ultrustructural evaluation. J Eur Acad Dermatol Venereol. 2013;27:686–93.

    Article  CAS  PubMed  Google Scholar 

  29. Patel MPA, Sinclair R. An overview of female pattern hair loss. Expert Rev Dermatol. 2011;6:311–27.

    Article  Google Scholar 

  30. van Zuuren EJ, Fedorowicz Z, Carter B. Evidence-based treatments for female pattern hair loss: a summary of a Cochrane systematic review. Br J Dermatol. 2012;167:995–1010.

    Article  PubMed  Google Scholar 

  31. Sinclair R, Wewerinke M, Jolley D. Treatment of female pattern hair loss with oral antiandrogens. Br J Dermatol. 2005;152:466–73.

    Article  CAS  PubMed  Google Scholar 

  32. Peereboom-Wynia JD, van der Willigen AH, van Joost T, Stolz E. The effect of cyproterone acetate on hair roots and hair shaft diameter in androgenetic alopecia in females. Acta Derm Venereol. 1989;69:395–8.

    CAS  PubMed  Google Scholar 

  33. Paradisi R, Porcu E, Fabbri R, Seracchioli R, Battaglia C, Venturoli S. Prospective cohort study on the effects and tolerability of flutamide in patients with female pattern hair loss. Ann Pharmacother. 2011;45:469–75.

    Article  CAS  PubMed  Google Scholar 

  34. Carmina E, Lobo RA. Treatment of hyperandrogenic alopecia in women. Fertil Steril. 2003;79:91–5.

    Article  PubMed  Google Scholar 

  35. Yazdabadi A, Sinclair R. Treatment of female pattern hair loss with the androgen receptor antagonist flutamide. Aust J Dermatol. 2011;52:132–4.

    Article  Google Scholar 

  36. Adenuga P, Summers P, Bergfeld W. Hair regrowth in a male patient with extensive androgenetic alopecia on estrogen therapy. J Am Acad Dermatol. 2012;67:e121–3.

    Article  PubMed  Google Scholar 

  37. Blume-Peytavi U, Kunte C, Krisp A, Garcia Bartels N, Ellwanger U, Hoffmann R. Comparison of the efficacy and safety of topical minoxidil and topical alfatradiol in the treatment of androgenetic alopecia in women. J Dtsch Dermatol Ges. 2007;5:391–5.

    Article  PubMed  Google Scholar 

  38. Wozel GNS, Jackel A, Lutz GA. An effective and safe therapy for the treatment of androgenetic alopecia in women and men. Aktuel Dermatol. 2005;31:553–60.

    Article  Google Scholar 

  39. Sovak M, Seligson AL, Kucerova R, Bienova M, Hajduch M, Bucek M. Fluridil, a rationally designed topical agent for androgenetic alopecia: first clinical experience. Dermatol Surg. 2002;28:678–85.

    PubMed  Google Scholar 

  40. Kucerova R, Bienova M, Novotny R. Current therapies of female androgenetic alopecia and use of fluridil, a novel topical antiandrogen. Scr Med (Brno). 2006;79:35–48.

    CAS  Google Scholar 

  41. Ohnemus U, Unalan M, Handjiski B, Paus R. Topical estrogen accelerates hair regrowth in mice after chemotherapy-induced alopecia by favoring the dystrophic catagen response pathway to damage. J Investig Dermatol. 2004;122:7–13.

    Article  CAS  PubMed  Google Scholar 

  42. Gassmueller J, Hoffmann R, Webster A. Topical fulvestrant solution has no effect on male and postmenopausal female androgenetic alopecia: results from two randomized, proof-of-concept studies. Br J Dermatol. 2008;158:109–15.

    CAS  PubMed  Google Scholar 

  43. Goh C, Zippin JH. Androgenetic alopecia: diagnosis and treatment with a focus on recent genetic implications. J Drugs Dermatol. 2009;8:185–92.

    PubMed  Google Scholar 

  44. Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S. Minoxidil use in dermatology, side effects and recent patents. Recent Pat Inflamm Allergy Drug Discov. 2012;6:130–6.

    Article  CAS  PubMed  Google Scholar 

  45. Valente Duarte de Sousa IC, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs. 2013;22:573–89.

    Article  CAS  PubMed  Google Scholar 

  46. van Zuuren EJ, Fedorowicz Z, Carter B, Andriolo RB, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2012;5:CD007628.

    PubMed  Google Scholar 

  47. Tsuboi R, Arano O, Nishikawa T, Yamada H, Katsuoka K. Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men. J Dermatol. 2009;36:437–46.

