Comparative efficacy and safety of low-level laser therapy and topical Minoxidil combination vs. topical Minoxidil monotherapy in androgenetic alopecia management: a systematic review and meta-analysis of randomized controlled trials.

Topical minoxidil is currently a standard treatment for androgenic alopecia (AGA). Low-level laser therapy (LLLT) is an innovative technology that may enhance the hair growth effects of minoxidil. This study intends to evaluate the efficacy and safety of the combination therapy of LLLT and topical minoxidil in comparison to topical minoxidil alone for the treatment of AGA. A thorough search was performed on the Cochrane Library, ClinicalTrials.gov, Europe PMC, Medline, and Scopus databases until March 25th, 2025. All randomized controlled trials (RCTs) that examined the comparison between LLLT combined with topical minoxidil and topical minoxidil alone for AGA were included in this review. We utilized random-effects models to evaluate the risk ratio (RR) and mean difference (MD) for the outcomes presented. A total of 7 RCTs were incorporated. The findings of our meta-analysis indicated that the combination of LLLT and topical minoxidil was correlated with a greater increase in hair density (MD 6.62; 95%CI: 2.04, 11.20, p = 0.005, I2 = 56%) and mean hair diameter (MD 0.01 mm; 95%CI: 0.00, 0.01, p = 0.002, I2 = 29%) than topical minoxidil alone. Patients' satisfaction rate was also higher among AGA patients who received combination therapy of LLLT + topical minoxidil compared to topical minoxidil alone (RR 1.71; 95%CI: 1.23, 2.38, p = 0.002, I2 = 36%). Regarding safety, no difference in the adverse events (AEs) was observed between two groups. This study suggests superior efficacy of combination LLLT and topical minoxidil over topical minoxidil alone for the management of AGA with comparable safety profile.