Efficacy and Safety of Mesotherapy With 0.5% Minoxidil Versus Topical 2% Minoxidil for Female Androgenetic Alopecia: A Randomized Controlled Trial

Objective To evaluate the efficacy and safety of mesodermal injection of low‐concentration minoxidil versus topical minoxidil in treating female androgenetic alopecia (FAGA). Methods This single‐blind, randomized, controlled trial enrolled 40 FAGA patients divided into experimental ( n = 20) and control groups ( n = 20). The experimental group received mesodermal injections of 0.5% minoxidil solution once every 1–4 weeks for 16 weeks, while the control group applied topical 2% minoxidil solution twice daily for 16 weeks. The primary efficacy endpoints were changes in trichoscopic parameters (e.g., hair density and diameter) before and after treatment. The secondary endpoints comprised hairline height and physician/patient assessments. Results After 16 weeks of treatment, the experimental group demonstrated significantly greater increases versus the control group in hair density (8.70 ± 6.17 versus 4.50 ± 2.98 hairs/cm 2 , respectively; p = 0.009), hair coverage ( p = 0.004), and hairline height reduction (4.81 ± 0.60 mm versus 3.95 ± 0.82 mm; p = 0.002). Physician assessments indicated greater improvement in the experimental versus control groups ( p = 0.04), while patient self‐assessments showed no significant difference between the groups. No serious adverse events occurred in either group. Conclusion For patients with FAGA, 0.5% minoxidil mesotherapy demonstrated superior efficacy versus conventional topical therapy in promoting hair growth, improving hair quality, and lowering the hairline, with good safety. This therapy is an effective treatment option. Trial Registration: China Clinical Trial Registry: ChiCTR2500110837