Article

Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial

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  • NSW Sydney Australia
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Abstract

Rosmarinus officinalis L. is a medicinal plant with diverse activities including enhancement microcapillary perfusion. The present study aimed to investigate the clinical efficacy of rosemary oil in the treatment of androgenetic alopecia (AGA) and compare its effects with minoxidil 2%. Patients with AGA were randomly assigned to rosemary oil (n = 50) or minoxidil 2% (n = 50) for a period of 6 months. After a baseline visit, patients returned to the clinic for efficacy and safety evaluations every 3 months. A standardized professional microphotographic assessment of each volunteer was taken at the initial interview and after 3 and 6 months of the trial. No significant change was observed in the mean hair count at the 3-month endpoint, neither in the rosemary nor in the minoxidil group (P > .05). In contrast, both groups experienced a significant increase in hair count at the 6-month endpoint compared with the baseline and 3-month endpoint (P < .05). No significant difference was found between the study groups regarding hair count either at month 3 or month 6 (> .05). The frequencies of dry hair, greasy hair, and dandruff were not found to be significantly different from baseline at either month 3 or month 6 trial in the groups (P > .05). The frequency of scalp itching at the 3- and 6-month trial points was significantly higher compared with baseline in both groups (P < .05). Scalp itching, however, was more frequent in the minoxidil group at both assessed endpoints (P < .05). The findings of the present trial provided evidence with respect to the efficacy of rosemary oil in the treatment of AGA.

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... The main active compounds responsible for these functions in RO are carnosic acid (CaA), carnosol, and rosmarinic acid [95]. Although CaA has the most potent antioxidant and antimicrobial activity among these active compounds [94][95][96], its deployment in water-based food systems is limited by its low solubility [97]. RO is used in cosmetic products and displays different properties, including enhancement of microcapillary perfusion [97]. ...
... Although CaA has the most potent antioxidant and antimicrobial activity among these active compounds [94][95][96], its deployment in water-based food systems is limited by its low solubility [97]. RO is used in cosmetic products and displays different properties, including enhancement of microcapillary perfusion [97]. Indeed, in the study by Panahi et al. (2015), patients with AGA were randomly assigned to rosemary oil or MXD 2% for 6 months, and the results obtained evidenced no significant change in the mean hair count at the 3 month endpoint, neither in the RO nor in the MXD group. ...
... RO is used in cosmetic products and displays different properties, including enhancement of microcapillary perfusion [97]. Indeed, in the study by Panahi et al. (2015), patients with AGA were randomly assigned to rosemary oil or MXD 2% for 6 months, and the results obtained evidenced no significant change in the mean hair count at the 3 month endpoint, neither in the RO nor in the MXD group. Conversely, the authors reported that both groups reported a significant increase in hair count at the 6 month endpoint [97]. ...
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Abstract: Hair loss is a disorder in which the hair falls out from skin areas such as the scalp and the body. Several studies suggest the use of herbal medicine to treat related disorders, including alopecia. Dermal microcirculation is essential for hair maintenance, and an insu�cient blood supply can lead to hair follicles (HF) diseases. This work aims to provide an insight into the ethnohistorical records of some nutritional compounds containing flavonoids for their potential beneficial features in repairing or recovering from hair follicle disruption. We started from a query for “alopecia” OR “hair loss” AND “Panax ginseng C.A. Mey.“ (or other six botanicals) terms included in Pubmed and Web of Sciences articles. The activities of seven common botanicals introduced with diet (Panax ginseng C.A. Mey., Malus pumila Mill cultivar Annurca, Co�ea arabica, Allium sativum L., Camellia sinensis (L.) Kuntze, Rosmarinum o�cinalis L., Capsicum annum L.) are discussed, which are believed to reduce the rate of hair loss or stimulate new hair growth. In this review, we pay our attention on the molecular mechanisms underlying the bioactivity of the aforementioned nutritional compounds in vivo, ex vivo and in vitro studies. There is a need for systematic evaluation of the most commonly used plants to confirm their anti-hair loss power, identify possible mechanisms of action, and recommend their best adoption.
... In a randomized, single-blind clinical trial, 100 male AGA patients aged between 18 and 49 years were treated with either rosemary oil lotion (n = 50) or 2% minoxidil (n = 50; Table 1). 20 The patients applied 1 ml of rosemary oil lotion (3.7 mg/ml 1,8-cineole) or 2% minoxidil twice a day to the frontoparietal and vertex areas of the scalp for 6 months. 20 Patients did not experience any significant increase in hair count after 3 months in either group; however, after 6 months, both rosemary oil group (baseline: 122.8 ± 48.9, month 6: 129.6 ± 51.2) and minoxidil groups (baseline: 138.4 ± 38.03, month 6: 140.7 ± 38.5) observed a significant increase in hair counts (p < 0.05). ...
... 20 The patients applied 1 ml of rosemary oil lotion (3.7 mg/ml 1,8-cineole) or 2% minoxidil twice a day to the frontoparietal and vertex areas of the scalp for 6 months. 20 Patients did not experience any significant increase in hair count after 3 months in either group; however, after 6 months, both rosemary oil group (baseline: 122.8 ± 48.9, month 6: 129.6 ± 51.2) and minoxidil groups (baseline: 138.4 ± 38.03, month 6: 140.7 ± 38.5) observed a significant increase in hair counts (p < 0.05). 20 The treatment, either with minoxidil or rosemary oil, did not cause increased dry hair, greasy hair, or dandruff compared to baseline. ...
... 20 Patients did not experience any significant increase in hair count after 3 months in either group; however, after 6 months, both rosemary oil group (baseline: 122.8 ± 48.9, month 6: 129.6 ± 51.2) and minoxidil groups (baseline: 138.4 ± 38.03, month 6: 140.7 ± 38.5) observed a significant increase in hair counts (p < 0.05). 20 The treatment, either with minoxidil or rosemary oil, did not cause increased dry hair, greasy hair, or dandruff compared to baseline. 20 However, both groups reported scalp pruritus-the reporting frequency was comparatively higher in the minoxidil group. ...
