Background Androgenetic alopecia involves the gradual miniaturization of hair follicles, resulting in progressive hair loss. Despite its prevalence, it remains a therapeutic challenge. Current treatments, such as minoxidil and oral finasteride, have limitations. Botulinum toxin type A (BTXA) offers a complementary approach by relaxing scalp muscles, potentially improving blood flow and prolonging hair follicle lifespan. Objectives This review aims to evaluate the therapeutic potential of BTXA in AGA treatment by analyzing recent literature. The primary focus is to assess BTXA’s effectiveness, underlying mechanisms, and safety as an adjunctive therapeutic option. Methods A systematic search of PubMed identified studies on BTXA for AGA from the database’s inception to December 2024. Emtree and MeSH terms such as “Botulinum Toxins, Type A” and “Androgenetic Alopecia” were used along with additional combinations designed to thoroughly identify relevant studies in the field. Eleven studies met PRISMA guidelines and predefined inclusion and exclusion criteria. Results BTXA treatment proved effective in androgenetic alopecia, increasing hair density by 13%–20% within 12–24 weeks ( p < 0.05) and improving follicle diameter by 3 months ( p < 0.001). It reduced DHT‐induced apoptosis in dermal papilla cells via anti‐inflammatory mechanisms and improved seborrhea and scalp vascularization with no significant adverse effects, supporting its role as a safe adjunctive therapy. Conclusions BTXA improves hair density and follicle health in AGA through enhanced vascular dynamics and anti‐inflammatory actions. It is a promising adjunctive therapy requiring further studies to refine protocols and assess long‐term outcomes.
Zygmunt et al. (2026) studied this question.