    Article  CAS  PubMed  Google Scholar 

  48. Khandpur S, Suman M, Reddy BS. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. J Dermatol. 2002;29:489–98.

    CAS  PubMed  Google Scholar 

  49. Berger RS, Fu JL, Smiles KA, et al. The effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trial. Br J Dermatol. 2003;149:354–62.

    Article  CAS  PubMed  Google Scholar 

  50. Bazzano GS, Terezakis N, Galen W. Topical tretinoin for hair growth promotion. J Am Acad Dermatol. 1986;15:880–3, 90–3.

  51. Shin HS, Won CH, Lee SH, Kwon OS, Kim KH, Eun HC. Efficacy of 5% minoxidil versus combined 5% minoxidil and 0.01% tretinoin for male pattern hair loss: a randomized, double-blind, comparative clinical trial. Am J Clin Dermatol. 2007;8:285–90.

    Article  PubMed  Google Scholar 

  52. Vexiau P, Chaspoux C, Boudou P, et al. Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial. Br J Dermatol. 2002;146:992–9.

    Article  CAS  PubMed  Google Scholar 

  53. Pazoki-Toroudi H, Babakoohi S, Nilforoushzadeh MA, et al. Therapeutic effects of minoxidil high extra combination therapy in patients with androgenetic alopecia. Skinmed. 2012;10:276–82.

    PubMed  Google Scholar 

  54. Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007;57:767–74.

    Article  PubMed  Google Scholar 

  55. Blume-Peytavi U, Hillmann K, Dietz E, Canfield D, Garcia Bartels N. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermat. 2011;65:1126–34 e2.

  56. Banka N, Bunagan MJ, Shapiro J. Pattern hair loss in men: diagnosis and medical treatment. Dermatol Clin. 2013;31:129–40.

    CAS  PubMed  Google Scholar 

  57. American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 1994;93:137–50.

    Google Scholar 

  58. Garza LA, Liu Y, Yang Z, et al. Prostaglandin D2 inhibits hair growth and is elevated in bald scalp of men with androgenetic alopecia. Sci Transl Med. 2012;4:126ra34.

    Article  PubMed Central  PubMed  Google Scholar 

  59. Blume-Peytavi U, Lonnfors S, Hillmann K, Garcia Bartels N. A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. J Am Acad Dermatol. 2012;66:794–800.

    Article  CAS  PubMed  Google Scholar 

  60. Emer JJ, Stevenson ML, Markowitz O. Novel treatment of female-pattern androgenetic alopecia with injected bimatoprost 0.03% solution. J Drugs Dermatol. 2011;10:795–8.

    PubMed  Google Scholar 

  61. Olsen EA, DeLong E. Transdermal viprostol in the treatment of male pattern baldness. J Am Acad Dermatol. 1990;23:470–2.

    Article  CAS  PubMed  Google Scholar 

  62. Hugo Perez BS. Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. Med Hypotheses. 2004;62:112–5.

    Article  CAS  PubMed  Google Scholar 

  63. Inui S, Itami S. Reversal of androgenetic alopecia by topical ketoconzole: relevance of anti-androgenic activity. J Dermatol Sci. 2007;45:66–8.

    Article  CAS  PubMed  Google Scholar 

  64. Sonino N, Scaroni C, Biason A, Boscaro M, Mantero F. Low-dose ketoconazole treatment in hirsute women. J Endocrinol Investig. 1990;13:35–40.

    Article  CAS  Google Scholar 

  65. Fischer TW, Slominski A, Tobin DJ, Paus R. Melatonin and the hair follicle. J Pineal Res. 2008;44:1–15.

    Article  CAS  PubMed  Google Scholar 

  66. Fischer TW, Burmeister G, Schmidt HW, Elsner P. Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Br J Dermatol. 2004;150:341–5.

    Article  CAS  PubMed  Google Scholar 

  67. Fischer TW, Trueb RM, Hanggi G, Innocenti M, Elsner P. Topical melatonin for treatment of androgenetic alopecia. Int J Trichol. 2012;4:236–45.

    Article  Google Scholar 

  68. Rose PT. The latest innovations in hair transplantation. Facial Plast Surg. 2011;27:366–77.

    Article  CAS  PubMed  Google Scholar 

  69. Miao Y, Sun YB, Sun XJ, Du BJ, Jiang JD, Hu ZQ. Promotional effect of platelet-rich plasma on hair follicle reconstitution in vivo. Dermatol Surg. 2013;39:1868–76.

    Article  CAS  PubMed  Google Scholar 

  70. Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118(6):1458–66.

  71. Perez-Meza D, Leavitt M, Mayer M. The growth factor. Part 1: clinical and histological evaluation of the wound healing and revascularization of the hair graft after the hair transplant surgery. Hair Transpl Forum Int. 2007;17:173–5.