Article
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Androgenetic alopecia (AGA) is the most common cause of hair loss in men, often requiring medical attention. The US FDA approved topical minoxidil and oral finasteride to treat AGA. Topical minoxidil requires a long-term application to observe improvement; oral finasteride may cause undesirable side effects. Therefore, natural products may be an alternative when patients are skeptical about these two conventional treatments. Physicians may also suggest natural products in conjunction with topical minoxidil or oral finasteride to enhance clinical outcomes. This article reviews the prospect of natural products in treating male AGA. A systematic search was conducted in PubMed, CINAHL, Scopus, Web of Science, and EMBASE (Ovid) on July 19, 2021. In addition, the bibliographies of selected articles were hand-searched to identify relevant studies. After deduplication and screening, 11 clinical studies meet the criteria for detailed review. The selected clinical studies suggest that saw palmetto, caffeine, melatonin, marine extracts, rosemary oil, procyanidin, pumpkin seed oil, and cannabidiol (CBD) oil might be considered in male AGA treatment.
... officinalis is a well-known Mediterranean aromatic plant. The essential oil of R. officinalis improves microcirculation surrounding the hair follicle (9). Bioactive compounds of R. officinalis are phenolic acids, mainly caffeic and rosmarinic acid, and monoterpenoids like 1,8-cineole (10). ...
... Significant increase in hair count was reported for both treatments without significant difference between the study groups. Scalp irritation was more frequent in minoxidil 2 % solution group (9). ...
Article
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Treatment of skin conditions with medicinal plants has been an ongoing human activity lasting over thousands of years. The use of specific plant species developed regionally, based on local flora. Commonly used medicinal plants for dermatological complaints are: Phlebodium aureum (L.) J. Sm., Ginkgo biloba L., Rosmarinus officinalis L., Panax ginseng C.A.Mey., Allium cepa L., Aloe vera (L.) Burm.f., Capsicum annuum L., Berbe ris aquifolium Pursh, Camellia sinensis (L.) Kuntze, and Podophyllum peltatum L. The demand for complementary therapeutics is an emerging trend due to the awareness of potential side effects that synthetic drugs might cause. More scientific evidence and better documentation are needed before advising dermatologic patients on herbal medicinal treatment. Standardised extracts and formulations with proven clinical efficacy should be developed for this cause. Here provided review entails the use of herbal medicinal products in the treatment of frequent chronic skin diseases, such as vitiligo, alopecia, psoriasis and genital warts.
... Also, it favors the blood circulation in the hair follicle because of its vasodilation properties. 64 The Cinnamomum zeylanicum L. EO acts as an important antioxidant due to the phenolic and polyphenolic substances. GC-MS analysis identified cinnamaldehyde (96.8%), α-copaene (0.2%), α-muurolene (0.11%), p-methoxycinnamaldehyde (0.6%) and δcadinene (0.4%). ...
... Rosemary EO is also known for its vasodilating properties, which promote increased blood circulation in the hair follicle. 64 Although the species has not been clearly specified in this document, Mediterranean cedars have been reported as lebanon cedar (Cedrus libani) and have the greatest genetic diversity within the population of all cedars. 76 Thus, this EO is used in perfumery and personal hygiene due to its pleasant and persistent fragrance. ...
Article
Background Essential oils have great interest among the increasing demand for herbal cosmetics in the market. They are natural sources of biologically active ingredients due to the wide application of such compounds as well as their particular chemical composition. Several researches have evaluated the effectiveness of these bioactive ingredients for use in cosmeceuticals, mainly in both hair scalp and shaft hair damage repair. Thus, the amounts and their associations define the properties of these compositions with interest for hair cosmetic use, such as antioxidant, inflammatory, and antimicrobial activities. Because they are complex compounds, their actions on the skin, hair scalp, and shaft are not yet fully understood. Aims The purpose of this review is to highlight the relevant researches and findings on essential oils in hair care. Methods In order to achieve this objective, the present work comprises an updated bibliographic review related to essential oils used in hair care. Results It was possible to observe that cosmeceuticals containing essential oils applied to the scalp are preferably for topical activity. Also, it was noticed that there are few reports regarding their use in hair shaft. However, it was found that some oils are used to intensify the brightness and fix the hair color. Conclusions This work demonstrated that the use of essential oils in both cosmetic products (industrial application) and those associated with oils carriers (as individual protocols) may lead to satisfactory results in the treatment of some scalp dysfunctions.
... 19,33 It was observed that when compared to Minoxidil, Rosemary results did not show a significant difference from the results obtained of Minoxidil. 34 Rosemary acts by improving blood circulation and improving vascularity helping the regeneration of follicles similar effect that is provided by Minoxidil. 33,34 Other uses of Rosemary are antidepressant activity, antitumor genic effect, choleretic and hepatoprotective effects, antimycotic activity, treatment for alopecia areata, treatment of dermatological disorders, anti-inflammatory action, spasmolytic activity on smooth muscles helping relaxation, and antioxidant activity ( Figure 7). ...
... 34 Rosemary acts by improving blood circulation and improving vascularity helping the regeneration of follicles similar effect that is provided by Minoxidil. 33,34 Other uses of Rosemary are antidepressant activity, antitumor genic effect, choleretic and hepatoprotective effects, antimycotic activity, treatment for alopecia areata, treatment of dermatological disorders, anti-inflammatory action, spasmolytic activity on smooth muscles helping relaxation, and antioxidant activity ( Figure 7). 33,34 the most active and potential ones. ...
