International Journal of Trichology International Journal of Trichology
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 4  |  Issue : 4  |  Page : 236-245

Topical Melatonin for Treatment of Androgenetic Alopecia


1 Department for Dermatology, Allergology and Venereology, University of Lübeck, Lübeck, Germany
2 Center for Dermatology and Hair Diseases, Wallisellen/Zurich, Switzerland
3 Thalwil, Switzerland
4 European Dermatology Institute, Milan, Italy
5 Department for Dermatology, Clinic for Skin Diseases, Jena University Hospital, Jena, Germany

Correspondence Address:
Tobias W Fischer
Department of Dermatology, Clinic for Dermatology, Allergology and Venereology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck
Germany
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-7753.111199

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Background: In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (AGA), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo studies. Materials and Methods: One pharmacodynamic study on topical application of melatonin and four clinical pre-post studies were performed in patients with androgenetic alopecia or general hair loss and evaluated by standardised questionnaires, TrichoScan, 60-second hair count test and hair pull test. Results: Five clinical studies showed positive effects of a topical melatonin solution in the treatment of AGA in men and women while showing good tolerability: (1) Pharmacodynamics under once-daily topical application in the evening showed no significant influence on endogenous serum melatonin levels. (2) An observational study involving 30 men and women showed a significant reduction in the degree of severity of alopecia after 30 and 90 days ( P < 0.001) based on questionnaires completed by investigators and patients. (3) Using a digital software-supported epiluminescence technique (TrichoScan) in 35 men with AGA, after 3 and 6 months in 54.8% to 58.1% of the patients a significant increase of hair density of 29% and 41%, respectively was measured (M0: 123/cm² M3: 159/cm² M6: 173/cm²) ( P < 0,001). (4) In 60 men and women with hair loss, a significant reduction in hair loss was observed in women, while hair loss in men remained constant ( P < 0.001). (5) In a large, 3-month, multi-center study with more than 1800 volunteers at 200 centers, the percentage of patients with a 2- to 3-fold positive hair-pull test decreased from 61.6% to 7.8%, while the percentage of patients with a negative hair-pull test increased from 12.2.% to 61.5% ( P < 0.001). In addition, a decrease in seborrhea and seborrheic dermatitis of the scalp was observed. Conclusions: Since safety and tolerability in all of the studies was good, the topical application of a cosmetic melatonin solution can be considered as a treatment option in androgenetic alopecia.


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