Oral dutasteride 0.5mg ranked highest in effectiveness for increasing hair density among all evaluated prescription and over-the-counter treatments for male androgenetic alopecia, according to a recent study.
The analysis showed that oral dutasteride 0.5 mg produced a mean improvement of 19 hairs/cm² compared with control. “The most efficacious comparator was dutasteride 0.5 mg (oral) in the base [network meta-analysis] NMA ([surface under the cumulative ranking curve] SUCRA = 95.8%) and severity-adjusted NMA (SUCRA = 94%),” noted the lead author Aditya K. Gupta, MD, PhD, FRCPC, of the Mediprobe Research Inc., London, Ontario, Canada, and colleagues.
Oral finasteride 1 mg and topical minoxidil 5% also demonstrated substantial increases in hair density, with mean gains of 12 and 20 hairs/cm², respectively. Among over-the-counter products, topical melatonin and rosemary oil were evaluated for relative efficacy compared to conventional treatments.
A Bayesian NMA was conducted to compare the efficacy of conventional and nonconventional, over-the-counter treatments for male androgenetic alopecia. The study evaluated both US Food and Drug Administration–approved medications and alternative agents commonly used by patients seeking hair regrowth.
Published in the Journal of Cosmetic Dermatology, the researchers performed systematic searches in PubMed and Scopus on April 30, 2025, with no date restrictions. Eligible randomized controlled trials included men diagnosed with androgenetic alopecia, and the primary endpoint was change in total hair density (hairs/cm²) after 24 weeks of treatment. Data from 24 randomized controlled trials were analyzed under a fixed-effects Bayesian model with uniform priors. The analysis expressed relative efficacy as mean differences in hair density and used SUCRA values to rank treatments by effectiveness. Evidence quality was assessed using the Risk-of-bias VISualization tool, and node-splitting analysis was applied to confirm consistency between direct and indirect evidence.
Eight conventional therapies were compared—oral dutasteride 0.5 mg, oral finasteride (1 mg and 5 mg), topical finasteride (0.25% and 1% gel), oral minoxidil (5 mg,) and topical minoxidil (2% and 5%)—against seven over-the-counter options, including topical rosemary oil, melatonin, saw palmetto, watercress, procyanidin, marine complex, and ketoconazole 2%. Most comparisons showed strong agreement between direct and indirect data, indicating network consistency.
The researchers reported no conflicts of interest
Source: Journal of Cosmetic Dermatology
