The efficacy of tretinoin gel 0.1% followed by topical minoxidil-5% in individuals with androgenetic alopecia

Abstract

Androgenetic alopecia (AGA) is a progressive hair loss condition, with a higher prevalence among males aged 30-50 years in the Indian population. Minoxidil, a topical treatment, is commonly used but shows variable efficacy, particularly in non-responders. Recent studies suggest that combining minoxidil with tretinoin may enhance its effectiveness by increasing scalp absorption and improving hair follicle activity. This case series included 20 patients with AGA (male Norwood-Hamilton grades II-V and female Ludwig grades I-II), clinically diagnosed as non-responders to minoxidil. Participants received a combination therapy of 0.1% tretinoin gel and 5% minoxidil solution over 90 days. Improvements were observed in trichoscopic parameters where 32.9% increase in hair count and density, 3.5% rise in anagen-phase hairs, and 4.8% increase in hair thickness. Investigator global photography assessments revealed 20% of participants showed 51-75% improvement. Advanced AGA grades showed partial reversal. Patient self-assessments indicated 50% improvement in hair quality, 70% in hair coverage, and 75% in overall appearance. Most participants reported new hair growth (80%) and satisfaction with treatment. The combination of 0.1% tretinoin gel and 5% minoxidil demonstrated efficacy in improving hair growth and patient satisfaction in AGA patients who are non- responder to minoxidil.