Recent studies, explained

What they did

Women with self-perceived thinning hair, confirmed by a dermatologist, were randomized to one of four different Nutrafol formulations (with no inactive placebo group) and followed for 6 months, measuring hair growth rate, total and terminal hair counts, and scalp coverage.

What they found

Hair growth rate increased 18.6-36.7% across the four formulations; total hair counts rose 4.4-8.2%; terminal (thick, visible) hair counts rose 6-7.9%; scalp coverage improved 5.3-8.5%; more hairs were measured in the active growth (anagen) phase. Improvements were visible by 90 days and continued through 180 days.

What it means for you

Women using this supplement saw measurable improvements in hair growth speed and visible scalp coverage over 6 months -- but because there was no placebo group and participants knew which product they were taking, some of this improvement could reflect expectation effects or natural month-to-month fluctuation in hair growth rather than the supplement itself.

Limitations

No placebo or inactive control arm -- a major limitation for any supplement trial, since hair growth naturally fluctuates and placebo effects in hair-loss studies are well documented; open-label (not blinded) design; the study was funded and run by the manufacturer's parent company, including paying the journal's publication fees -- a clear and significant industry-funding conflict of interest.

Funding

Nutraceutical Wellness, Inc. (Nutrafol's parent company) funded the research and publication fees

Read the study ↗ · DOI 10.1007/s13555-026-01866-z · summarised from the abstract

A 6-Month Prospective, Open-Label, Randomized Study Showing Increased Hair Growth Rate in Women Using Multi-Targeting Hair Growth Nutraceuticals · Dang R, et al.

What they did

Pooled 43 randomized controlled trials (1,877 participants) testing PRP injections for various types of hair loss against placebo/saline or other treatments, separately analyzing 'activated' versus 'non-activated' PRP preparations.

What they found

Activated PRP (platelets chemically triggered before injection) significantly increased hair density and reduced relapse compared with placebo. Non-activated PRP was associated with more frequent side effects. PRP did not significantly improve hair thickness in either form.

What it means for you

PRP injections can meaningfully help regrow hair density, especially when platelets are 'activated' before injection, but they work better for density than for making existing hairs thicker -- the specific PRP preparation method affects both how well it works and its side-effect risk.

Limitations

Full text could not be accessed (publisher login wall blocked retrieval); summary relies on search-engine excerpts of the abstract and author list could not be confirmed. High heterogeneity across the 43 included trials in PRP preparation protocols; potential publication bias common in this research area; most individual trials were small.

Funding

Not confirmed from accessible sources

Read the study ↗ · DOI 10.1007/s13555-025-01542-8 · summarised from the abstract

Platelet-Rich Plasma in the Management of Alopecia: A Systematic Review and Meta-Analysis of Clinical Evidence · Not confirmed from accessible abstract (author list unavailable)

What they did

Searched 7 databases through September 2024 and statistically ranked different low-level laser therapy (LLLT) treatments and combinations (laser alone, laser plus LED, laser plus PRP, laser plus botulinum toxin plus minoxidil, radiofrequency, etc.) against sham treatment and against each other.

What they found

For increasing hair thickness, red laser combined with LED and PRP injection ranked best (odds ratio 8.30 versus sham). For hair density, botulinum toxin plus red laser plus topical minoxidil ranked best (odds ratio 13.55). Nearly all laser-based treatments beat sham, except radiofrequency. No severe side effects were reported, though adverse events trended higher (not statistically significant) with laser-plus-PRP combinations.

What it means for you

Laser devices for hair loss (such as laser combs or caps) appear to help beyond placebo, and combining them with other treatments like PRP or minoxidil may boost results further -- though the specific 'best' combinations identified here are complex, specialist treatments rather than simple over-the-counter options.

Limitations

Full text could not be accessed (paywalled, payment required); findings rely on search-engine and secondary medical-news summaries. Network meta-analyses combine many small, heterogeneous trials through indirect statistical comparison, which is less reliable than a single large head-to-head trial; no India-specific or long-term (beyond study duration) data included.

