Comparative study between fractional CO2 laser alone versus fractional CO2 laser combined with topical dutasteride in treatment of male androgenic alopecia

Androgenic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by marked hair follicle miniaturization. AGA is a challenging skin condition with limited treatment results. Laser light can promote hair growth at specific wavelengths. The efficacy of fractional CO2 laser in scalp AGA treatment was reported in a few studies. We aimed to compare the efficacy of fractional CO2 laser alone versus the combination of fractional CO2 laser with topical dutasteride in the treatment of male AGA. 30 male patients with AGA were enrolled in the study; they were divided into two groups. All patients received three sessions of ablative fractional CO2 laser one month apart on the scalp, where group (I) patients were subjected to laser sessions only, and group (II) patients were subjected to topical dutasteride, first immediately after each session and secondly fifteen days after each session. The evaluation was done according to dermoscopy (DermLite^® DL4) and photographic assessment. Patient satisfaction and side effects were reported. According to the global photo assessment, the combination of fractional CO2 laser with topical dutasteride showed a statistically significant improvement compared to the fractional CO2 laser alone group. The combination of fractional CO2 laser with topical dutasteride is more efficient in improving male androgenic alopecia than fractional CO2 laser alone according to the investigator's global assessment. There was a significant improvement in all dermoscopic parameters in both groups.