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J Eur Acad Dermatol Venereol. 2018 Dec;32(12):2112-2125. doi: 10.1111/jdv.15081. Epub 2018 Jul 11.

Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis.

Author information

1
Mediprobe Research Inc., London, Canada.
2
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada.
3
Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Canada.
4
Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom.
5
Division of Dermatology, Women's College Hospital, Toronto, Canada.

Abstract

Androgenetic alopecia, or male/female pattern baldness, is the most common type of progressive hair loss disorder. The aim of this study was to review recent advances in non-surgical treatments for androgenetic alopecia and identify the most effective treatments. A network meta-analysis (NMA) was conducted of the available literature of the six most common non-surgical treatment options for treating androgenetic alopecia in both men and women; dutasteride 0.5 mg, finasteride 1 mg, low-level laser therapy (LLLT), minoxidil 2%, minoxidil 5% and platelet-rich plasma (PRP). Seventy-eight studies met the inclusion criteria, and 22 studies had the data necessary for a network meta-analysis. Relative effects show LLLT as the superior treatment. Relative effects show PRP, finasteride 1 mg (male), finasteride 1 mg (female), minoxidil 5%, minoxidil 2% and dutasteride (male) are approximately equivalent in mean change hair count following treatment. Minoxidil 5% and minoxidil 2% reported the most drug-related adverse events (n = 45 and n = 23, respectively). The quality of evidence of minoxidil 2% vs. minoxidil 5% was high; minoxidil 5% vs. placebo was moderate; dutasteride (male) vs. placebo, finasteride (female) vs. placebo, minoxidil 2% vs. placebo and minoxidil 5% vs. LLLT was low; and finasteride (male) vs. placebo, LLLT vs. sham, PRP vs. placebo and finasteride vs. minoxidil 2% was very low. Results of this NMA indicate the emergence of novel, non-hormonal therapies as effective treatments for hair loss; however, the quality of evidence is generally low. High-quality randomized controlled trials and head-to-head trials are required to support these findings and aid in the development of more standardized protocols, particularly for PRP. Regardless, this analysis may aid physicians in clinical decision-making and highlight the variety of non-surgical hair restoration options for patients.

PMID:
29797431
DOI:
10.1111/jdv.15081
[Indexed for MEDLINE]

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