Article
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The second most common alopecia—Androgenetic alopecia (AGA)—occurs due to hormonal imbalance. Dihydrotestosterone (DHT) an androgenic hormone is a sex steroid, produced in the gonads. The target sites of DHT are similar to that of testosterone, and it attaches easily remaining bound for 53 minutes as compared to 35 minutes of testosterone. Excess of DHT causes miniaturization of hair reducing the anagen phase and increasing the telogen phase leading to hair loss. Normally up to ten percent of testosterone in the body irreversibly gets converted into DHT by the action of enzyme 5‐alpha‐reductase. Inadequate blood flow to the scalp can also be another reason for hair loss encountered due to lower oxygen and nutrients reaching it. AGA affects both sexes; however in males, it leads to major hair loss. Conventional drugs such as minoxidil and finasteride are widely used for the treatment. However, several drawbacks such as allergic contact dermatitis, burning, ejaculation disorder, and decreased libido are reported. Available literature suggests the role of herbal drugs to have the action against 5‐alpha‐reductase enzyme inhibiting it and reducing the hair loss. This can be further potentiated since they exhibit lesser side effects. Recent advancements observed in the medicinal, cosmetic, and engineering fields can prove to be an asset. This article focuses on herbs which can be used in AGA. A review of Saw palmetto (Serenoa repens), Green tea (Camellia sinensis), Pumpkin seed (Curcurbita pepo), Rosemary (Rosmarinus officinalis), Grape seed (Vitis vinifera), and Licorice (Glycyrrhiza glabra) is attempted.
... For friction in alopecia: Acetic acid 2-5 g Rosemary tincture 25 g Jarobardi tincture 25 g Quinine tincture 25 g Water 50-60 g These and more antecedents are the basis of the investigations addressing the anti-alopecia properties of rosemary. Panahi et al. [81] treated two groups of volunteers suffering from AGA (n = 50) for six months, one with rosemary oil and the other with minoxidil at 2%. The final result was an Based on our experience of Spanish pharmacies, rosemary alcohol is sold and people demand it to treat friction irritation and frictional alopecia; that is, there is a belief that rosemary prevents hair loss. ...
... These and more antecedents are the basis of the investigations addressing the anti-alopecia properties of rosemary. Panahi et al. [81] treated two groups of volunteers suffering from AGA (n = 50) for six months, one with rosemary oil and the other with minoxidil at 2%. The final result was an improvement in the capillary count in the two cases without significant differences, but the rosemary group reported less itchy scalps. ...
Article
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This work is a bibliographical review of rosemary (Rosmarinus officinalis) that focuses on the application of derivatives of this plant for cosmetic products, an application which has been recognized and valued since Ancient Egyptian times. Rosemary is a plant of Mediterranean origin that has been distributed throughout different areas of the world. It has many medicinal properties, and its extracts have been used (mainly orally) in folk medicine. It belongs to the Labiatae family, which contains several genera-such as Salvia, Lavandula, and Thymus-that are commonly used in cosmetics, due to their high prevalence of antioxidant molecules. Rosemary is a perennial shrub that grows in the wild or is cultivated. It has glandular hairs that emit fragrant volatile essential oils (mainly monoterpenes) in response to drought conditions in the Mediterranean climate. It also contains diterpenes such as carnosic acid and other polyphenolic molecules. Herein, the botanical and ecological characteristics of the plant are discussed, as well as the main bioactive compounds found in its volatile essential oil and in leaf extracts. Afterward, we review the applications of rosemary in cosmetics, considering its preservative power, the kinds of products in which it is used, and its toxicological safety, as well as its current uses or future applications in topical preparations, according to recent and ongoing studies.
... In all those trials promotion of hair growth were higher in the herb-treated group compared with placebo group. Only one study showed randomized comparative trial where efficacy of rosemary oil in the treatment of AGA was compared with 2% minoxidil [112]. A significant increase in hair count at (;) Hair growth inhibition AA alopecia areata, AGA androgenetic alopecia, TGF-b transforming growth factor b the 6-month endpoint was shown in both treatment groups compared with the baseline, but scalp itching was more frequent in the minoxidil group than the rosemary oil group. ...
Article
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Currently available conventional therapies of hair loss using synthetic drugs are still imperfect and have a number of limitations. Their effectiveness as well as the safety of their use is often questioned. It has led to an increased interest in alternative treatments with fewer side-effects such as formulations containing herbs and/or their active constituents. For this purpose several electronic databases and hand-searched references were used to summarize current knowledge regarding topically used herbal products for the treatment of hair loss acquired on the basis of preclinical and clinical studies. Moreover, mechanism of their action, follicular penetration and possible adverse effect of herbal products will be also described.
... For a detailed overview on the different miscellaneous products, please refer to the long version of the guidelines. 1 When looking at the includes studies, 21 trials examined a single product, 37,39,50,[115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130][131][132] while five trials investigated combinations of different products. 36,40,45,116,133 Evaluation of individual ingredients is limited, as most of the tested products contain multiple different substances. ...
Article
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life. The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
... In 2015, one study conducted on patients with pattern hair loss (androgenic alopecia) compared the effectiveness of rosemary oil vs. 2% Minoxidil in the treatment of adrogenic alopecia. It was discovered that rosemary oil was as effective as 2% Minoxidil and that patients in the rosemary group experienced less side effects compared to patients in the Minoxidil group [56]. ...
Article
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Essential oils are widely incorporated in cosmetic products, perfumes and related household products due to the variety of their properties but mainly due to their pleasant odour. The composition of these volatile natural complex mixtures may vary depending on the quality of plant material from which they were obtained and the extraction method by which they were derived. These factors are also important in ensuring the safe use of essential oils in personal care products. As they contain compounds with varied chemical structure and effects, skin sensitivity and irritations as well as other symptoms may arise after their application. Although essential oils are considered as safe and nontoxic when used at low concentrations, available scientific literature indicates that essential oils and their compounds may possess a strong allergy potential. This review focuses on side effects and allergy contact dermatitis caused by selected essential oils and their single compounds in cosmetic products, summarizing data from the most recent scientific literature.