Funding

Not confirmed from accessible sources

Read the study ↗ · summarised from the abstract

Evaluating the efficacy of low-level laser-based treatments for androgenetic alopecia: A network meta-analysis · Not confirmed from accessible abstract (author list unavailable)

What they did

Premenopausal women aged 18-45 with mild-to-moderate female pattern hair loss were randomized to spironolactone 100 mg/day plus topical minoxidil 3% twice daily, or placebo plus the same topical minoxidil, for 24 weeks, with hair counts, diameter, and photographic assessment as outcomes.

What they found

The spironolactone group had numerically greater increases in hair count and diameter, but the difference in hair count did not reach statistical significance. On doctor-rated photographic assessment, significantly more women on spironolactone showed moderate-to-marked improvement (38%) versus placebo (9%). Side effects: menstrual irregularities occurred in roughly 38-50% of the spironolactone group (mostly mild; two women withdrew over this, and cycles returned to normal after stopping). Transient high potassium occurred in two spironolactone patients and one placebo patient, resolving without intervention.

What it means for you

Adding spironolactone to topical minoxidil may give women a better overall look of improvement than minoxidil alone by doctor assessment, though the actual hair-count data was not statistically convincing in this small trial -- and a substantial share of women may experience menstrual side effects worth discussing with a doctor before starting.

Limitations

Small pilot study (48 participants) likely underpowered to detect a true difference in hair counts; only 24 weeks of follow-up; the primary journal page could not be accessed directly (paywalled), so details come from a dermatology newsletter's summary of the published abstract rather than the original article; author list and funding/conflict-of-interest disclosures could not be confirmed.

Funding

Not disclosed in the accessible secondary source

Read the study ↗ · summarised from the abstract

Efficacy and safety of oral spironolactone for female pattern hair loss in premenopausal women: a randomized, double-blind, placebo-controlled, parallel-group pilot study · Not confirmed from accessible secondary source (author list unavailable)

What they did

Pooled 18 randomized trials comparing minoxidil alone against minoxidil combined with other treatments, including a topical combination of 0.25% finasteride plus 3% minoxidil, ranking all options using network meta-analysis.

What they found

In men, topical finasteride plus minoxidil ranked highly (SUCRA 80.21%), producing about 29.68 more hairs per cm² than minoxidil alone, and was statistically superior to minoxidil monotherapy. However, it was not clearly better than other combination approaches (comparisons were underpowered).

What it means for you

Adding a topical finasteride to minoxidil may boost hair regrowth beyond minoxidil alone, offering men who want to avoid the whole-body hormonal effects of an oral finasteride pill a potential middle-ground option -- but solid head-to-head proof against other combination treatments is still lacking.

Limitations

Small sample sizes within each comparison arm; no trials directly compared combination treatments to each other; did not include dutasteride or oral minoxidil arms; most comparisons rated very-low to low certainty evidence (GRADE); severity of alopecia not well reported across included trials.

Funding

Fundamental Research Funds for the Central Universities, China (academic, non-industry)

Read the study ↗ · DOI 10.3389/fmed.2025.1638496

Relative efficacy of minoxidil in combination with other treatments for androgenic alopecia: a network meta-analysis based on randomized controlled trials · Xia Y, Chen H, Chen Y, Chen Z

What they did

Systematically reviewed all published clinical studies (not just lab or animal studies) testing exosome-based scalp injections for various types of hair loss, across different exosome sources (adipose tissue, placenta, hair follicles, bone marrow, foreskin, umbilical cord, and plant extracts).

What they found

Across studies, hair density increased by roughly 9.5 to 35 hairs per cm², and hair thickness improved by up to about 13 micrometers. Patient satisfaction was generally high and no serious adverse events were reported; mild, temporary scalp irritation occurred occasionally (in about 20% of patients using one plant-extract-derived product).

