Alopecia

Low-Level Laser and LED Therapy in Alopecia: A Systematic Review and Meta-Analysis.

Perez SM, Vattigunta M, Kelly C, Eber A · Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2025 · n=98

Low-level laser/LED therapy (LLLT) has been described as a treatment option for alopecia, but no study has comprehensively reviewed its efficacy in multiple alopecia types. To review and evaluate LLLT for various alopecia types. A systematic search of PubMed/MEDLINE, Embase, and CENTRAL was conducted to identify studies assessing the effect of LLLT on patients diagnosed with alopecia. Prespecified outcome measure was the change in hair density. Meta-analysis was performed to calculate the standardized mean difference in hair density before and after LLLT compared with placebo. Thirty-eight studies were included that described 3,098 patients with androgenetic alopecia (2,930/3,098), scarring alopecia (49/3,098), alopecia areata (50/3,098), telogen effluvium (17/3,098), and chemotherapy-induced alopecia (32/3,098). The mean change in hair density increased significantly in androgenetic alopecia patients after LLLT for 4 to 26 weeks compared with placebo (<20 weeks: SMD = 1.14; 95%

Systematic review and indirect treatment comparisons of ritlecitinib against baricitinib in alopecia areata.

Aceituno D, Fawsitt CG, Power GM, Law E, Vaghela S, Thom H · Journal of the European Academy of Dermatology and Venereology : JEADV · 2025

Ritlecitinib and baricitinib are recently approved systemic treatments for severe alopecia areata (AA). Both demonstrated superiority over placebo in hair regrowth measured by the Severity of Alopecia Tool (SALT), but they have not been directly compared in randomized controlled trials (RCTs). We conducted a systematic review of RCTs evaluating treatments in AA and estimated the efficacy and safety of ritlecitinib and baricitinib at Week 24 using Bayesian network meta-analysis. To adjust and explore effect modifiers, population-adjusted indirect comparison was performed via multilevel network meta-regression (ML-NMR) using ritlecitinib individual patient data (IPD). Co-primary endpoints were SALT ≤20 and SALT ≤10 at Week 24. Unanchored population adjusted ITCs were also computed to evaluate SALT ≤10 and SALT ≤20 endpoints at Week 48/52. Four RCTs (ALLEGRO 2a [NCT02974868], ALLEGRO 2b/3 [NCT03732807], BRAVE-AA1 [NCT03570749] and BRAVE-AA2 [NCT03899259]) were

Treatments for alopecia areata: a network meta-analysis.

Mateos-Haro M, Novoa-Candia M, Sánchez Vanegas G, Correa-Pérez A, Gaetano Gil A, Fernández-García S · The Cochrane database of systematic reviews · 2023 · n=25

Alopecia areata is an autoimmune disease leading to nonscarring hair loss on the scalp or body. There are different treatments including immunosuppressants, hair growth stimulants, and contact immunotherapy. To assess the benefits and harms of the treatments for alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) in children and adults. The Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, ClinicalTrials.gov and WHO ICTRP were searched up to July 2022. We included randomised controlled trials (RCTs) that evaluated classical immunosuppressants, biologics, small molecule inhibitors, contact immunotherapy, hair growth stimulants, and other therapies in paediatric and adult populations with AA. We used the standard procedures expected by Cochrane including assessment of risks of bias using RoB2 and the certainty of the evidence using GRADE. The primary outcomes were short-term hair regrowth ≥ 75% (between 12 and 26 weeks of follow-up), and inci

Micronutrients and Androgenetic Alopecia: A Systematic Review.

Wang R, Lin J, Liu Q, Wu W, Wu J, Liu X · Molecular nutrition & food research · 2024

Hair loss is a common problem that can negatively impact individuals' psychological well-being. Androgenetic alopecia (AGA) is one of the most prevalent types of nonscarring hair loss. This review summarizes the existing evidence on the relationship between AGA and various micronutrients, including vitamin B, vitamin D, vitamin A, vitamin C, iron, selenium, zinc, manganese, and copper. A literature search was conducted to identify relevant articles published between 1993 and 2023. The search identified 49 relevant articles. The findings suggest that deficiencies or imbalances in these micronutrients may contribute to the pathogenesis of AGA and represent modifiable risk factors for hair loss prevention and treatment. Vitamin B, vitamin D, iron, and zinc appear to play critical roles in hair growth and maintenance. Deficiencies in these micronutrients have been associated with increased risk of AGA, while supplementation with these nutrients has shown potential benefits in improving h

Mesotherapy as a Promising Alternative to Minoxidil for Androgenetic Alopecia: A Systematic Review.

