Mesotherapy as a Promising Alternative to Minoxidil for Androgenetic Alopecia: A Systematic Review.
Esraa M Aledani,
Harleen Kaur,
Malik Kasapoglu,
Rajesh Yadavalli,
Sarosh Nawaz
et al.
Review
Cureus
2024
4 sitasi
PubMed
DOI
PDF
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Study Design
- Jenis Studi
- Review
- Ukuran Sampel
- 11
- Intervensi
- Mesotherapy as a Promising Alternative to Minoxidil for Androgenetic Alopecia: A Systematic Review. microinjections of medications/vitamins
- Pembanding
- Placebo
- Arah Efek
- Positive
- Risiko Bias
- Moderate
Abstract
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 mesotherapy and minoxidil in AGA, including techniques, complications, limitations, and outcomes. In conclusion, available trials and research on mesotherapy and minoxidil demonstrated excellent statistical significance and a high patient satisfaction rate, with the exception of two publications that took into account certain uncommon adverse effects of mesotherapy. However, recent research suggests that a mesotherapy method for alopecia with a low risk of side effects is effective.
Full Text
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Tables
Table 1
| Inclusion Criteria | Exclusion Criteria |
| Peer-reviewed | Non-peer-reviewed |
| Targeting people with androgenetic alopecia who used either minoxidil or mesotherapy | Include other interventions |
| Studies that are written in English only | Studies that are written in languages other than English |
| RCTs, systematic reviews, and case reports | Editorials, commentaries, abstracts, and unpublished literature |
| Studies that have free full-text | Studies that do not have free full-text |
Table 2
| Study Design | Quality Assessment Tool | Total Score | Total Score | Number of Papers |
| RCT | RoB2 | N/A | Low risk | 5 |
| Narrative review | SANRA | 12 | 11 | 1 |
| Systematic review | AMSTAR | 16 | 14 | 2 |
| Case reports | JBI | 8 | 8 | 2 |
| Case series | JBI | 10 | 10 | 1 |
Table 3
| Study | Study Design | Number of Patients | Statistically Difference | Follow-up Period | Complications | Agent Formation | Main Outcome |
| Esmat et al. [ | RCT | 45 | A significant difference regarding Ludwig classification was also documented in those who received combination therapy (group C) (P=0.005). | 4 months | Irritation, scalp tenderness. | Low-level light-minoxidil (LLLT) in comparison to topical minoxidil 5% and to a combination of both therapies. | In the treatment of FPHL, low-level light-minoxidil 5% is an effective and safe method with equivalent outcomes to minoxidil 5%. Combination treatment is indicated to speed hair regeneration due to its much greater benefits. |
| Gajjar et al. [ | RCT | 49 | No statistically significant difference between mesotherapy and minoxidil. | 4 months | Erythema, headache. | Mesohair solution had 56 constituents, which included 24 amino acids, 13 vitamins, four coenzymes, four nucleic acids, five minerals, and two reducing agents. Decapeptide 4, acetyl decapeptide, and copper tripeptide were the active ingredients. | More research with a larger sample size and a longer follow-up time are needed to determine the effect of mesotherapy in AGA. Although effective therapy choices are limited, AGA continues to be a field where ongoing research is contributing more understanding about pathophysiology and more therapeutic alternatives are being developed accordingly. |
| Lucky et al. [ | RCT | 381 | N/A | 48 weeks | Pruritus, dermatitis, hypertrichosis, scaling, headache. | 5% and 2% topical minoxidil solutions. | Superiority of 5% topical minoxidil over placebo and 2% topical minoxidil with promoting hair growth. |
| Hunter et al. [ | RCT | 30 | A statistically significant difference was found between groups regarding the increase in the number of hair follicle after treatment, with the mesotherapy group showing more increase. There was no significant difference between the groups regarding the change in the diameter of the largest hair follicle after treatment. | 12 weeks | Headache, pain. | Amino acids (alanine, arginine, aspartic acid, cystine, glutamine, glycine, histidine, isoleucine, leucine, lysine, phenylalanine, proline, serine, taurine, and threonine), minerals (zinc, selenium, copper, manganese, and chrome), hyaluronic acid (1.5%), ginkgo biloba extract, and vitamins (A, C, E, and B-complex). | In the treatment of FPHL, mesotherapy with vitamins and minerals alone is more successful, patient-acceptable, and bearable than topical minoxidil 5%. |
| Alhanshali et al. [ | Narrative review | N/A | N/A | N/A | N/A | N/A | Current research suggests that mesotherapy may be a successful treatment method for alopecia with a minimal risk of side effects, although it has the limitations that have been highlighted. |
| Cura et al. [ | Case report | 2 women | N/A | 3 months | Injection-site infections, granulomatous foreign body reactions, fat necrosis, lichenoid drug eruptions, and Nicolau syndrome, pain, headache, itching. | Mesotherapy dutasteride (second-generation 5a-reductase enzyme inhibitor that decreases serum dihydrotestosterone levels by 90%). | Two cases of paradoxical nonscarring alopecia following dutasteride mesotherapy were described. In both cases, ethanol was utilized as a solvent in a solution containing dutasteride. Based on the current ethanol toxicity data, we believe that this drug may cause cell damage and death in the hair follicle, resulting in hair loss. |
| Tang et al. [ | Systematic review | N/A | N/A | N/A | N/A | Mesotherapy | Mesotherapy has shown some positive results in treating PHL without significant side effects, and it is regarded as a potential treatment for hair loss and recommended as a List B procedure in a guideline for doctors working in aesthetic practices when approved treatments fail to provide an ideal outcome. Although it is still in its early stages and has challenges in terms of popularization in hair regrowth, a better use of mesotherapy in PHL may be anticipated with clear instructions and suggestions. |
| Gupta et al. [ | Systematic review | N/A | N/A | N/A | Headache, injection-site pain, and scalp tightness or itching. | Mesotherapy | Mesotherapy is a method of intradermal medication and bioactive material delivery with the potential to cure hair loss diseases such as PHL and TE. Several studies have found statistically significant increases in hair growth following mesotherapy injections with various therapeutic agents and homoeopathic solutions. Lower medication dosages, targeted delivery, and fewer injections are all aspects that can increase the usefulness of mesotherapy. |
| Melo et al. [ | Case series | 14 | N/A | 4 days | Burning, erythema and headaches, subcutaneous necrosis, scalp abscesses, and angioedema, frontal edema. | Mesotherapy | This is the largest case series focusing on frontal edema after AGA mesotherapy and provides doctors with useful information while doing this method. More research is needed to investigate the function of minoxidil, dutasteride, and possibly lidocaine as potential causes of frontal edema in mesotherapy. |
| Magdaleno-Tapial et al. [ | Case report | 1 | N/A | 24 hours | Facial swelling and erythema. | Mesotherapy with dutasteride. | Mesotherapy is a popular cosmetic technique, and ACD has already been mentioned as a side effect. This is the first report of ACD induced by dutasteride. More research is needed to determine the appropriate dutasteride patch test concentration. |
| Uzel et al. [ | RCT | 54 | N/A | 10 weeks | Frontal edema, mild pain and burning sensation, multifocal scalp abscess. | 2 mL of 0.5% minoxidil against 2 mL of 0.9% saline. | Intradermal injections of 0.5% minoxidil solution once a week for 10 weeks were shown to be more effective than placebo in the treatment of FAGA, with no significant side effects. |
References
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