Androgenetic Alopecia

  • Maria ColavincenzoEmail author
  • Stefan G. Vanderweil


Androgenetic alopecia (AGA) is a common, non-scarring form of hair loss characterized by progressive miniaturization of terminal hair follicles on the scalp. First-line therapy for AGA consists of medical therapy with topical minoxidil and oral anti-androgens. Two emerging procedural therapies, platelet-rich plasma (PRP) injections and low-level light therapy (LLLT), represent novel therapeutics for the management of AGA. The details of these procedural treatment modalities are discussed within this chapter.


Androgenetic alopecia Platelet-rich plasma Low level light therapy 


  1. 1.
    Otberg N, Finner AM, Shapiro J. Androgenetic alopecia. Endocrinol Metab Clin N Am. 2007;36(2):379–98.Google Scholar
  2. 2.
    Ramos PM, Miot HA. Female pattern hair loss: a clinical and pathophysiological review. An Bras Dermatol. 2015;90(4):529–43.Google Scholar
  3. 3.
    Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: a systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(1):136–14.Google Scholar
  4. 4.
    Ferneini EM, Beauvais D, Castiglione C, Ferneini MV. Platelet-rich plasma in androgenic alopecia: indications, technique, and potential benefits. J Oral Maxillofac Surg. 2017;75(4):788–95.Google Scholar
  5. 5.
    Xiao SE, Miao Y, Wang J, Jiang W, Fan ZX, Liu XM, Hu ZQ. As a carrier-transporter for hair follicle reconstitution, platelet-rich plasma promotes proliferation and induction of mouse dermal papilla cells. Sci Rep. 2017;7(1):1125.Google Scholar
  6. 6.
    Li ZJ, Choi HI, Choi DK, Sohn KC, Im M, Seo YJ, Lee YH, Lee JH, Lee Y. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38(7 Pt 1):1040–6.Google Scholar
  7. 7.
    Gupta AK, Carviel J. A mechanistic model of platelet-rich plasma treatment for androgenetic alopecia. Dermatol Surg. 2016;42(12):1335–9.Google Scholar
  8. 8.
    Giordano S, Romeo M, Lankinen P. Platelet-rich plasma for androgenetic alopecia: does it work? Evidence from meta analysis. J Cosmet Dermatol. 2017;16(3):374–81.Google Scholar
  9. 9.
    Alves R, Grimalt R. Randomized placebo-controlled, double-blind, half-head study to assess the efficacy of platelet-rich plasma on the treatment of androgenetic alopecia. Dermatol Surg. 2016;42(4):491–7.Google Scholar
  10. 10.
    Puig CJ, Reese R, Peters M. Double-blind, placebo-controlled pilot study on the use of platelet-rich plasma in women with female androgenetic alopecia. Dermatol Surg. 2016;42(11):1243–7.Google Scholar
  11. 11.
    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.Google Scholar
  12. 12.
    Garg S, Manchanda S. Platelet-rich plasma-an ‘Elixir’ for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investig. 2017;4:64.Google Scholar
  13. 13.
    Gentile P, Cole JP, Cole MA, Garcovich S, Bielli A, Scioli MG, Orlandi A, Insalaco C, Cervelli V. Evaluation of not-activated and activated PRP in hair loss treatment: role of growth factor and cytokine concentrations obtained by different collection systems. Int J Mol Sci. 2017;18(2):408.Google Scholar
  14. 14.
    Gentile P, Garcovich S, Bielli A, Scioli MG, Orlandi A, Cervelli V. The effect of platelet-rich plasma in hair regrowth: a randomized placebo-controlled trial. Stem Cells Transl Med. 2015;4(11):1317–23.Google Scholar
  15. 15.
    Shah KB, Shah AN, Solanki RB, Raval RC. A comparative study of microneedling with platelet-rich plasma plus topical minoxidil (5%) and topical minoxidil (5%) alone in androgenetic alopecia. Int J Trichology. 2017;9(1):14–8.Google Scholar
  16. 16.
  17. 17.
    Mester E, Szende B, Gartner P. Die Wirkung der Laserstrahlen auf den Haarwwuchs der Maus [in German]. Radiobiol Radiother (Berl). 1967;9:621–6.Google Scholar
  18. 18.
    Mester E, Szende B, Tota JG. Effect of laser on hair growth in mice. Kiserl Orvostud. 1967;19:628–31. 24.Google Scholar
  19. 19.
    Lolis MS, Marmur ES. Paradoxical effects of hair removal systems: a review. J Cosmet Dermatol. 2006;5:274–6.Google Scholar
  20. 20.
