For adults with alopecia, combining fractional laser with another therapy is more effective than any other therapy alone, according to findings from a systematic review and meta-analysis published in the Journal of Cosmetic Dermatology.
Investigators conducted a literature search of randomized controlled trials (RCTs) involving patients with androgenic alopecia or alopecia areata undergoing fractional laser as either mono or adjunctive therapy, and a comparison group of either control or a different therapy. The outcome of the integrated data was the total efficiency of hair regrowth, defined as the percentage of a clinically significant response (>10% improvement) in patients after treatment and evaluated by risk ratios (RR). The second outcome was hair density.
There were 13 studies included in the meta-analysis. For 3 studies comparing the efficacy of fractional laser with different therapy, the fixed-effects-model meta-analysis showed a statistically significant difference between fractional laser and other therapy in total efficiency (RR, 1.58; 95% CI, 1.16-2.14; P =.003). There was no statistical difference in total efficiency between fractional laser therapy combined with other therapy and fractional laser therapy alone in data from 3 studies (RR, 1.24; 95% CI, 0.87-1.77; P =.24). Among 8 studies comparing fractional laser plus other therapy and other therapy alone, the meta-analysis showed a significant difference with better outcomes for the inclusion of laser therapy (RR, 1.23; 95% CI, 1.02-1.49; P =.03). All 4 studies reporting hair density showed highly significant improvement in hair density for patients with combination laser therapy compared with monotherapy. All side effects mentioned in the included studies were tolerable, with the most common being mild pain, erythema, edema, and itching.
The study was limited by the moderate risk for bias in the included trials and the absence of double-blind study designs.
“The adjustment of laser types and energy density still relies on the clinician’s empirical choice, which may lead to potential risks,” the study authors wrote, recommending “more high-quality studies with larger samples” to “further validate this treatment.”
Gao YL, Zhang Y, Zheng JC, Li YL. The efficacy and safety of fractional lasers for alopecia in mono and adjunctive therapy: a systematic review and meta-analysis. J Cosmet Dermatol. Published online August 10, 2022. doi:10.1111/jocd.15293