Aledani EM, Kaur H, Kasapoglu M, Yadavalli R, Nawaz S, Althwanay A · Cureus · 2024

Patterned hair loss (PHL) is a severe hair condition that affects both sexes. Mesotherapy is a treatment that involves microinjecting medications and/or vitamins into the middle layer of the skin. Mesotherapy reduces systemic adverse effects by delivering drugs directly to the hair follicle, increasing local bioavailability while lowering systemic exposure. Local side effects and reactions may develop due to mesotherapy. This study systematically evaluated the safety and efficacy of mesotherapy to minoxidil 5%, as well as addressing its limitations, dosing, and technique, with the intent of providing valuable trials and insights for clinicians and patients considering mesotherapy for improved androgenetic alopecia (AGA) outcomes. The literature search carried out by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria yielded 11 relevant studies from an initial pool of 18 articles. These studies covered various aspects of the role of mesoth

Trichoscopy of Androgenetic Alopecia: A Systematic Review.

Kuczara A, Waśkiel-Burnat A, Rakowska A, Olszewska M, Rudnicka L · Journal of clinical medicine · 2024

Background: Androgenetic alopecia, the most common cause of non-scarring hair loss, is a consequence of the gradual miniaturization of the hair follicles. In the majority of male androgenetic alopecia cases, a patient's history and clinical evaluation may be sufficient to establish the diagnosis, while for women, they should be supplemented with trichoscopy. Methods: The PubMed and Scopus databases were used to collate published studies and to analyze the most typical trichoscopic findings in patients diagnosed with androgenetic alopecia. A total of 34 articles were retrieved after exclusion. Results: The most common features identified using trichoscopy included hair diameter variability (94.07% of patients), vellus hairs (66.45%) and the peripilar sign (43.27%). Others, such as the honeycomb pattern, yellow and white dots, were less relevant. Conclusions: We concluded that hair diameter variability, vellus hairs and the peripilar sign represented valuable indicators for the diagnosis

Consensus Document on the Clinical Management of Frontal Fibrosing Alopecia: Recommendations From Spanish Working Group on Trichology and Onychology of the AEDV.

Saceda-Corralo D, Combalia A, Fernandez-Crehuet P, Garnacho G, Pindado-Ortega C, Porriño-Bustamante ML · Actas dermo-sifiliograficas · 2026

Frontal fibrosing alopecia (FFA) is a scarring alopecia first described in 1994. Due to its increasing incidence rate in dermatology clinics, and the scarcity of approved specific treatments, the diagnosis and treatment of FFA can be an increasingly common challenge for dermatologists in their routine daily practice. This FFA management consensus was produced via a Delphi methodology involving 22 dermatologists from the Spanish working group on trichology and onychology of the AEDV. Because hair loss is irreversible, multimodal therapy with complementary mechanisms and routes should be used starting with oral dutasteride along with topical and/or intralesional agents; if inflammation persists, hydroxychloroquine should be added to the mix.

Japanese Dermatological Association's Clinical Practice Guidelines for Alopecia Areata 2024: A Complete English Translated Version.

Ohyama M, Ito T, Amoh Y, Inui S, Imanishi H, Ueki R · The Journal of dermatology · 2025

This is an English-translated version of the Japanese Dermatological Association's clinical practice guidelines for alopecia areata (AA) 2024. It includes the sections of summary, pathogenesis and epidemiology, evaluation and diagnosis, and treatment of AA. Updates based on recent evidence/advances were made in each part. The treatment part contains the statements of recommendation for 25 clinical questions (CQs) with respective recommendation/evidence levels. AA-cube, a graphic illustration conceptualizing the treatment strategy based on individual patients' factors, was newly proposed. Taking into account the recent approval of a JAK inhibitor and a JAK3/TEC family kinase selective inhibitor, a CQ for these modalities was also added. These guidelines aim to support evidence-based management of AA as well as prompt understanding of disease etiopathogenesis.

II Consensus of the Brazilian Society of Dermatology for the treatment of alopecia areata.