What it means for you

Exosome injections show early, genuinely promising signals for hair regrowth and appear safe in the studies conducted so far -- but this remains a new, largely unregulated, and unproven treatment, backed by only 2 real randomized trials out of 11 studies; it should be seen as experimental rather than an established option, and treatment costs can be high.

Limitations

Very small total evidence base (298 patients across 11 studies, several using weaker study designs like case reports and uncontrolled single-arm trials); large differences in how exosomes were sourced, dosed, and delivered across studies, making direct comparison difficult; most studies lacked a placebo or control group; no regulatory (FDA or equivalent) approval exists for any exosome product for hair loss.

Funding

Authors report no conflicts of interest for the review itself; underlying primary studies had varied, not fully detailed, funding sources

Read the study ↗ · DOI 10.2147/CCID.S543451

Exosomes and Hair Regeneration: A Systematic Review of Clinical Evidence Across Alopecia Types and Exosome Sources · Al Ameer MA, Alnajim AT, Al Ameer A, Alsalman Z, Al Ameer GA, Alnajim ST, Alghamdi AA, Moideen R, Al Hadi EM

What they did

Indian men (20-60 years) with androgenetic alopecia were randomized to one of three strengths of topical dutasteride solution (0.01%, 0.02%, 0.05%), oral finasteride 1 mg, or placebo, once daily for 24 weeks, with hair counted at the vertex via standardized macrophotography.

What they found

All active treatments beat placebo. Target-area hair count increases were: 0.01% dutasteride +32.3, 0.02% +27.5, 0.05% +75.5 hairs/cm², versus oral finasteride +41.2 and placebo +0.07 hairs/cm². The highest-dose topical dutasteride (0.05%) significantly beat oral finasteride (P=0.0083); 69% of the 0.05% group showed marked photographic improvement versus 21% on finasteride. No serious adverse events occurred in any group; only minimal skin irritation was seen.

What it means for you

A dutasteride solution applied directly to the scalp may out-perform the standard finasteride pill for hair regrowth, potentially with less systemic hormone exposure -- an encouraging early finding, but the product is not yet approved or widely available.

Limitations

All participants were Indian men; the entire study team, including all named authors, were employees of the sponsoring company, which also holds a patent on the product -- a significant industry-funding conflict of interest; only 24 weeks of follow-up; no trichoscopy used; needs independent Phase III confirmation before being considered proven.

Funding

Shilpa Medicare Limited (manufacturer); all authors are company employees; company holds patent US 10,993,934 B2 on the product

Read the study ↗ · DOI 10.7759/cureus.89309

A Randomized, Double-Blind, Placebo and Active Controlled Phase II Study to Evaluate the Safety and Efficacy of Novel Dutasteride Topical Solution (0.01%, 0.02%, and 0.05% w/v) in Male Subjects With Androgenetic Alopecia · Panuganti VK, Madala PK, Grandhi VR, Alluri CV, Mohammad J, Sanyasi Rao KSSVV, Dundigalla MR

What they did

Pooled 12 randomized controlled trials comparing minoxidil plus microneedling against minoxidil alone in people with androgenetic alopecia, examining hair count, hair diameter, and doctor-rated improvement.

What they found

Combined therapy significantly improved hair count (standardized mean difference 1.32) and hair diameter (SMD 0.34) compared with minoxidil alone. Doctors' visual assessments favored the combination about 5 times more often (odds ratio 5.01). Needle depth, treatment duration, and device type did not substantially change outcomes. Mild, self-limiting side effects were somewhat more common with the combination (74 vs 59 events) but none were serious.

What it means for you

Adding microneedling (at-home or in-clinic) to minoxidil appears to meaningfully boost hair regrowth beyond minoxidil alone, with only a modest increase in mild irritation risk -- a reasonable, low-cost add-on for people already using minoxidil.

