Comparative Study between Mesotherapy and Topical 5% Minoxidil by Dermoscopic Evaluation for Androgenic Alopecia in Male: A Randomized Controlled Trial
Prachi Chetankumar Gajjar, Hita Hemant Mehta, Manish Barvaliya, Bhavesh Sonagra, Prachi Chetankumar Gajjar, Hita Hemant Mehta, Manish Barvaliya, Bhavesh Sonagra
Abstract
Aim: This study aims to compare efficacy and safety between mesotherapy (intralesional injection) and 5% topical minoxidil solution in male androgenic alopecia (AGA) by dermoscopic evaluation.
Methodology: In a randomized active controlled trial, we enrolled 49 clinically diagnosed males of AGA and randomly allotted them into two groups - mesotherapy (A) (25) and minoxidil (B) (24). Males in Group A were given total 8 sessions of intralesional mesosolution with microneedling procedure while Group B males were prescribed topical solution of minoxidil 5% twice daily for 4 months. Results were evaluated at baseline and then monthly for 4 months with clinical photographs, dermoscopy, trichoscan, 7-point standard assessment tool, and patient-self assessment scores.
Results: Grade II was the most common presentation in our study. All dermoscopic parameters such as variation of hair shaft diameter, follicular units with single and multiple hairs, yellow dots, and perifollicular halo did not show any significant difference between the groups at all time points except at 1st month where the difference in variation of hair shaft diameter between the two group was 0.04. We observed a significant increase (P = 0.01) in the variation of hair shaft diameter between pre- and post-treatment in mesotherapy group compared to minoxidil group. The rest of parameters failed to show any significant difference within the group in mesotherapy and minoxidil.
Conclusion: In our study, we observed a significant increase in the variation of hair shaft diameter between pre- and post-treatment in Group A compared to B. Other dermoscopic, trichoscan, and subjective measurement tool failed to show significant difference between two groups. Our observation suggests that there is no significant improvement of mesotherapy in male AGA over minoxidil.
Keywords: Androgenic alopecia; mesotherapy; trichoscopy.
Conflict of interest statement
There are no conflicts of interest.
Figures
References
- Kaliyadan F, Nambiar A, Vijayaraghavan S. Androgenetic alopecia: An update. Indian J Dermatol Venereol Leprol. 2013;79:613–25.
- Sehgal VN, Kak R, Aggarwal A, Srivastava G, Rajput P. Male pattern androgenetic alopecia in an Indian context: A perspective study. J Eur Acad Dermatol Venereol. 2007;21:473–9.
- Dhurat R, Saraogi P. Hair evaluation methods: Merits and demerits. Int J Trichology. 2009;1:108–19.
- Mohamed H, Hala M. Comparative study between 2% minoxidil topical spray vs. intradermal injection (Mesotherapy) for treatment of androgenetic alopecia in female patients: A controlled, 4-month randomized trial. Egypt Dermatol Online J. 2010;6:5.
- Wang TL, Zhou C, Shen YW, Wang XY, Ding XL, Tian S, et al. Prevalence of androgenetic alopecia in China: A community-based study in six cities. Br J Dermatol. 2010;162:843–7.
- Kaufman KD, Girman CJ, Round EM, Johnson-Levonas AO, Shah AK, Rotonda J, et al. Progression of hair loss in men with androgenetic alopecia (male pattern hair loss): Long-term (5-year) controlled observational data in placebo-treated patients. Eur J Dermatol. 2008;18:407–11.
- Seleit IA, El-Bakry OA, El-Sherif RM. Dermoscopy in hair disorders. Menoufia Med J. 2014;27:762–5.
- Rakowska A, Slowinska M, Kowalska-Oledzka E, Olszewska M, Rudnicka L. Dermoscopy in female androgenic alopecia: Method standardization and diagnostic criteria. Int J Trichology. 2009;1:123–30.
- Saraogi PP, Dhurat RS. Automated digital image analysis (TrichoScan®) for human hair growth analysis: Ease versus errors. Int J Trichology. 2010;2:5–13.
- Lee WS, Lee HJ, Choi GS, Cheong WK, Chow SK, Gabriel MT, et al. Guidelines for management of androgenetic alopecia based on BASP classification – The Asian consensus committee guideline. J Eur Acad Dermatol Venereol. 2013;27:1026–34.
- Tsuboi R, Arano O, Nishikawa T, Yamada H, Katsuoka K. Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men. J Dermatol. 2009;36:437–46.
- Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47:377–85.
- Vedamurthy M. Mesotherapy. Indian J Dermatol Venereol Leprol. 2007;73:60–2.
- Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P, et al. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. Int J Trichology. 2013;5:6–11.
- Ganjoo S, Thappa DM. Dermoscopic evaluation of therapeutic response to an intralesional corticosteroid in the treatment of alopecia areata. Indian J Dermatol Venereol Leprol. 2013;79:408–17.
- Rudnicka L, Olszewska M, Rakowska A, Slowinska M. Trichoscopy update 2011. J Dermatol Case Rep. 2011;5:82–8.
- Duque-Estrada B, Vincenzi C, Misciali C, Tosti A. Alopecia secondary to mesotherapy. J Am Acad Dermatol. 2009;61:707–9.
- Kadry R, Hamadah I, Al-Issa A, Field L, Alrabiah F. Multifocal scalp abscess with subcutaneous fat necrosis and scarring alopecia as a complication of scalp mesotherapy. J Drugs Dermatol. 2008;7:72–3.
- DeVillez RL. Topical minoxidil for androgenetic alopecia: Optimizing the chance for success by appropriate patient selection. Dermatologica. 1987;175(Suppl 2):50–3.
- Mapar MA, Omidian M. Is topical minoxidil solution effective on androgenetic alopecia in routine daily practice? J Dermatolog Treat. 2007;18:268–70.
Source: PubMed