Müller Ramos P, Anzai A, Duque-Estrada B, Melo DF, Sternberg F, Santos LDN · Anais brasileiros de dermatologia · 2025

Alopecia areata is a highly frequent disease with great variability in clinical presentation, severity, and prognosis. It has a significant negative impact on quality of life, especially in the moderate and severe forms. To disseminate guidelines, prepared by a group of Brazilian experts, for the treatment and follow-up of patients with alopecia areata. Eight specialists from different university centers with experience in alopecia areata were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Using the adapted DELPHI methodology, relevant elements were considered and then an analysis of the recent literature was carried out and the text produced. Consensus on the guidelines was defined with the approval of at least 70% of the panel of experts. Treatments vary according to patient age and disease severity. Intralesional injectable corticosteroid therapy was considered the first option for localized disease in adults. In severe cases, Janus Kinas

Does creatine cause hair loss? A 12-week randomized controlled trial.

Lak M, Forbes SC, Ashtary-Larky D, Dadkhahfar S, Robati RM, Nezakati F · Journal of the International Society of Sports Nutrition · 2025

Creatine is a widely used ergogenic aid that enhances muscle strength and lean mass. However, concerns have been raised about the potential role in promoting hair loss by increasing dihydrotestosterone (DHT). Currently, there is no direct evidence examining the relationship between creatine supplementation and hair follicle health. Therefore, the purpose was to determine the effects of 12 weeks of creatine supplementation on androgen levels and hair follicle health in healthy young males. Forty-five resistance-trained males (ages 18-40 years) were recruited and randomly assigned to either a creatine monohydrate (5 g/day) or placebo (5 g maltodextrin/day) group. Participants maintained their habitual diets and training routines. Blood samples were collected at baseline and after 12 weeks to measure total testosterone, free testosterone, and DHT. Hair follicle health was assessed using the Trichogram test and the FotoFinder system (hair density, follicular un

Oral Supplementation with l-Cystine, Serenoa repens, Cucurbita pepo, and Pygeum africanum in Chronic Telogen Effluvium and Androgenetic Alopecia: A Double-Blind, Placebo-Controlled, Randomized Clinical Study.

Piquero-Casals J, Saceda-Corralo D, Aladren S, Bustos J, Fernández-Botello A, Navasa A · Skin appendage disorders · 2025 · n=80

Chronic telogen effluvium (TE) and androgenetic alopecia represent two prevalent forms of hair loss that can significantly impact individuals' quality of life. Insufficiency of essential micronutrients has been associated with hair loss. The objective of this study was to evaluate the safety and efficacy of an oral supplement containing l-Cystine, Serenoa repens, Cucurbita pepo, Pygeum africanum, vitamins, and micronutrients in chronic TE (CTE) and androgenetic alopecia (AGA). Eighty patients of both sexes aged 18-60 years with CTE or AGA were randomized to receive one capsule daily of the oral supplement or placebo for 6 months. Dermatological evaluations, clinical pictures and phototrichograms were done at baseline, 3 months and 6 months. The overall hair volume and appearance were assessed before and after treatment as well as subject's self-assessment via standardized questionnaire. Hair density increased by 9.9 hairs/cm2 after 3 months and 12.3 hairs/cm2 after 6 months in the or

Randomized controlled trial on the efficacy and safety of the combination therapy of topical 0.1% finasteride - 5% Minoxidil in male androgenetic alopecia.

Lubis FF, Legiawati L, Saulina M, Saldi SRF · Archives of dermatological research · 2025 · n=40

Current FDA-approved treatments for androgenetic alopecia (AGA) are oral finasteride and topical minoxidil. Topical finasteride offers a potential alternative with similar efficacy and fewer systemic side effects. This study evaluated the effectiveness and safety of combining topical finasteride and minoxidil for male AGA. This 12-week randomized controlled trial divided subjects into two groups which are topical finasteride 0.1%-minoxidil 5% (treatment) and topical minoxidil 5% (control) (NCT05990400, registered 2023-08-04). Hair density, hair diameter, terminal hair rate, and vellus hair rate (assessed using phototrichogram), and the occurrence of side effects (SE) was monitored at four-week intervals. Out of 40 subjects, 2 dropped out in the treatment group. Significant increases in hair density, diameter, and terminal hair rate; and decrease of vellus hair rate were observed at each visit compared to baseline, yet no differences between groups. Systemic SEs included libido reductio

Evidence-based consensus on the clinical application of photobiomodulation.

