Evidence-Based Treatments for Androgenetic Alopecia

Combination Therapy for Maximal Efficacy

The combination of PRP with topical minoxidil 5% demonstrates significantly superior efficacy compared to minoxidil monotherapy, with hair density increasing 1.74 times and hair diameter increasing 14.3 times, as recommended by the American Academy of Dermatology 1, 2

Standard protocol: Three intradermal scalp injection sessions spaced one month apart (months 0, 1, and 3), with maintenance injections every 6 months sustaining results long-term, according to the American Academy of Dermatology 1, 2
Nonactivated PRP demonstrates 31% greater increases in hair count and total hair density compared to activated PRP—activation before injection is unnecessary, as supported by the American Academy of Dermatology 1, 2
A 25% improvement in hair density at 2 months predicts sustained response at 6 months, as reported by the American Academy of Dermatology 2

PRP shows particular value in mild-to-moderate androgenetic alopecia cases, with complex therapy (PRP with minoxidil) applied as early as possible for best results, as recommended by the American Academy of Dermatology 2, 3
The evidence for PRP remains somewhat controversial due to highly variable study protocols, preparations, and treatment intervals—standardized approaches are still evolving, according to the American Academy of Dermatology 2, 3

Trichoscopy can be used to evaluate hair density and diameter, as supported by the American Academy of Dermatology 2

Contact immunotherapy (DPCP/SADBE), PUVA photochemotherapy, Dithranol, systemic immunosuppressants (ciclosporin, methotrexate), and prostaglandin analogues for eyelash loss are not recommended for androgenetic alopecia, as they address a completely different pathophysiology, as stated by the British Association of Dermatologists 4, 5, 6

The American Academy of Dermatology recommends topical minoxidil 2-5% as the first-line treatment for women with androgenetic alopecia, applied twice daily 7
The combination of topical minoxidil and platelet-rich plasma (PRP) shows superior efficacy compared to minoxidil alone for women with androgenetic alopecia 7, 8

Treatment must continue indefinitely, as discontinuation reverses all benefits, according to the American Academy of Dermatology 7

Oral minoxidil can cause dose-dependent hypertrichosis (unwanted body hair growth) 9

The American Academy of Dermatology recommends assessing treatment efficacy using standardized before-and-after photographs, trichoscopy to evaluate hair density and diameter, and patient self-assessment questionnaires 7