Limitations

Nearly all participants were Asian, Middle Eastern, or North African, so it is unclear whether results generalize to other populations (including typical Western or mixed-ancestry groups); could not analyze results by age; substantial heterogeneity in microneedling schedules across studies.

Funding

No external funding reported

Read the study ↗ · DOI 10.1007/s00403-025-04032-1

Evaluating the efficacy and safety of combined microneedling therapy versus topical Minoxidil in androgenetic alopecia: a systematic review and meta-analysis · Ahmed KMA, Kozaa YA, Abuawwad MT, Al-Najdawi AI, Mahmoud YW, Ahmed AM, Taha MJJ, Fadhli T, Giannopoulou A

What they did

Compared specific PITX2 gene variants between 70 Indian men with androgenetic alopecia and 60 men without it, to see which gene variants were linked to higher odds of baldness.

What they found

Several PITX2 variants were linked to much higher odds of androgenetic alopecia: one variant (rs2200733, CT genotype) was associated with roughly 6-fold higher odds (P<0.001); another (rs13143308, GT genotype) with about 4-fold higher odds (P<0.001); a third (rs10033464, G allele) with roughly 2-fold higher odds (P<0.019). Men carrying multiple risk variants had up to 13-fold greater odds of alopecia versus men with none.

What it means for you

Male pattern baldness has a genetic component beyond the well-known androgen receptor gene, and this particular gene (PITX2) appears relevant specifically in an Indian population -- reinforcing that family history and genetics, not lifestyle, are the dominant drivers for most men with classic pattern baldness.

Limitations

Small sample (70 cases vs 60 controls) -- the authors themselves flag the 'relatively small sample size' as needing larger-scale validation; a single genetic marker study cannot be used for individual risk prediction; the case-control design cannot establish how large a role this gene plays compared with already well-established genes (like the androgen receptor).

Funding

Indian Council of Medical Research (ICMR) Senior Research Fellowship and ICMR Adhoc Project support (Indian government, academic, non-industry)

Read the study ↗ · DOI 10.25259/IJDVL_1147_2023

Association between PITX2 polymorphism and androgenetic alopecia in the Indian population · Murugan M, Sadasivam IP, Manoharan A, Jayakumar S, Vetriselvan Y, Samuel MS, Sambandam R

What they did

Followed patients with severe alopecia areata taking ritlecitinib 50 mg/day for up to 2 years (104 weeks) in an open-label extension study, tracking scalp, eyebrow, and eyelash regrowth alongside side effects.

What they found

By month 24 (observed data), 73.5% of patients had 20% or less scalp hair loss remaining (SALT≤20) and 66.4% had 10% or less remaining; 82.4% reported meaningful overall improvement; eyebrows regrew in 60.8% and eyelashes in 65.7% of patients. On safety: 86.1% had some adverse event (mostly mild-to-moderate), 4.9% had a serious adverse event, and 6.5% stopped the drug due to side effects; rarer events included 6 cases of shingles, 4 serious infections, 3 cancers, and 3 major cardiovascular events.

What it means for you

For people with significant hair loss from alopecia areata, this daily pill can produce major, durable regrowth over 2 years for most people who respond -- but it carries real, if infrequent, risks (shingles, serious infections, rare cancer and cardiovascular events) that need ongoing medical monitoring rather than a 'set and forget' approach.

Limitations

Open-label with no placebo comparison group for this long-term phase, making it hard to fully rule out natural fluctuation in alopecia areata (which can spontaneously improve); sponsored and run by the drug manufacturer (Pfizer); results reported as 'observed' (only in patients still in the study) looked notably better than 'last observation carried forward' analyses that account for dropouts.

