Evaluating the efficacy of low-level laser-based treatments for androgenetic alopecia: A network meta-analysis

Abstract Background: Androgenetic alopecia (AGA) is a common hair disorder affecting both sexes, causing a significant psychological burden. Patients with AGA experience hair miniaturization and reduced patterned hair density. While topical minoxidil (TM) and oral finasteride are first-line treatments, outcomes remain unsatisfactory. Low-level laser therapy (LLLT) has shown efficacy in treating alopecia when combined with other interventions. Objectives: We conducted a network meta-analysis (PROSPERO: CRD42025634789) to rank different LLLT treatments for AGA. Methods: A comprehensive literature search across seven databases up to September 2024 identified randomized controlled trials involving AGA patients receiving LLLT treatments. Hair density, hair diameter, and adverse events were analyzed. Results: A total of 26 randomized controlled trials with 1638 participants were included in the network meta-analysis. Compared with shams, botulinum injection combined with red laser (RL) and TM was the most effective intervention for increasing hair density (odds ratio [OR], 13.55; 95% confidence interval, 4.26–22.84), followed by RL + light-emitting diode (LED) + platelet-rich plasma (PRP) injection and RL + PRP injection. For increasing hair thickness/diameter, RL + LED + PRP injection was the most effective (OR, 8.30; 95% confidence interval, 1.68–14.91). No severe side effects were reported. Adverse events were most frequent with RL and PRP injection but not statistically significant. Conclusion: Botulinum injection + RL + TM and RL + LED + PRP injection are the most effective adjuvant LLLT-based therapies for increasing hair density and diameter. LLLT combined with interventions demonstrates significant efficacy and safety, making it a promising option.