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.

Using Direct Non-thermal Atmospheric Pressure Plasma With Penetration Enhancement for the Treatment of Hair Loss

n=19 · NCT06149221 · COMPLETED · COMPLETED

In-office applied non-thermal atmospheric pressure plasma treatment on NS pretreated scalp

AN INTERVENTIONAL PK, PD, PHASE 1, OPEN-LABEL STUDY TO INVESTIGATE PK AND PD OF MULTIPLE-DOSE RITLECITINIB IN CHILDREN 6 TO LESS THAN 12 YEARS OF AGE WITH SEVERE ALOPECIA AREATA

n=15 · NCT05650333 · COMPLETED · COMPLETED

The purpose of the study is to evaluate the pharmacokinetics (how the medicine is changed and eliminated from your body after you take it) and pharmacodynamics (effects of the medicine in the body) of the study medicine (called Ritlecitinib) in children of 6 to \<12 years of age with Alopecia Areata, a condition of scalp hair loss. 12 children with alopecia areata will be participating in this study. All participants will receive study medicine with a dose of 20 milligram (mg) orally once daily for 7 days. 5 blood samples will be collected on day 7 for pharmacokinetic evaluation and 2 blood samples each at screening and on Day 7 will be collected for pharmacodynamic evaluation. Participants will take part in the study for about 10 weeks.

A Single-Group Clinical Trial Investigating the Effects of a Hair Vitamin Combination on Hair Growth and Hair Health

n=25 · NCT06120933 · COMPLETED · COMPLETED

This clinical trial aims to investigate the effectiveness of two Vitamins Revive hair supplements in promoting hair growth, reducing hair loss, and improving overall hair health. The products under assessment are Hair Nutra Growth and Hair Nutra Boost. The trial will assess the efficacy of the products to induce better hair growth, reduction in hair loss and shedding, increased hair thickness and fullness, and improvement in hair appearance and vitality over a 12-week testing period. Participants will complete study-specific questionnaires at Baseline, Week 4, Week 8, and Week 12. Participants will also provide photos of their hair at Baseline, Week 4, Week 8, and Week 12.

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.