Funding

Pfizer Inc. (drug manufacturer)

Read the study ↗ · DOI 10.1111/jdv.20526

Long-term safety and efficacy of ritlecitinib in adults and adolescents with alopecia areata and at least 25% scalp hair loss: Results from the ALLEGRO-LT phase 3, open-label study · Tziotzios C, Sinclair R, Lesiak A, Mehlis S, Kinoshita-Ise M, Tsianakas A, Luo X, Law EH, Ishowo-Adejumo R, Wolk R, Sadrarhami M, Lejeune A

What they did

Pooled existing studies of low-dose oral minoxidil (roughly 0.25-5 mg) used for hair loss, analyzing changes in systolic and diastolic blood pressure, heart rate, and reports of hypotensive (low blood pressure) symptoms.

What they found

No significant change in systolic blood pressure (mean difference -0.13 mmHg) or diastolic blood pressure (mean difference -1.25 mmHg). Heart rate rose slightly but significantly (mean difference +2.67 bpm). Hypotensive symptoms (dizziness/lightheadedness) were reported in 5.0% of patients, with no actual fainting episodes recorded.

What it means for you

For most healthy adults, the low-dose minoxidil pill used for hair loss does not meaningfully lower blood pressure, though it can modestly speed up the heart and occasionally cause mild dizziness. This is reassuring, but does not replace medical supervision, especially for people with existing heart conditions.

Limitations

Full text could not be opened (PubMed page blocked by a cookie wall); summary relies on search-engine excerpts of the abstract. Underlying studies pooled were heterogeneous in dose and duration; mostly short follow-up; retrospective designs in several contributing studies.

Funding

Not confirmed from accessible sources

Read the study ↗ · DOI 10.1016/j.jaad.2024.10.057 · summarised from the abstract

Low-dose oral minoxidil does not significantly affect blood pressure: A systematic review and meta-analysis · Chen M, et al.

What they did

Systematically reviewed 90 global studies (searched through March 2024) reporting telogen effluvium rates, then statistically modeled worldwide and regional prevalence before versus after the pandemic began, using a Bayesian hierarchical model.

What they found

Global telogen effluvium prevalence rose from an estimated 3.44% before the pandemic to 5.41% after it -- roughly a 1.6-fold increase. Regional rates ranged from 2.83% (high-income North America) to 11.11% (East Asia); the lowest country-level estimate was the US (2.08%) and the highest was China (13.33%). Women were affected far more often than men.

What it means for you

COVID-19-related illness and stress caused a real, measurable worldwide rise in diffuse hair shedding, not just anecdotally -- useful context for anyone who noticed heavier shedding roughly 2-4 months after a COVID infection or other major illness/stress, since this pattern typically resolves on its own within 6-12 months.

Limitations

Most included studies were based on outpatient dermatology clinic visits, which may not reflect the general population (many people with shedding never see a doctor); the review could not reliably separate 'acute' (temporary) from 'chronic' telogen effluvium cases; no dengue-specific telogen effluvium data were identified in this review or elsewhere during this research.

Funding

Korea Medical Institute research program; National Research Foundation of Korea grant RS-2023-00249120 (academic, non-industry)

Read the study ↗ · DOI 10.1016/j.jdin.2024.08.018

Global epidemiology of telogen effluvium after the COVID-19 pandemic: A systematic review and modeling study · Jeon JJ, Kim YH, Kang H, Ha MC, Jung SW, Son H, Kim MH, Lee WS, Lee S

What they did

The UK Medicines and Healthcare products Regulatory Agency (MHRA) reviewed spontaneous adverse-event reports and published literature on finasteride's psychiatric and sexual side effects, prompted by patient advocacy and a rise in reported cases.

What they found

Mood changes (depressed mood, depression, and, less often, suicidal thoughts) were reported, more frequently early in treatment. Sexual dysfunction (reduced libido, erectile difficulty) is the most frequent adverse effect, typically appearing early and resolving with continued treatment in most but not all patients; in some cases sexual dysfunction persisted after stopping the drug. The MHRA strengthened product warnings and introduced a patient alert card.

