ANDROGENETIC alopecia (AGA) is a common condition typically managed with topical minoxidil. However, alternative treatments such as low-dose oral minoxidil and platelet-rich plasma (PRP) therapy have gained interest. This study aimed to compare the efficacy and safety of these approaches, evaluating their impact on hair density and overall improvement in AGA severity.
Seventy-five participants were randomly divided into three treatment groups: low-dose oral minoxidil (G1), topical minoxidil (G2), and a combination of PRP with topical minoxidil (G3). Over the 32-week study period, 60 patients completed all assessments, which included clinical and videodermoscopic evaluations at predefined intervals.
At the end of the study, 25% of participants in G1 and G3 showed a one-grade improvement in AGA severity, compared to 10% in G2. The median percentage increase in terminal hair density was highest in G3 (57%), followed by G2 (48%) and G1 (47.5%). Statistical analysis demonstrated that G3 showed significantly greater improvements compared to both G1 (p = 0.03) and G2 (p = 0.02). Additionally, G1 resulted in the highest median percentage decrease in vellus hair density (26%), compared to 21% in G2 and 19% in G3, with a statistically significant advantage over G3 (p = 0.03). Despite these variations, all three groups experienced a significant reduction in hair diameter diversity by the end of the trial, with no major differences between them.
Side effects were generally mild and well-tolerated. Participants in G1 reported headaches (20%), dizziness (15%), and pedal oedema (5%). In G2, 75% experienced scalp itching and dryness. PRP treatment caused transient pain in all patients, with 15% experiencing minimal bleeding and 5% reporting dizziness.
These findings highlight the effectiveness of low-dose oral minoxidil as an alternative to topical minoxidil. Furthermore, the combination of PRP with topical minoxidil appears to enhance hair density outcomes. While side effects varied, most were manageable, supporting the potential of these treatments in AGA management.
Katie Wright, EMJ
Reference
Janaani P et al. Analysing efficacy of low-dose oral minoxidil, topical minoxidil, and platelet-rich plasma with topical minoxidil combination in patients with androgenetic alopecia: a randomized controlled observer blinded trial. Arch Dermatol Res. 2025;317(1):421.
