A Comparative Clinical and Trichoscopic Study Between Fractional Radiofrequency Microneedling (FRM) Versus Intralesional Steroids in Treatment of Alopecia Areata

Presenter: Sarah Akram Kamal Hussein Orabi

Alopecia areata (AA) is an autoimmune hair-loss disorder associated with psychosocial burden, and alternative treatments to intralesional corticosteroids (ILCS) are being explored. This comparative clinical and trichoscopic study assessed fractional radiofrequency microneedling (FRM) versus ILCS in 24 patients with multifocal patchy AA. In each patient, three patches were randomly assigned to FRM, ILCS, or an untreated control. Six treatment sessions were administered at three-week intervals. Outcomes included trichoscopic scores for dystrophic and terminal hairs, Severity of Alopecia Tool (SALT) score, Physician Global Assessment (PGA), and patient satisfaction. Both FRM and ILCS demonstrated clinical and trichoscopic improvement, with no statistically significant differences in trichoscopic hair scores, PGA, or patient satisfaction. FRM may be an effective and well-tolerated treatment option for patchy alopecia areata , offering a potential alternative to intralesional corticosteroids  with fewer adverse effects.

Combination Therapy Versus Monotherapy in Androgenetic Alopecia: A Comparative Systematic Review and Meta-Analysis of Treatment Strategies

Presenter: Laurentia Fidella Averina Setia Santoso

Androgenetic alopecia (AGA) is a common cause of adult hair loss, with variable responses to standard treatments. This network meta-analysis evaluated the efficacy and safety of nonsurgical combination therapies compared with monotherapies. A systematic review of eight databases identified 43 eligible  studies involving 3,174 patients from a total of 2,171 records published over the previous decade. Nonsurgical combination therapies (including topical/oral minoxidil, topical finasteride, topical 2% flutamide, oral vitamin D3, topical/oral spironolactone, oral bicalutamide 25 mg/d, fractional, low-level laser therapy, microneedling, platelet-rich plasma, basic fibroblast growth factor, secretome from adipose-derived stem cells, and thread therapy employing poly-L-lactic acid)were compared with monotherapy or placebo for hair density, hair thickness, shaft diameter, global photographic assessment (GPA), and adverse events. Combination treatments generally favoured improvements in hair density, although most comparisons were not statistically significant. Minoxidil plus topical flutamide or PLLA threads performed better than minoxidil alone (SMD 0.85) Standardised mean differences (SMDs) favoured microneedling plus minoxidil (2.69), platelet-rich plasma plus minoxidil (1.55), and laser plus minoxidil (1.40). Minoxidil plus topical finasteride significantly improved hair shaft diameter versus minoxidil alone (SMD 0.68). Laser plus minoxidil and microneedling plus minoxidil also favoured hair thickness and GPA outcomes. Adverse events showed no discernible differences between treatments.

Combination therapies, including regenerative approaches, may improve treatment outcomes in AGA compared with monotherapy, without a discernible increase in adverse events. However, short follow-up periods (≤6 months), inadequate reporting of ethnicity, and methodological limitations highlight the need for larger, well-designed RCTs with longer follow-up to establish long-term efficacy and safety .

Early Intervention of 5% Minoxidil Usage Yields Improved Hair Regrowth in Male Androgenetic Alopecia: The Effects of Age and Stage

Presenter: Ramond J Waide

The age at which treatment begins and the severity of hair loss may influence hair regrowth outcomes in male androgenetic alopecia (AGA). This post hoc analysis of a Phase III study assessed changes in target area hair count (TAHC) after 16 weeks of twice-daily 5% minoxidil topical foam (MTF), according to age and baseline hair loss severity. The study included men with Norwood–Hamilton Type III (vertex), Type IV, and Type V hair loss, representing different stages of male androgenetic alopecia. By age group, mean changes in hair count were 26.25 in younger millennials (20–30 years), 19.22 in older millennials (31–40 years), and 20.41 in Generation X (41–50 years). Hair regrowth with MTF was significantly greater than with placebo across all three age groups (p<0.005). Men treated with 5% MTF twice daily demonstrated improvements in non-vellus hair counts across all age groups, from baseline for Type III hair loss pattern than for Type IV and Type V.  By Norwood-Hamilton classification, mean hair count increases were 23.06 for Type III, 15.83 for Type IV, and 21.57 for Type V hair loss, with significant improvement versus placebo across all three classifications (p<0.002). Early intervention with topical minoxidil may improve hair regrowth in male AGA, with greater improvements observed in younger men and those with less severe hair loss. These findings may help guide evidence-based treatment decisions and inform clinical approaches to managing male AGA.

EADV Congress 2026, 30 Sep - 03 Oct 26, Vienna.