TOPLINE:

Skin patting and iontophoresis with 6% dutasteride gel significantly improved hair density and shaft diameter in men and menopausal women with treatment-resistant androgenetic alopecia. This combination yielded meaningful clinical and trichoscopic improvements and high patient satisfaction, with no adverse events.

METHODOLOGY:

• Researchers conducted an open-label, non-randomised, single-centre pilot study, enrolling 20 adult patients with androgenetic alopecia (mean age, 39 years; 50% men) unresponsive to 1 year or more of standard therapy, including topical minoxidil and/or oral finasteride.
• The study was divided into three phases: screening at baseline, four monthly sessions of skin patting and iontophoresis with 6% dutasteride gel, and an 8-week follow-up after completion of treatment.
• Researchers assessed hair density and shaft diameter in the frontal and vertex scalp regions, along with pull tests conducted at baseline and 8 weeks post-treatment.
• Patient-reported outcomes were assessed through a structured questionnaire evaluating perceived effectiveness on a 5-point Likert scale; cosmetic satisfaction on a 0-4 scale; and treatment tolerability rated as unpleasant, neutral, or pleasant.

TAKEAWAY:

• Hair density improved significantly in both the frontal and vertex regions, with the mean frontal hair density increasing from 113 at baseline to 131 hairs per cm² at 6 months (P < .001) and the mean vertex hair density increasing from 94.7 to 109 hairs per cm² (P < .001).
• Hair shaft diameter increased significantly in both treatment areas, with the average hair shaft diameter increasing from 0.0508 to 0.0582 mm in the frontal region (P = .046) and from 0.0521 to 0.0609 mm in the vertex region (P < .001).
• Pull test scores were significantly improved, decreasing from a mean of 8.25 hairs at baseline to 3.40 hairs at follow-up (P < .001), indicating reduced hair shedding and enhanced hair retention.
• Patient satisfaction remained high, with 70% rating the treatment as moderately to very effective; the mean cosmetic satisfaction score was 3.4, and 85% described the procedure as pleasant, with no adverse events recorded during treatment or follow-up.

IN PRACTICE:

"Delivery of dutasteride gel through SPi [skin patting] and iontophoresis appears to be a promising therapeutic option for AGA [androgenic alopecia] in treatment-resistant men and menopausal women. The combination of physical and pharmacological mechanisms produced meaningful clinical and trichoscopic improvements with excellent patient satisfaction and no adverse effects," the authors concluded, suggesting that, "larger, controlled trials are warranted to validate these preliminary findings and refine treatment protocols."

SOURCE:

This study was led by Stephano Cedirian, Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy. It was published online on September 03, 2025, in Dermatology and Therapy.

LIMITATIONS:

The pilot study design had several methodological constraints that limited interpretation of results. The small sample size reduced the statistical power and limited the generalisability of findings. The study lacked a comparator arm, had a short follow-up duration, and relied on non-validated outcome measures.

DISCLOSURES:

The publication fee was funded by APS Srl. One author disclosed serving as an Editorial Board Member of Dermatology and Therapy and currently working as a speaker for Tricopat. The remaining authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.