... Due to these diverse activities, rosemary extracts either alone or in combination with other essential herbs are being tested for clinical efficacy and safety. In 2015 a randomized comparative trial by Panahi et al., compared clinical efficacy of rosemary oil and minoxidil, an antihypertensive vasodialator, for the treatment of androgenetic alopecia (AGA), commonly called male or female pattern baldness [124]. Their findings provided evidence with respect to efficacy of rosemary oil in the treatment of AGA. ...
Article
Growing modernization and lifestyle changes with limited physical activity have impacted diet and health, leading to an increased cancer mortality rate worldwide. As a result, there is a greater need than before to develop safe and novel anticancer drugs. Current treatment options such as chemotherapy, radiotherapy and surgery, induce unintended side effects, compromising patient's quality of life, and physical well-being. Therefore, there has been an increased global interest in the use of dietary supplements and traditional herbal medicines for treatment of cancer. Recently, nutraceuticals or “natural” substances isolated from food have attracted considerable attention in the cancer field. Emerging research suggests that nutraceuticals may indeed prevent and protect against cancer. The intent of this article is to review some of the current spice-derived nutraceuticals in the treatment of melanoma and skin cancer.
... Both groups demonstrated a significant increase in hair count at 6 months. The most common adverse effect reported was scalp itching, more frequent with MXD use [66]. Rosemary oil appeared to be a safe nonprescription alternative for AGA, and the results of this study merit further investigation. ...
Article
The treatment of alopecia is limited by a lack of therapies that induce and sustain disease remission. Given the negative psychosocial impact of hair loss, patients that do not see significant hair restoration with conventional therapies often turn to complementary and alternative medicine (CAM). Although there are a variety of CAM treatment options on the market for alopecia, only a few are backed by multiple randomized controlled trials. Further, these modalities are not regulated by the Food and Drug Administration and there is a lack of standardization of bioactive in gredients in over-the-counter vitamins, herbs, and supplements. In this article, we provide a comprehensive review of the efficacy, safety, and tolerability of CAM, including natural products and mind and body practices, in the treatment of hair loss. Overall, there is a need for additional studies investigating CAM for alopecia with more robust clinical design and standardized, quantitative outcomes.
... A study of rosemary essential oil alone in human candidates produced an equivalent outcome compared to 2% minoxidil (Panahi et al., 2015); however, true efficacy from minoxidil is experienced at 5% in men (Varothai and Bergfeld, 2014). Furthermore, increased blood circulation was derived from application of the essential oil to smooth muscles, by agonistic effects on α-adrenergic receptors (Sagorchev et al., 2010). ...
Article
Abstract Ethnopharmacological relevance Research in the past half a century has gradually sketched the biological mechanism leading to androgenetic alopecia (AGA). Until recently the aetiological paradigm has been too limited to enable intelligent commentary on the use of folk remedies to treat or reduce the expression of this condition. However, our understanding is now at a point where we can describe how some folk remedies work, predict how effective they will be or why they fail. Results The new paradigm of AGA is that inheritance and androgens (dihydrotestosterone) are the primary contributors and a secondary pathology, microinflammation, reinforces the process at more advanced stages of follicular miniaturisation. The main protagonist to microinflammation is believed to be microbial or Demodex over-colonization of the infundibulum of the pilosebaceous unit, which can be ameliorated by antimicrobial/acaricidal or anti-inflammatory therapies that are used as adjuvants to androgen dependent treatments (either synthetic or natural). Furthermore, studies reveal that suboptimal androgen metabolism occurs in both AGA and insulin resistance (low SHBG or high DHT), suggesting comorbidity. Both can be ameliorated by dietary phytochemicals, such as specific classes of phenols (isoflavones, phenolic methoxy abietanes, hydroxylated anthraquinones) or polycyclic triterpenes (sterols, lupanes), by dual inhibition of key enzymes in AGA (5α-reductase) and insulin resistance (ie., DPP-4 or PTP1B) or agonism of nuclear receptors (PPARγ). Evidence strongly indicates that some plant-based folk remedies can ameliorate both primary and secondary aetiological factors in AGA and improve insulin resistance, or act merely as successful adjuvants to mainstream androgen dependent therapies. Conclusion Thus, if AGA is viewed as an outcome of primary and secondary factors, then it is better that a ‘multimodal’ or ‘umbrella’ approach, to achieve cessation and/or reversal, is put into practice, using complementation of chemical species (isoflavones, anthraquinones, procyanidins, triterpenes, saponins and hydrogen sulphide prodrugs), thereby targeting multiple ‘factors’.
... Other actives of interest with clinical data are red clover extract [72]; raspberry ketone [73]; capsaicin from red chilli [74]; rosemary oil [75]; onion juice [76]; saw palmetto [77]; ...
Article
It is known that hair growth disorders and hair loss can cause personal distress and affect well-being. Whilst clinical conditions remain a target for medical research, current research on hair follicle biology and hair growth control mechanisms also provides opportunities for a range of non-medical and cosmetic interventions that have a modulating effect on the scalp and follicle function. Furthermore, an improvement of the hair fibre characteristics (cuticle structure, cortex size and integrity) could add to the overall positive visual effect of the hair array. Since phytochemicals are a popular choice because of their traditional appeal, this review provides a critical evaluation of the available evidence of their activity for hair benefit, excluding data obtained from animal tests, and offers recommendations on improving study validity and the robustness of data collection in pre-clinical and clinical studies. © 2019 Society of Cosmetic Scientists and the Société Française de Cosmétologie.
