The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta-analysis

Dermatol Ther. 2020 Jul;33(4):e13741. doi: 10.1111/dth.13741. Epub 2020 Jul 2.


Androgenetic alopecia (AGA) is the most common type of baldness affecting both men and women. Studies investigating combination therapies for AGA reported greater efficacy than monotherapy but without rigorous examination. The authors performed a meta-analysis and systemic review to further verify the evidence. To evaluate the effectiveness of three common combination therapies of minoxidil with finasteride, low-level laser light therapy (LLLT) or microneedling versus minoxidil monotherapy. We conducted a systematic review of randomized controlled trials (RCTs) of combination therapies consisting of topical minoxidil for AGA through April 2020. Quality assessment and data analysis were performed by Review Manager 5.3. Fifteen studies met the inclusion criteria involving a total of 1172 AGA patients. We conducted meta-analysis for three groups of combined treatment separately, and all were superior to monotherapy in terms of global photographic assessment (P < .05). Combination of LLLT or microneedling with minoxidil also showed significant increase in hair count (P < .05) compared to monotherapy. The present study suggests that combination therapy could be an effective, safe and promising option for the treatment of AGA. However, more RCTs are needed to further investigate and confirm the efficacy of combined treatment.

Keywords: androgenetic alopecia; combination therapy; efficacy; minoxidil.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Alopecia* / diagnosis
  • Alopecia* / drug therapy
  • Female
  • Finasteride
  • Hair
  • Humans
  • Male
  • Minoxidil* / adverse effects
  • Treatment Outcome


  • Finasteride
  • Minoxidil