Melatonin in der topischen Behandlung der androgenetischen Alopezie

On the search for new substances against androgenetic alopecia, melatonin, a strong antioxidant and growth modulator was identified as a promising candidate from in vitro and in vivo studies. 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 melatonin plasma levels. (2) A use test with 30 men and women showed by evaluation of investigators and patients questionnaires a significant reduction of severeness of alopecia after 30 and 90 days (p<0.001). (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 of hair loss was observed in women, while hair loss in men was kept on a constant level (p<0.001). (5) In a large 3-months multi-center study with more than 1800 volunteers in 200 centers, the percentage of patients with 2- to 3-fold positive hair pull test decreased from 61.6% to 7.8%, while the percentage of patients with negative hair pull test increased from 12.2.% to 61.5% (p<0.001). Additionally, a decrease of seborrhea and seborrhoic dermatitis of the scalp skin was observed. Since safety and tolerability in all studies was good, the topical application of a cosmetic melatonin solution can be considered as a meaningful treatment option or complementary treatment of androgenetic alopecia.