... The Rosmarinus officinalis L. essential oil, whose major components are 1,8-cineol, borneol, bornyl acetate, camphor, alpha-pinene and beta-pinene, increased the hair counts after 6 months of treatment in AGA patients (Panahi, Taghizadeh, Marzony, & Sahebkar, 2015), with similar effects to those obtained with minoxidil. The authors suggest that the antioxidant and vasodilatation properties of rosemary essential oil may be responsible for its stimulatory effect on hair growth. ...
Article
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Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. Objective: To review the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. Design: The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. Results: The most used medical treatments for AGA - minoxidil and finasteride - present non-satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques - mesotherapy, microneedling, carboxytherapy and platelet-rich plasma - are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. Conclusions: The association of different strategies, i.e., substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes. This article is protected by copyright. All rights reserved.
... As a side effect of treatment, itching of the scalp was observed, which was slightly worse in the minoxidil group. Treatments with rosemary oil and with minoxidil did not affect the reduction of dandruff, or the dryness or greasiness of the hair [81]. ...
Article
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Though hair does not serve any crucial physiological function in modern humans, it plays an important role in our self-esteem. Androgenic baldness (androgenic alopecia) and circular/spot baldness (alopecia areata) are the most common forms of hair loss. Many active ingredients of synthetic origin are available for treatment; however, they have a number of limitations. Their effectiveness and safety are questionable and the amount of time needed to achieve the effect is both long and unclear. This has increased interest in finding an alternative approach against hair loss using preparations containing plants and/or their isolated active ingredients. A number of studies (mostly randomized, placebo-controlled) of plants and preparations made of plants have been performed to confirm their effectiveness in treating hair loss. The plants with the most evidence-based effect against alopecia are Curcuma aeruginosa (pink and blue ginger), Serenoa repens (palmetto), Cucurbita pepo (pumpkin), Trifolium pratense (red clover), and Panax ginseng (Chinese red ginseng). The assumed mechanism of action is predominately inhibition of 5α-reductase, with enhanced nutritional support and scalp blood circulation playing a role as well.
... In a randomized comparative study by Panahi et al, it was shown that twice daily application of rosemary oil can be as effective as 2% minoxidil, by improving microcirculation surrounding the hair follicle. 47 Clinical, Cosmetic and Investigational Dermatology 2022:15 https://doi.org/10.2147/CCID.S359052 ...
Article
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Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.
... Hair regrowth improvement, through inhibition of testosterone 5α-reductase (Murata et al., 2013;Panahi, Taghizadeh, Marzony, & Sahebkar, 2015), skin permeation, and antiwrinkle activity with a mod- and cyclooxygenase-2 [COX-2]) expression through suppressing STAT3 activity. It is also able to significantly reduce skin inflammation through inhibition of iNOS and COX-2 expression in the skin tissue and to decrease the serum levels of some proinflammatory cytokines, such as tumor necrosis factor (TNF)-α and IL-1β. ...
Article
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Rosmarinus species are aromatic plants that mainly grow in the Mediterranean region. They are widely used in folk medicine, food, and flavor industries and represent a valuable source of biologically active compounds (e.g., terpenoids, flavonoids, and phenolic acids). The extraction of rosemary essential oil is being done using three main methods: carbon dioxide supercritical extraction, steam distillation, and hydrodistillation. Furthermore, interesting antioxidant, antibacterial, antifungal, antileishmanial, anthelmintic, anticancer, anti‐inflammatory, antidepressant, and antiamnesic effects have also been broadly recognized for rosemary plant extracts. Thus the present review summarized data on economically important Rosmarinus officinalis species, including isolation, extraction techniques, chemical composition, pharmaceutical, and food applications. Rosmarinus species are aromatic plants that mainly grow in the Mediterranean region. They are widely used in folk medicine, food, and flavor industries and represent a valuable source of biologically active compounds (e.g., terpenoids, flavonoids, and phenolic acids). The extraction of rosemary essential oil is being done using three main methods: carbon dioxide supercritical extraction, steam distillation, and hydrodistillation.
... 39 shows a hair growth property by stimulating the scalp. 40 It has been reported that alcoholic terpenes, such as , and PEaT (B, E) groups at 17 days after shaving. IGF-1 and VEGF immunoreactivity is detected in the outer root sheath in all the groups. ...
Article
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In this study, we investigated the effect of a mixture of Platycladus orientalis (L.) Franco leaf extract and α-terpineol, a natural monoterpene alcohol (PEaT), on hair growth and its mechanisms. C57/BL6 mice (total n = 14) in the telogen phase of hair growth were used. Either distilled water as vehicle or PEaT was topically applied to the dorsal skin for 17 days. Chronological hair growth change was examined by hair growth-promoting scores. In addition, to find out mechanisms of PEaT on hair growth, insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), Ki-67, wnt3, and β-catenin expressions were investigated by using immunohistochemistry. We found that PEaT remarkably promoted hair growth by inducing early anagen transition compared with the control group. In addition, treatment with PEaT significantly increased numbers of Ki-67-positive cells and expressions of IGF-1, VEGF, wnt3, and β-catenin in the outer root sheath. These results indicate that PEaT used in this study might be a good hair growth promoter, showing that PEaT treatment increased growth factors and cell proliferation through upregulation of wnt3 and β-catenin expressions.
... A standardized professional microphotographic assessment of each volunteer was taken at the initial interview and after 3 and 6 months of the trial. It was seen in both groups it enhanced the hair count after 6 months and the only common adverse effect reported was scalp itching, more frequent with Minoxidil use [77] Saw Palmetto SP (Saw Palmetto) is a competitive, nonselective inhibitor of both forms of 5α-reductase. SP blocks nuclear uptake of DHT in target cells and decreases DHT binding to androgen receptors by approximately 50%. ...
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Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA. Graphic Abstract
... Studies that met inclusion criteria are summarized in Table 1. [10][11][12][13][14][15][16][17] ...