What it means for you

Finasteride (and the related drug dutasteride) carries a small but real risk of mood and sexual side effects that can occasionally persist even after stopping -- men considering these drugs for hair loss should be told about this risk upfront, not just reassured it is rare.

Limitations

Based largely on spontaneous adverse-event reporting, which is prone to reporting bias and cannot prove the drug caused the effects; this is a regulatory bulletin, not a controlled trial. Full text could not be accessed directly (blocked); relied on search-engine summaries and corroborating Medscape/Pharmaceutical Journal coverage of the same MHRA review.

Funding

Not applicable -- regulatory body publication

Read the study ↗ · summarised from the abstract

Safety update: psychiatric and sexual adverse effects with finasteride · Drug and Therapeutics Bulletin editorial panel (MHRA safety review)

What they did

Men aged 18-55 with moderate androgenetic alopecia were randomized to oral minoxidil 5 mg/day plus a topical placebo, or topical minoxidil 5% twice daily plus an oral placebo, for 24 weeks. Hair density was measured by trichoscopy and blinded dermatologists scored standardized photographs.

What they found

No significant difference between groups in the frontal scalp area (P=.27). At the vertex (crown), the oral group gained 21.6% more terminal hair versus a -5.6% change with topical (P=.005); photographic assessment favored oral at the vertex (P=.04) but not frontally. Hypertrichosis (unwanted body/facial hair) was more common with oral (49% vs 25%, P=.02); headache was more frequent with oral (14% vs 2%); scalp irritation/eczema was more common with topical (16% vs 2%). No significant blood pressure or heart rate changes were seen. Only 4 participants (1 oral, 3 topical) stopped due to side effects.

What it means for you

A once-daily oral minoxidil pill can work at least as well as, and at the crown possibly better than, the standard topical liquid/foam -- a reasonable option under medical supervision for men who find the topical messy, irritating, or inconvenient, though it trades scalp irritation for a higher chance of unwanted hair growth elsewhere and headaches.

Limitations

Single-center study; relatively small and underpowered; 25% dropout (partly pandemic-related); only 24 weeks of follow-up; no women included; results may not generalize beyond the doses tested.

Funding

Brazilian Dermatology Society Support Fund (FUNADERM); no pharmaceutical industry funding disclosed

Read the study ↗ · DOI 10.1001/jamadermatol.2024.0284

Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial · Penha MA, et al.

What they did

Followed patients from the BRAVE-AA1 and BRAVE-AA2 trials who had responded (SALT score of 20 or less) by week 52, continuing baricitinib 2 mg or 4 mg through week 104, and tracked whether they kept their hair regrowth, plus anxiety and depression scores.

What they found

Among week-52 responders, 90.7% (4 mg group) and 89.2% (2 mg group) still had a SALT score of 20 or less at week 104. Anxiety and depression scores remained improved throughout. No new safety signals were reported over the full 104-week period.

What it means for you

For people whose alopecia areata responds well to baricitinib in the first year, that improvement is very likely to be sustained through at least a second year of treatment, with no new safety surprises identified -- reassuring for people worried the drug might stop working or cause unexpected harm with longer-term use.

Limitations

Only reports on patients already classified as 'responders' at week 52, so it does not describe what happens to non-responders over the long term; full text could not be accessed directly (paywalled), so details rely on a secondary trade-press summary (Dermatology Times) and search-engine excerpts rather than the primary article; these BRAVE-AA trials are run and funded by the drug's manufacturer.

Funding

Likely Eli Lilly and Company (manufacturer), consistent with the BRAVE-AA trial program sponsorship; not explicitly confirmed in the accessible text

Read the study ↗ · DOI 10.1111/jdv.19665 · summarised from the abstract

Long-term efficacy and safety of baricitinib in patients with severe alopecia areata: 104-week results from BRAVE-AA1 and BRAVE-AA2 · Senna M, Mostaghimi A, Ohyama M, et al. (full author list not confirmed from accessible sources)