    Willey A, Torrontegui J, Azpiazu J, Landa N. Hair stimulation following laser and intense pulsed light photo-epilation: review of 543 cases and ways to manage it. Lasers Surg Med. 2007;39:297–301.Google Scholar
  21. 21.
    Zarei M, Wikramanayake TC, Falto-Aizpurua L, Schachner LA, Jimenez JJ. Low level laser therapy and hair regrowth: an evidence-based review. Lasers Med Sci. 2016;31:363–71.Google Scholar
  22. 22.
    Avci P, Gupta GK, Clark J, et al. Low-level laser (light) therapy (LLLT) for treatment of hair loss. Lasers Surg Med. 2014;46(2):144–51.Google Scholar
  23. 23.
    Metelitsa AI, Green JB. Home-use laser and light devices for the skin: an update. Semin Cutan Med Surg. 2011;30(3):144–7.Google Scholar
  24. 24.
    Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. 2012;40(2):516–33.Google Scholar
  25. 25.
    Lohr NL, Keszler A, Pratt P, Bienengraber M, Warltier DC, Hogg N. Enhancement of nitric oxide release from nitrosyl hemoglobin and nitrosyl myoglobin by red/near infrared radiation: potential role in cardioprotection. J Mol Cell Cardiol. 2009;47(2):256–63.Google Scholar
  26. 26.
    Gupta AK, Foley KA. A critical assessment of the evidence for low-level laser therapy in the treatment of hair loss. Dermatol Surg. 2017;43(2):188–97.Google Scholar
  27. 27.
    Sheen YS, Fan SMY, Chan CC, Wu YF, et al. Visible red light enhances physiological anagen entry in vivo and has direct and indirect stimulative effects in vitro. Lasers Surg Med. 2015;47:50–9.Google Scholar
  28. 28.
    Afifi L, Maranda EL, Zarei M, Delcanto GM, Falto-Aizpurua L, Kluijfhout WP, Jimenez JJ. Low-level laser therapy as a treatment for androgenetic alopecia. Lasers Surg Med. 2017;49(1):27–39.Google Scholar
  29. 29.
    Wikramanayake TC, Rodriguez R, Choudhary S, Mauro LM, Nouri K, Schachner LA, Jimenez JJ. Effects of the Lexington LaserComb on hair regrowth in the C3H/HeJ mouse model of alopecia areata. Lasers Med Sci. 2012;27(2):431–6.Google Scholar
  30. 30.
    Friedman S, Schnoor P. Novel approach to treating androgenetic alopecia in females with photobiomodulation (low-level laser therapy). Dermatol Surg. 2017;43(6):856–67.Google Scholar
  31. 31.
    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.Google Scholar
  32. 32.
    Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, et al. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med. 2013;45:487–95.Google Scholar
  33. 33.
    Lanzafame R, Blanche R, Chiacchierini R, et al. The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med. 2014;46:601–7.Google Scholar
  34. 34.
    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;15:115–27.Google Scholar
  35. 35.
    Kim H, Choi JW, Kim JY, et al. Low level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind. Sham device-controlled multicenter trial. Dermatol Surg. 2013;39(8):1177–83.Google Scholar
  36. 36.
    Munck A, Gavazzoni MF, Trüeb RM. Use of low-level laser therapy as monotherapy or concomitant therapy for male and female androgenetic alopecia. Int J Trichology. 2014;6(2):45–9.Google Scholar
  37. 37.
    Esmat SM, Hegazy RA, Gawdat HI, Abdel Hay RM, Allam RS, El Naggar R, Moneib H. Low level light-minoxidil 5% combination versus either therapeutic modality alone in management of female patterned hair loss: a randomized controlled study. Lasers Surg Med. 2017;49:835–43.Google Scholar
  38. 38.
    Satino JL, Markou M. Hair regrowth and increased hair tensile strength using the HairMax LaserComb for low-level laser therapy. Int J Cosmet Surg Aesthet Dermatol. 2003;5:113–7.Google Scholar
  39. 39.
    Frigo L, Luppi JS, Favero GM, Maria DA, Penna SC, Bjordal JM, Bensadoun RJ, Lopes-Martins RA. The effect of low-level laser irradiation (In-Ga–Al–AsP – 660 nm) on melanoma in vitro, in vivo. BMC Cancer. 2009;9:404.Google Scholar
  40. 40.
    Blum K, Han D, Madigan M, Lohmann R, Braverman E. “Cold” X5 Hairlaser used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study. BMC Res Notes. 2014;7:103.Google Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DermatologyNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Clinical InstructorNorthwestern Memorial HospitalChicagoUSA

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