Efficacy of Skin Patting and Iontophoresis with Dutasteride Gel in Male and Menopausal Female Androgenetic Alopecia: A Pilot Study.

INTRODUCTION: Androgenetic alopecia (AGA) is a chronic, progressive condition often resistant to conventional treatments. Transdermal delivery systems such as iontophoresis and skin patting (SPi) may enhance drug penetration and follicular targeting. Dutasteride, a potent dual 5α-reductase inhibitor, has shown superior efficacy to finasteride, but topical delivery is limited by variable absorption. In this pilot study, we evaluated the efficacy and safety of dutasteride gel delivered via SPi and iontophoresis in men and postmenopausal women with treatment-resistant AGA. METHODS: In this single-center pilot study, 20 adults (10 males, 10 postmenopausal females) with AGA unresponsive to ≥ 12 months of standard therapy underwent four monthly sessions of SPi and iontophoresis with 6% dutasteride gel. Hair density, shaft diameter, and pull test results were assessed at baseline and 8 weeks post-treatment; patient satisfaction (0-4 scale) and safety were recorded. Paired tests were used to analyze the results, with p < 0.05 considered to indicate significance. RESULTS: Hair density improved significantly in frontal (p < 0.001) and vertex (p < 0.001) regions. Shaft diameter increased in vertex (p < 0.001) and frontal areas (p = 0.046). Pull test scores improved (p < 0.001). Mean satisfaction was 3.4/4. No adverse events occurred. CONCLUSION: SPi with iontophoresis effectively delivered topical dutasteride, yielding significant clinical improvement and excellent safety in treatment-resistant AGA. Larger randomized trials are warranted to confirm these findings.