    Google Scholar 

  72. Park KY, Kim HK, Kim BJ, Kim MN. Letter: platelet-rich plasma for treating male pattern baldness. Dermatol Surg. 2012;38:2042–4.

    Article  CAS  PubMed  Google Scholar 

  73. Takikawa M, Nakamura S, Nakamura S, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg. 2011;37:1721–9.

    Article  CAS  PubMed  Google Scholar 

  74. Watanabe Y, Nagashima S, Hanzawa N. Efficacy of adenosine on male androgenetic alopecia. Jpn J Dermatol. 2005;115:57.

    Google Scholar 

  75. Oura H, Iino M, Nakazawa Y, et al. Adenosine increases anagen hair growth and thick hairs in Japanese women with female pattern hair loss: a pilot, double-blind, randomized, placebo-controlled trial. J Dermatol. 2008;35:763–7.

    Article  CAS  PubMed  Google Scholar 

  76. Semalty M, Semalty A, Joshi GP, Rawat MS. Hair growth and rejuvenation: an overview. J Dermatol Treat. 2011;22:123–32.

    Article  Google Scholar 

  77. Morganti P, Fabrizi G, James B, Bruno C. Effect of gelatin-cystine and serenoa repens extract on free radicals level and hair growth. J Appl Cosmetol. 1998;16:57–64.

    Google Scholar 

  78. Gehring W, Gloor M. Use of the phototrichogram to assess the stimulation of hair growth—an in vivo study of women with androgenetic alopecia. Z Hautkr. 2000;75:419–23.

    Google Scholar 

  79. Shao LX. Effects of the extract from bergamot and boxthorn on the delay of skin aging and hair growth in mice. Zhogguo Zhong Yao Za Zhi. 2003;28:766–9.

    Google Scholar 

  80. Bussoletti C, Mastropietro F, Tolaini MV, Celleno L. Use of a cosmetic caffeine lotion in the treatment of male androgenetic alopecia. J Appl Cosmetol. 2011;29:167–80.

    CAS  Google Scholar 

  81. Buonocore D, Nobile V, Michelotti A, Marzatico F. Clinical efficacy of a cosmetic treatment by Crescina(®) human follicle stem cell on healthy males with androgenetic alopecia. Dermatol Ther. 2013;3:53–62.

    Article  Google Scholar 

  82. Kessels AG, Cardynaals RL, Borger RL, et al. The effectiveness of the hair-restorer “Dabao” in males with alopecia androgenetica. A clinical experiment. J Clin Epidemiol. 1991;44:439–47.

    Article  CAS  PubMed  Google Scholar 

  83. Kobayashi N, Suzuki R, Koide C, Suzuki T, Matsuda H, Kubo M. Effect of leaves of Ginkgo biloba on hair regrowth in C3H strain mice. Yakugaku zasshi. 1993;113:718–24.

    CAS  PubMed  Google Scholar 

  84. Matsuda H, Yamazaki M, Asanuma Y, Kubo M. Promotion of hair growth by ginseng radix on cultured mouse vibrissal hair follicles. Phytother Res. 2003;17:797–800.

    Article  CAS  PubMed  Google Scholar 

  85. Kim SH, Jeong KS, Ryu SY, Kim TH. Panax ginseng prevents apoptosis in hair follicles and accelerates recovery of hair medullary cells in irradiated mice. In vivo (Athens, Greece). 1998;12:219–22.

    CAS  Google Scholar 

  86. Thorat RM, Jadhav VM, Kadam VJ. Development and evaluation of polyherbal formulation for hair growth-promoting activity. Int J Pharm Tech Res. 2009;1:1251–4.

    CAS  Google Scholar 

  87. Kamimura A, Takahashi T, Watanabe Y. Investigation of topical application of procyanidin B-2 from apple to identify its potential use as a hair growing agent. Phytomedicine. 2000;7:529–36.

    Article  CAS  PubMed  Google Scholar 

  88. Harada N, Okajima K, Narimatsu N, Kurihara H, Nakagata N. Effect of topical application of raspberry ketone on dermal production of insulin-like growth factor-I in mice and on hair growth and skin elasticity in humans. Growth Horm IGF Res. 2008;18:335–44.

    Article  CAS  PubMed  Google Scholar 

  89. Roh SS, Kim CD, Lee MH, Hwang SL, Rang MJ, Yoon YK. The hair growth promoting effect of Sophora flavescens extract and its molecular regulation. J Dermatol Sci. 2002;30:43–9.

    Article  PubMed  Google Scholar 

  90. Camacho FM, Camacho-Serrano F, Moreno Gimenez JC, et al. Treatment of alopecias of male and female patterns. Clinical efficacy of aminexil and SP94 in two surveys of 180 patients, men and women. Medicina Cutanea Ivero-Latino-Americana. 2013;41:18–33.

