Effects and Safety of Botulinum Toxin Injection in Treatment of Androgenetic Alopecia: A Meta-analysis and Systematic Review

Dermatol Surg. 2025 Jan 22. doi: 10.1097/DSS.0000000000004557. Online ahead of print.

Abstract

Background: Androgenetic alopecia (AGA) is a prevalent condition that significantly affects the psychosocial well-being of many individuals, and its treatment remains a clinical challenge. Botulinum toxin (BTX) injections have been reported to have a therapeutic effect on AGA. Although several studies have explored the efficacy and safety of this novel treatment, most are clinical studies with small sample sizes.

Objective: To evaluate the efficacy and safety of BTX injections in the treatment of AGA through a meta-analysis and systematic review.

Methods: A comprehensive literature search was conducted using PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, ScienceDirect, Springer, and Web of Science to identify studies investigating the use of BTX in the treatment of AGA. The primary outcome was hair count.

Results: Eight studies were included in the systematic review. The pooled data demonstrated a statistically significant increase in hair count in patients treated with BTX compared with the control group (standardized mean difference = 1.02; 95% confidence interval, 0.30-1.74, p < .05).

Conclusion: Injectable BTX seems to be a promising treatment for AGA, showing significant efficacy and good safety.