Maghfour J, Mineroff J, Ozog DM, Jagdeo J, Lim HW, Kohli I · Journal of the American Academy of Dermatology · 2025 · n=21

There is a lack of evidence-based consensus to assist clinicians in using photobiomodulation (PBM). To create a consensus on the safe and effective use of PBM. A systematic literature review of Embase and MEDLINE was conducted in June 2022 to identify publications reporting research on PBM. An international multidisciplinary panel was convened to draft recommendations informed by the systematic search; they were refined through 2 rounds of Delphi survey, 2 consensus meetings, and iterative review by all panelists until unanimous consensus was achieved. A multidisciplinary panel of experts (n = 21) was assembled based on publication history. The key findings that informed the consensus developed by the expert panel were as follows: PBM is a safe treatment modality for adult patients and red light PBM does not induce DNA damage. PBM is an effective treatment option for peripheral neuropathy, androgenic alopecia, wound ulcers due to multiple etiologies, decubitus ulcers, pain attribute

Herbal Remedies for Hair Loss: A Review of Efficacy and Safety.

Ahmed A, Alali AM, Abdullah E, Alharbi MN, Alayoubi HM · Skin appendage disorders · 2025

Hair loss (HL) is a prevalent condition worldwide; it can affect both males and females of different age groups. Despite the availability of many conventional treatment options, these might be linked to causing different side effects, leading to a growing interest in natural and herbal remedies (HRs). This review aims to investigate the efficacy and safety of various HRs for HL and examine the current scientific evidence behind them. A literature search used several studies to identify relevant studies published up to March 2024. The search terms included HL, alopecia, HRs, and names of specific herbs such as rosemary, saw palmetto, onion juice, Korean red ginseng, pumpkin seed oil, azelaic acid, olive oil, coconut oil, henna, honey, rice bran extract, Ashwagandha, and amla. Studies have suggested potential benefits in promoting hair growth and treating various forms of HL. These remedies were found to be effective in different conditions, including androgenetic alopecia, telogen effl

Efficacy and safety of antibody-drug conjugates in pretreated HER2-low metastatic breast cancer: A systematic review and network meta-analysis.

Schettini F, Nucera S, Pascual T, Martínez-Sáez O, Sánchez-Bayona R, Conte B · Cancer treatment reviews · 2025 · n=956

Antibody-drug conjugates (ADCs) trastuzumab-deruxtecan (T-DXd) and sacituzumab-govitecan (SG) provided significant progression-free survival (PFS) and overall survival (OS) improvements over chemotherapy (CT) in pretreated hormone receptor-positive (HR+) and triple-negative (TN)/HER2-low metastatic breast cancer (MBC). However, no direct comparison between the two exists, nor with the more recent datopotamab-deruxtecan (Dato-DXd). We conducted a network meta-analysis (NMA) to compare efficacy and safety of T-DXd and SG in CT-pretreated HR+ and TN/HER2-low MBC and assess their benefit over standard CT, exploring also a comparison with Dato-DXd. Hazard ratios (HRs) with 95 % confidence intervals (CI) were calculated for PFS/OS. P-score was used for treatment ranking. Three RCTs (956 patients) were included in the primary analysis and 5 (1,445) in the exploratory NMA with Dato-DXd. In HR+/HER2-low, T-DXd showed no significant difference in PFS and OS when compared to SG. Simil

Hair loss

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The NHS provides information on common types of hair loss, their causes, and when to seek medical advice. It also outlines potential treatments and self-care tips.