    Google Scholar 

  91. Freund BJ, Schwartz M. Treatment of male pattern baldness with botulinum toxin: a pilot study. Plast Reconstr Surg. 2010;126:246e–8e.

    Article  PubMed  Google Scholar 

  92. Siedel U. Cimicifuga for the prevention of hair loss. Phamazeutische Zeitung. 2003;148:44.

    Google Scholar 

  93. Dhanotia R, Chauhan NS, Saraf DK, Dixit VK. Effect of Citrullus colocynthis Schrad fruits on testosterone-induced alopecia. Nat Prod Res. 2011;25:1432–43.

    Article  CAS  PubMed  Google Scholar 

  94. Pumthong G, Asawanonda P, Varothai S, et al. Curcuma aeruginosa, a novel botanically derived 5alpha-reductase inhibitor in the treatment of male-pattern baldness: a multicenter, randomized, double-blind, placebo-controlled study. J Dermatol Treat. 2012;23:385–92.

    Article  Google Scholar 

  95. Pandit S, Chauhan NS, Dixit VK. Effect of Cuscuta reflexa Roxb on androgen-induced alopecia. J Cosmet Dermatol. 2008;7:199–204.

    Article  PubMed  Google Scholar 

  96. Kwon OS, Han JH, Yoo HG, et al. Human hair growth enhancement in vitro by green tea epigallocatechin-3-gallate (EGCG). Phytomedicine. 2007;14:551–5.

    Article  CAS  PubMed  Google Scholar 

  97. Esfandiari A, Kelly AP. The effects of tea polyphenolic compounds on hair loss among rodents. J Natl Med Assoc. 2005;97:1165–9.

    PubMed Central  PubMed  Google Scholar 

  98. Pierard-Franchimont C, De Doncker P, Cauwenbergh G, Pierard GE. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology (Basel, Switzerland). 1998;196:474–7.

    Article  CAS  Google Scholar 

  99. Rossi A, Mari E, Scarno M, et al. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. 2012;25:1167–73.

    CAS  PubMed  Google Scholar 

  100. Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med. 2002;8:143–52.

    Article  PubMed  Google Scholar 

  101. Floersheim GL. An examination of effect of biotin on alopecia and hair quality. Zeitschrift fur Hautkrankheiten. 1992;67:246–52.

    Google Scholar 

  102. Pyo HK, Yoo HG, Won CH, et al. The effect of tripeptide-copper complex on human hair growth in vitro. Arch Pharm Res. 2007;30:834–9.

    Article  CAS  PubMed  Google Scholar 

  103. Trachy RE, Fors TD, Pickart L, Uno H. The hair follicle-stimulating properties of peptide copper complexes. Results in C3H mice. Ann N Y Acad Sci. 1991;642:468–9.

    Article  CAS  PubMed  Google Scholar 

  104. Draelos ZD, Jacobson EL, Kim H, Kim M, Jacobson MK. A pilot study evaluating the efficacy of topically applied niacin derivatives for treatment of female pattern alopecia. J Cosmet Dermatol. 2005;4:258–61.

    Article  PubMed  Google Scholar 

  105. Li ZJ, Choi HI, Choi DK, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38:1040–6.

    Article  CAS  PubMed  Google Scholar 

  106. Bunagan MJ, Banka N, Shapiro J. Hair transplantation update: procedural techniques, innovations, and applications. Dermatol Clin. 2013;31:141–53.

    Article  PubMed  Google Scholar 

  107. Kalia S, Lui H. Utilizing electromagnetic radiation for hair growth: a critical review of phototrichogenesis. Dermatol Clin. 2013;31:193–200.

    CAS  PubMed  Google Scholar 

  108. Gupta AD, Daigle D. The use of low level light therapy in the treatment of androgenetic alopecia and female pattern hair loss. J Dermatol Treat. 2014;25(2):162–3.

  109. Leavitt M, Charles G, Heyman E, Michaels D. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: a randomized, double-blind, sham device-controlled, multicentre trial. Clin Drug Investig. 2009;29:283–92.

    Article  PubMed  Google Scholar 

  110. Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind Study. Am J Clin Dermatol. 2014;15(2):115–27.

  111. Avram MR, Leonard RT Jr, Epstein ES, Williams JL, Bauman AJ. The current role of laser/light sources in the treatment of male and female pattern hair loss. J Cosmet Laser Ther. 2007;9:27–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to prepare this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wilma F. Bergfeld.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Varothai, S., Bergfeld, W.F. Androgenetic Alopecia: An Evidence-Based Treatment Update. Am J Clin Dermatol 15, 217–230 (2014). https://doi.org/10.1007/s40257-014-0077-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-014-0077-5

Keywords

Navigation