Article
BACKGROUND: Central centrifugal cicatricial alopecia (CCCA), a scarring alopecia that commonly affects women of African descent, can be challenging to manage, and there are limited treatment modalities available. The use of natural ingredients for nonscarring hair loss has gained popularity among patients, but has not been previously studied for CCCA. OBJECTIVE: We sought to review clinical studies evaluating the use of natural ingredients in the treatment of CCCA. METHODS: Systematic searches of the PubMed and SCOPUS databases were performed in March 2018 using various ingredient names and the terms alopecia, scarring alopecia, Central Centrifugal Cicatricial alopecia, and CCCA. Specific ingredients included azelaic acid, peppermint oil, pumpkin seed oil, garlic supplements/shampoo, Black castor oil, jojoba oil, argan oil, olive oil, horsetail plant oil, lavender oil, coconut oil, chamomile oil, thyme oil, tea tree oil, sulfur oil, menthol, and rosemary oil. Two reviewers independently screened titles, leading to the selection of eight clinical studies. RESULTS: A review of the literature revealed no clinical trials that evaluated the treatment of CCCA with natural ingredients. Despite limited evidence-based research for CCCA, several natural ingredients showed efficacy in alopecia areata, androgenetic alopecia, and psoriatic alopecia. CONCLUSION: Upon review of the literature, there were no randomized, controlled studies evaluating the use of natural ingredients or aromatherapy in the management of CCCA. Despite this, several botanical and natural ingredients do show promise in treating androgenetic alopecia and alopecia areata. More clinical studies need to be performed to evaluate treatment options as a whole, including natural modalities, to better serve these patients.
... However, considering the beneficial effects of the essential oils on hair, we thought that our emulsion formulation could be used for natural, surfactant-free hair treatment beyond the dyeing capability. For example, peppermint and rosemary oils have been reported to promote hair growth [41,42]. ...
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Inspired by the redox reactions in the preparation of the iron gall ink that has been used in Europe since the Middle Ages, we developed a technology for forming the oil-in-water emulsions, without any surfactants and emulsifiers, by homogenizing a mixture of tannic acid, gallic acid, Fe(D-gluconate)2, and natural oil, which are all approved as cosmetic ingredients. Various plant-derived oils, such as argan oil, olive oil, sunflower oil, grape seed oil, hemp seed oil, peppermint oil, rosemary oil, and ylang-ylang oil, were used as an oil phase for the emulsion formation, and all the fabricated emulsions exhibited the capability of black hair-dyeing. This surfactant-free emulsion technology for combining the hair-dyeing capability of Fe3+–tannin complex with the hair-fortifying property of natural oil would have great impact on the hair-cosmetic industry.
... Twice daily application of both MDX and rosemary oil respectively resulted in significant improvement of hair growth at 6 months (p < .05) [44]. ...
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Purpose of Review Androgenic alopecia (AGA) is the most common form of non-scarring alopecia, affecting millions of men and women in the United States (U.S.). This review highlights alternative and complementary treatment options for AGA. Recent Findings The treatment regimens for AGA have increased in pharmacotherapeutics, surgical, and complementary (CAM) categories. Each of the different treatment approaches can now be utilized by dermatologists to combat patient hair loss. Summary The U.S. Food and Drug Administration (FDA) has approved only two agents to treat AGA: prescription-only, oral finasteride and over-the-counter (OTC), topical minoxidil. Increased availability of therapies claiming hair regrowth properties, coupled with limited pharmacotherapeutic options for AGA, lead patients to seek alternative treatments. Increased awareness of the current evidence supporting complementary and alternative therapies among dermatologists will facilitate appropriate and timely education of AGA patients.
... 145 A randomized clinical trial compared the efficacy of topical rosemary oil vs. minoxidil 2% for the treatment of androgenetic alopecia. 146 50 subjects were assigned to each treatment group, and they were observed for a 6-month period with microphotographic assessments. Both groups experienced a significant increase in hair count at the 6-month endpoint compared to the baseline and 3-month endpoint. ...
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Background Androgenetic alopecia (AGA) is the most common form of hair loss consisting of a characteristic receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention, and can impact an individual's quality of life. The condition is primarily mediated by 5-alpha-reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles. Although a variety of medical, surgical, light-based and nutraceutical treatment options are available to slow or reverse the progression of AGA, it can be challenging to select appropriate therapies for this chronic condition. Aims To highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients. Materials and Methods A literature search was conducted using electronic databases (Medline, PubMed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' and other practitioners' clinical experiences in treating androgenetic alopecia, and the findings are presented here. Results Although topical minoxidil, oral finasteride, and low-level light therapy are the only FDA-approved therapies to treat AGA, they are just a fraction of the treatment options available, including other oral and topical modalities, hormonal therapies, nutraceuticals, PRP and exosome treatments, and hair transplantation. Discussion Androgenetic alopecia therapy remains challenging as treatment selection involves ethical, evidence-based decision-making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals, independent of potential financial benefits to the practitioners.
... Similar effects were found upon the application of formulations containing rosemary oil in a concentration allowing a final content of 3.7 mg of 1,8-cineole per mg of final product. This type of formulation is effective against alopecia, similar to formulations containing minoxidil at 2% w/w [132]. These results can be explained considering that the antioxidant characteristic of phenolic compounds may reduce the oxidative stress inducing alopecia. ...