Polymorphism of Janus Kinase 1 and 2 (JAK 1&2) in Patients With Alopecia Areata

n=100 · NCT05861401 · UNKNOWN · UNKNOWN

Introduction Alopecia areata (AA) is a complex inflammatory disease characterized by cellular infiltration of T- lymphocytes targeting hair follicles, disrupting the anagen phase, with spontaneous remission, recurrence, and exacerbation, making it very unpredictable and emotionally disturbing . It affects nearly 1-2% of the general population with a lifetime risk of 2%, The onset of AA might be at any age; however, most patients develop the disease before 40 years of age . Early-onset AA (a mean age of onset at 5-10 years) predominantly presents as a more severe subtype, such as alopecia universalis . Alopecia areata presents clinically as a non-scarring patchy hair loss primarily on the scalp, and/or other hairy areas and may progress to total scalp hair loss (alopecia totalis, AT ) or complete body hair loss (alopecia universalis, AU ) . Approximately 5- 10% of AA patients will progress into AT/AU . The course of AA varies greatly, the strongest predictors of a poor prognosis include AT, AU, or ophiasis pattern hair loss, as well as earlier age of onset . Severe and recurrent AA disturbs quality of life of patients and may also lead to depression, changed self-image,and interferes with social activities . Currently, the hypotheses for AA development mostly focus on the collapse of immune privilege properties of the hair follicles(HFs) and the nature of self-antigen presentation (follicular antigens) that result in the induction and subsequent attack of activated lymphocytes . Activation of the lymphocytes mainly CD8+NKG2D+induces release of severalTh1 cytokines; interleukin (IL)-1α , IL-1β , and tumor necrosis factor (TNF) alpha, capable of inhibiting (HF) growth with early termination of anagen . AA is a polygenic disorder in which several major genes dictate susceptibility to disease, up to 28% of patients report at least one affected family member, monozygotic twins have exhibited similar times of onset and patterns of hair loss. Genes loci for Human leucocyte antigens (HLA)DRB1\* 1104 and DQB1\* 03 are detected in patients with AA. The Janus kinases (JAKs) and signal transducer and activator of transcription (STAT); (JAK/STAT) pathway play an important role in inflammatory processes as they are involved in signaling for over 50 cytokines and growth factors. The JAK/STAT pathway transduces multiple extracellular signals involved in cell proliferation, differentiation, migration, and apoptosis . The JAK family is constituted by four types of cytoplasmic tyrosine kinases: JAK1, JAK2, JAK3, and TYK2 . STAT, of which there are seven different subtypes (STAT1, STAT2, STAT3, STAT4, STAT5a, STAT5b, and STAT6) (17), is the other fundamental component of the cascade . After being phosphorylated by JAK, STAT translocates to the nucleus to induce the transcription of specific genes. Alterations in the JAK/STAT pathway have been related to the pathophysiology of atopic dermatitis (AD), vitiligo, and AA.

A Within-subject, Randomized, Evaluator-blinded, Vehicle-controlled Study to Assess the Photosensitization Potential of Finasteride Cutaneous Solution(P-3074) in Human Subjects

n=58 · NCT02791243 · COMPLETED · COMPLETED

This study evaluates the potential for induction of photosensitization by P-3074 0.25% finasteride cutaneous solution compared to that of placebo vehicle cutaneous solution and a negative control (0.9% sodium chloride, NaCl)

Fractional Photothermolysis for the Induction of Hair Follicles Via Skin Rejuvenation

n=5 · NCT03382184 · TERMINATED · TERMINATED

This study is being done to evaluate the effects of fractional photothermolysis (known as laser resurfacing) using fractional laser for the induction of hair follicles via skin rejuvenation in subjects with scalp alopecia (specifically, alopecia on the superior forehead at the frontal hairline). Fractional photothermolysis has been shown to be effective in promoting hair growth. The investigators will study 50 subjects who will be treated 6-10 times at 2-4 week intervals. Each participant will have half of their head treated with a laser, either Fraxel DUAL 1550 or Halo by Sciton, and the other half of their head will be left untreated as a control. Half of the individuals will randomly be assigned to the group to be treated with Fraxel DUAL 1550, and the other half will be treated with Halo by Sciton. Visual observation and digital, photographic, non-invasive imaging will be used to compare the treated and untreated area to assess for differences in hair follicle stimulation rates, number and density of hairs. As noted above, the types of lasers we plan to use include the non-ablative fractional laser settings for the Fraxel DUAL 1550 and Halo by Sciton. A fractional laser is a laser that directs an intense burst of laser energy on the skin. The treatment deposits heat deep into the dermis to tighten skin and stimulate collagen remodeling. The necrotic (death of cells or tissue) injury heals rapidly and adverse effects are few. Laser resurfacing is commonly used for rejuvenation of the skin to improve quality, tone, and texture.

Cochrane Library: Alopecia

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses of healthcare interventions, offering high-quality evidence regarding treatments for alopecia. It is a key resource for evidence-based healthcare decisions.

Search: Alopecia

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence. A search for 'Alopecia' provides access to a wide range of evidence-based resources, including guidelines and systematic reviews.

Cochrane Reviews on Alopecia

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses of healthcare interventions, including those for alopecia. It offers high-quality, independent evidence to inform healthcare decision-making.