A systematic review of erbium lasers in the treatment of androgenetic alopecia.

Androgenetic alopecia (AGA) is the most common form of hair loss, affecting a significant portion of both men and women. Despite the availability of various treatments, challenges such as limited efficacy, ongoing treatment requirements, side effects, and high costs persist. We sought to evaluate the efficacy and safety of erbium lasers, specifically erbium-doped yttrium-aluminum-garnet (Er: YAG) and erbium: glass lasers, in the management of AGA. A comprehensive search of PubMed/Medline, Web of Science, and Ovid-Embase databases was conducted until November 18th, 2023, adhering to PRISMA guidelines. Clinical studies involving Er: YAG or erbium: glass lasers for AGA treatment were included. A total of 12 studies recruiting 344 patients were included in this study; six of them investigated Er: YAG and six others evaluated erbium: glass laser. As a result, both erbium lasers were effective in treating AGA with respect to hair density, growth rate, and hair thickness. Erbium: glass lasers were particularly effective with combination therapies, such as those with minoxidil or Platelet-rich plasma. Er: YAG lasers also showed promising results, although some studies reported variability in patient satisfaction and aesthetic outcomes. The safety profile of erbium lasers was generally favorable, with minimal adverse effects. Erbium lasers, especially when used in combination with other therapies, show considerable potential in managing AGA. However, variability in treatment protocols and patient responses highlights the need for further research.