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The current consumer demands together with the international regulations have pushed the cosmetic industry to seek new active ingredients from natural renewable sources for manufacturing more eco-sustainability and safe products, with botanical extract being an almost unlimited source of these new actives. Essential oils (EOs) emerge as very common natural ingredients in cosmetics and toiletries as a result of both their odorous character for the design and manufacturing of fragrances and perfumes, and the many beneficial properties of their individual components (EOCs), e.g., anti-inflammatory, antimicrobial and antioxidant properties, and, nowadays, the cosmetic industry includes EOs or different mixtures of their individual components (EOCs), either as active ingredients or as preservatives, in various product ranges (e.g., moisturizers, lotions and cleanser in skin care cosmetics; conditioners, masks or antidandruff products in hair care products; lipsticks, or fragrances in perfumery). However, the unique chemical profile of each individual essential oil is associated with different benefits, and hence it is difficult to generalize their potential applications in cosmetics and toiletries, which often require the effort of formulators in seeking suitable mixtures of EOs or EOCs for obtaining specific benefits in the final products. This work presents an updated review of the available literature related to the most recent advances in the application of EOs and EOCs in the manufacturing of cosmetic products. Furthermore, some specific aspects related to the safety of EOs and EOCs in cosmetics will be discussed. It is expected that the information contained in this comprehensive review can be exploited by formulators in the design and optimization of cosmetic formulations containing botanical extracts.
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The use of medicinal plants in the prevention and therapeutics of diseases has been carried out for a long time. Phytotherapeutic treatment is also applied in androgenetic alopecia, which is a condition characterized by hair loss and affects individuals of both sexes, with a higher prevalence in men. The objective of the article is to present the results of a bibliographical research related to the effectiveness of phytotherapy in the treatment of androgenetic alopecia. It is a literature review of the integrative type, for the construction of the research, was used of articles available in the following databases: PUBMED and ScienceDirect. After selection and analysis of the data obtained through reading, it was observed the use of several types of phytotherapics in the treatment of androgenic alopecia. The researches showed results with a positive effect of the use of this treatment on the hair growth of the individuals studied, with better resistance and increase of hair of the anagen phase.
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Androgenetic alopecia (AGA) is characterized by non-scarring follicle miniaturization. Despite the success of approved therapies, commonly reported side effects and the need for continual use has led to the investigation of alternative therapies. The aim of this paper is to critically review the success of off-label, topical monotherapies for treatment of AGA in men. A literature search was conducted to obtain randomized, controlled and blinded studies that investigated off-label, topical, monotherapies in male patients. Hair density, hair diameter and hair growth were used to evaluate treatment success. Fourteen off-label topical therapies were investigated among the 16 studies that met inclusion criteria. Nine off-label therapies were reported to produce a significantly greater improvement in hair restoration parameters (e.g. mean change from hair count and hair diameter) as compared to placebo (p < 0.05 for all treatments). In two studies, procyanidin oligomers exhibited greater efficacy over vehicle with response to mean change in hair density (hairs/cm2) (ps < 0.0001 at Week 24). In conclusion, prostaglandin analogs and polyphenols, such as latanoprost and procyanidin oligomers, can improve hair restoration parameters in male AGA patients, possibly through targeting mechanisms proposed in the etiology of AGA. The current evidence suggests short-term (24 weeks) use may provide benefit for hair loss patients; however, long-term efficacy and safety data are required.
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Androgenetic alopecia, or male/female pattern baldness, is the most common type of progressive hair loss disorder. The aim of this paper is to review recent advances in non‐surgical treatments for androgenetic alopecia and identify the most effective treatments. A network meta‐analysis (NMA) was conducted of the available literature of the six most common non‐surgical treatment options for treating androgenetic alopecia in both men and women; dutasteride 0.5mg, finasteride 1mg, low level laser therapy (LLLT), minoxidil 2%, minoxidil 5% and platelet rich plasma (PRP). Seventy‐eight studies met the inclusion criteria and twenty‐two studies had the data necessary for a network meta‐analysis. Relative effects show LLLT as the superior treatment. Relative effects show PRP, finasteride 1 mg (male), finasteride 1 mg (female), minoxidil 5%, minoxidil 2% and dutasteride (male) are approximately equivalent in mean change hair count following treatment. Minoxidil 5% and minoxidil 2% reported the most drug‐related adverse events (n=45 and n=23, respectively). The quality of evidence of minoxidil 2% vs. minoxidil 5% was high; minoxidil 5% vs. placebo was moderate; dutasteride (male) vs. placebo, finasteride (female) vs placebo, minoxidil 2% vs. placebo, minoxidil 5% vs. LLLT was low and finasteride (male) vs. placebo, LLLT vs. sham, PRP vs. placebo, finasteride vs. minoxidil 2% was very low. Results of this NMA indicate the emergence of novel, non‐hormonal therapies as effective treatments for hair loss; however, the quality of evidence is generally low. High quality randomized controlled trials and head to head trials are required to support these findings and aid in the development of more standardized protocols, particularly for PRP. Regardless, this analysis may aid physicians in clinical decision making and highlight the variety of non‐surgical hair restoration options for patients. This article is protected by copyright. All rights reserved.
Thesis
Hair loss is the medical condition characterized by earlier catagen onset leading to prolong thinning of the terminal hair to the vellus hair follicle. This study aimed to investigate the hair growth promotion effects of centipedegrass extract (CGE) and to unravel the molecular mechanism associated with the hair growth cycle progression in vitro and in vivo. The effects of CGE on cell proliferation and several signaling pathways related to hair induction were examined in keratinocytes (HaCaT cells) and human hair dermal papilla cells (HHDPC). Furthermore, the histological assessment was conducted after the topical application of CGE on the back skin of the telogen induced C57BL/6 and hairless SKH1 mice 14 days and ten weeks, respectively. The results showed that CGE increased the proliferation of HHDPC and HaCaT cells and the migration of HaCaT cells. CGE upregulated the ALP activity and HHDPC aggregation. CGE induced expression of genes related to TGFβ and Wnt/β-Catenin pathways in treated HaCAT cells. Also, CGE increased the expression of β-Catenin, p-Akt, p-ERK1/2, p-GSK3β, and Bcl2 protein in vitro. Hair promotion effects of CGE were confirmed with skin pigmentation in C57BL/6 or hair shaft growth in hairless SKH1 mice. CGE administration on the iv mice's skin allowed the transition of telogen to the anagen hair follicle. Also, the immunohistochemistry assay showed that CGE upregulated sonic hedgehog, β�catenin, ALP, and Ki-67 protein expression in the hair follicle compared to the control. These findings suggested that CGE encourages hair growth and enables the hair growth process to advance. CGE can, therefore, be used for hair loss treatment.
