Fractional CO2 Versus Radiofrequency as Hair Regrowth Enhancers for Female Androgenic Alopecia: A Randomized Controlled Trial

BACKGROUND Androgenic alopecia (AGA) is a cosmetically disfiguring condition, which accounts for most cases of diffuse hair loss among females, negatively impacting their quality of life. Combining Fractional CO 2 (FCO 2 ) or Fractional Microneedling Radiofrequency (FMRF) with topical minoxidil 5% could achieve a better clinical outcome. OBJECTIVE To compare efficacy and safety of FCO 2 and FMRF, combined with minoxidil, for the treatment of female AGA. METHODS Thirty patients with female AGA were randomly assigned to 2 groups (simple computerized randomization). Group A patients received FCO 2 to 1 randomly selected side of the scalp, and Group B patients received FMRF to 1 randomly selected side of the scalp (picking masked labeled cards). Patients received minoxidil 5%. RESULTS Significant increase in trichoscopic hair counts and density was found after treatment with each modality whether minoxidil 5% alone, minoxidil combined with FCO 2 , or minoxidil combined with FMRF. A significantly greater increase in trichoscopic hair counts and density followed the treatment with minoxidil + FMRF, compared to either minoxidil + FCO 2 or minoxidil alone. CONCLUSION It can be proposed that combining FMRF with minoxidil for the treatment of female AGA could be associated with higher efficacy and tolerability, compared to the other treatment modalities.