Which Androgenetic Alopecia Treatments Are Most Effective?

Platelet-rich plasma and low-level laser therapy (LLLT) may be more effective treatments for androgenetic alopecia than older therapy modalities, according to results from a meta-analysis presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.

Investigators conducted a network meta-analysis of studies appraising treatment methods for androgenetic alopecia. Only randomized-controlled trials were included. Meta-analyses were conducted separately for men and women. The primary outcome measure was mean change in hair count, expressed in hairs per square centimeter (hairs/cm²). The surface area under the cumulation curve (SUCRA) was used to measure treatment efficacy across studies, with higher SUCRA values denoting greater efficacy. Evidence quality and risk for bias were calculated for each study.

The network meta-analysis for men included 30 trials; the analysis for women included 9 trials. Eight treatment types were assessed for men: 5% minoxidil, 2% minoxidil, platelet-rich plasma, LLLT, 0.5mg dutasteride, 1mg finasteride, bimatoprost, and placebo/ sham. For women, 4 treatments were compared: LLLT, 5% minoxidil, 2% minoxidil and placebo/sham. In networks for men and women, the greatest SUCRA values were observed for platelet-rich plasma and LLLT, respectively. However, the 2 studies which assessed platelet-rich plasma and LLLT had high risk for bias. Studies describing other treatment modalities had lower risk for bias. As such, results should be interpreted with care. Although these recent treatment modalities demonstrated high efficacy, confirmation in large-scale clinical trials is necessary.

Reference

Gupta A, Bamimore M, Foley K. Efficacy of non-surgical treatments for androgenetic alopecia in men and women: a systematic review with network meta-analyses, and an assessment of evidence quality. Presented at: AAD VMX 2020; June 12-14, 2020. Abstract/Poster 16022.