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Background: Female pattern hair loss (FPHL), or androgenic alopecia, is the most common type of hair loss affecting women. It is characterised by progressive shortening of the duration of the growth phase of the hair with successive hair cycles, and progressive follicular miniaturisation with conversion of terminal to vellus hair follicles (terminal hairs are thicker and longer, while vellus hairs are soft, fine, and short). The frontal hair line may or may not be preserved. Hair loss can have a serious psychological impact on women. Objectives: To determine the efficacy and safety of the available options for the treatment of female pattern hair loss in women. Search methods: We updated our searches of the following databases to July 2015: the Cochrane Skin Group Specialised Register, CENTRAL in the Cochrane Library (2015, Issue 6), MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1872), AMED (from 1985), LILACS (from 1982), PubMed (from 1947), and Web of Science (from 1945). We also searched five trial registries and checked the reference lists of included and excluded studies. Selection criteria: We included randomised controlled trials that assessed the efficacy of interventions for FPHL in women. Data collection and analysis: Two review authors independently assessed trial quality, extracted data and carried out analyses. Main results: We included 47 trials, with 5290 participants, of which 25 trials were new to this update. Only five trials were at 'low risk of bias', 26 were at 'unclear risk', and 16 were at 'high risk of bias'.The included trials evaluated a wide range of interventions, and 17 studies evaluated minoxidil. Pooled data from six studies indicated that a greater proportion of participants (157/593) treated with minoxidil (2% and one study with 1%) reported a moderate to marked increase in their hair regrowth when compared with placebo (77/555) (risk ratio (RR) = 1.93, 95% confidence interval (CI) 1.51 to 2.47; moderate quality evidence). These results were confirmed by the investigator-rated assessments in seven studies with 1181 participants (RR 2.35, 95% CI 1.68 to 3.28; moderate quality evidence). Only one study reported on quality of life (QoL) (260 participants), albeit inadequately (low quality evidence). There was an important increase of 13.18 in total hair count per cm² in the minoxidil group compared to the placebo group (95% CI 10.92 to 15.44; low quality evidence) in eight studies (1242 participants). There were 40/407 adverse events in the twice daily minoxidil 2% group versus 28/320 in the placebo group (RR 1.24, 95% CI 0.82 to 1.87; low quality evidence). There was also no statistically significant difference in adverse events between any of the individual concentrations against placebo.Four studies (1006 participants) evaluated minoxidil 2% versus 5%. In one study, 25/57 participants in the minoxidil 2% group experienced moderate to greatly increased hair regrowth versus 22/56 in the 5% group (RR 1.12, 95% CI 0.72 to 1.73). In another study, 209 participants experienced no difference based on a visual analogue scale (P = 0.062; low quality evidence). The assessments of the investigators based on three studies (586 participants) were in agreement with these findings (moderate quality evidence). One study assessed QoL (209 participants) and reported limited data (low quality evidence). Four trials (1006 participants) did not show a difference in number of adverse events between the two concentrations (RR 1.02, 95% CI 0.91 to 1.20; low quality evidence). Both concentrations did not show a difference in increase in total hair count at end of study in three trials with 631 participants (mean difference (MD) -2.12, 95% CI -5.47 to 1.23; low quality evidence).Three studies investigated finasteride 1 mg compared to placebo. In the finasteride group 30/67 participants experienced improvement compared to 33/70 in the placebo group (RR 0.95, 95% CI 0.66 to 1.37; low quality evidence). This was consistent with the investigators' assessments (RR 0.77, 95% CI 0.31 to 1.90; low quality evidence). QoL was not assessed. Only one study addressed adverse events (137 participants) (RR 1.03, 95% CI 0.45 to 2.34; low quality evidence). In two studies (219 participants) there was no clinically meaningful difference in change of hair count, whilst one study (12 participants) favoured finasteride (low quality evidence).Two studies (141 participants) evaluated low-level laser comb therapy compared to a sham device. According to the participants, the low-level laser comb was not more effective than the sham device (RR 1.54, 95% CI 0.96 to 2.49; and RR 1.18, 95% CI 0.74 to 1.89; moderate quality evidence). However, there was a difference in favour of low-level laser comb for change from baseline in hair count (MD 17.40, 95% CI 9.74 to 25.06; and MD 17.60, 95% CI 11.97 to 23.23; low quality evidence). These studies did not assess QoL and did not report adverse events per treatment arm and only in a generic way (low quality evidence). Low-level laser therapy against sham comparisons in two separate studies also showed an increase in total hair count but with limited further data.Single studies addressed the other comparisons and provided limited evidence of either the efficacy or safety of these interventions, or were unlikely to be examined in future trials. Authors' conclusions: Although there was a predominance of included studies at unclear to high risk of bias, there was evidence to support the efficacy and safety of topical minoxidil in the treatment of FPHL (mainly moderate to low quality evidence). Furthermore, there was no difference in effect between the minoxidil 2% and 5% with the quality of evidence rated moderate to low for most outcomes. Finasteride was no more effective than placebo (low quality evidence). There were inconsistent results in the studies that evaluated laser devices (moderate to low quality evidence), but there was an improvement in total hair count measured from baseline.Further randomised controlled trials of other widely-used treatments, such as spironolactone, finasteride (different dosages), dutasteride, cyproterone acetate, and laser-based therapy are needed.
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