China: In a breakthrough discovery in dermatology, a recent study has illuminated the potential of botulinum toxin A as a novel therapeutic option for female pattern hair loss (FPHL). The findings, published in Skin Research and Technology, offer new hope for individuals grappling with this distressing condition and signify a paradigm shift in hair loss management.

The study suggested the effectiveness of Botulinum Toxin Type A (BTA) for female pattern hair loss is limited to three months. However, it can be considered for tentative use after effective communication with patients. Further observation and study are needed for BTA's long-term safety and efficacy in treating FPHL.

Female pattern hair loss, characterized by progressive hair thinning primarily over the crown and frontal scalp regions, affects a significant proportion of women worldwide, exerting profound psychological and emotional impact. Despite its prevalence, treatment options have traditionally been limited, with topical minoxidil and oral medications like spironolactone comprising the mainstay of therapy.
However, the emergence of botulinum toxin A, commonly known for its cosmetic applications in wrinkle reduction, heralds a promising alternative for FPHL sufferers. Xiuzu Song, The Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou City, China, and colleagues aimed to assess the safety and efficacy of subcutaneous injections of Botulinum Toxin Type A in FPHL treatment.
The study included outpatients with FPHL who exhibited an allergic reaction to minoxidil solution. FPHL diagnosis was established through trichoscopy and clinical examination. Inclusion criteria involved patients with no prior treatment within the last year and without comorbidities.
BTA, specifically 100 units, was mixed with 2 mL of 0.9% normal saline. Twenty injection target sites, spaced 2–3 cm apart, were symmetrically marked on the scalp's hairless area. At each target site, a dosage of five units was injected intradermally. Scalp's representative photographs and dermoscopic images were captured before and after three months of treatment.
The study included ten women with FPHL, aged between 26 and 40 years. The average age was 30.3 ± 4.64 years, and all patients had a positive family history of Androgenetic Alopecia. The average disease duration was 3.70 ± 1.42 years.
The study led to the following findings:
According to patients' self-assessment, after one month of treatment, 10 FPHL patients reported experiencing moderate to marked improvement in symptoms related to scalp oil secretion.
Three months later, dermatological assessments showed that three had mild improvement, six had no change, and one had a worsening condition.
No adverse effects were observed.
The study showed that the effectiveness of Botulinum Toxin Type A for treating Female Pattern Hair Loss treatment is limited to 3 months. However, it can be considered for tentative use after effective communication with patients.
The study limitations were the small sample size of this experiment, FPHL patients of different severity have not been grouped and stratified compared, and for a short follow-up period.
"The long-term safety and efficacy of BTA in treating FPHL require further observation and study," the researchers concluded.
Reference:
Hu, L., Dai, Y., Zhang, H., Wu, Y., Wang, T., & Song, X. (2024). Efficacy and safety of botulinum toxin A in the treatment of female pattern hair loss. Skin Research and Technology, 30(4), e13696. https://doi.org/10.1111/srt.13696