Trichoscopic Evaluation of the Effectiveness of Topical Stemoxydine for Hair Restoration in Androgenetic Alopecia: A Prospective Pre-Post Single-Arm Exploratory Study.

BACKGROUND

Androgenetic Alopecia (AGA) is a prevalent hereditary disorder leading to hair loss. Stemoxydine, a competitive (Prolyl 4-hydroxylase) inhibitor, may activate Hypoxia-Inducible Factor 1-alpha signaling and shorten the hair kenogen phase, potentially increasing hair density as a proposed treatment for AGA.

AIMS: This study aimed to evaluate the effectiveness of topical Stemoxydine in the treatment of AGA.

PATIENTS AND

METHODS

The study included 35 patients with AGA treated with a topical solution of Stemoxydine twice daily for 3 months. Clinical outcomes were evaluated at 6 and 12 weeks using clinical photography, dermoscopy, and digital dermoscopy. The primary endpoint was the percentage of clinical improvement after 12 weeks of treatment application. Dermoscopy and digital image analysis were performed to assess hair growth, density, and diameter. Subgroup analysis compared outcomes between males and females. Adverse events were recorded and evaluated for severity and tolerability.

RESULTS

A total of 35 participants (23 females, 12 males) aged 19-45 years (mean ± SD: 29.2 ± 6.98) were enrolled. The mean age was 31.1 ± 7.28 years for females and 25.7 ± 4.87 years for males. A positive family history of alopecia was reported in 62.9% of participants. Baseline alopecia severity included Grade 2 in 25.7%, Grade 3 in 45.7%, and Grade 4 in 28.6% of cases. After 3 months of treatment application, we observed a median clinical improvement of 80% (range: 35%-100%). As per the Quartile Grading Scale, 57.1% of patients demonstrated significant improvement, while 34.3% showed moderate improvement. Statistically significant improvements in AGA grades were observed post-treatment. The dermoscopic evaluation revealed new hair growth in 97.1% of patients by 1.5 months, with digital analysis demonstrating significant increases in both hair density (p < 0.001) and diameter (p < 0.001). Subgroup analysis indicated males achieved significantly more significant clinical improvement (p < 0.001), increased hair density (p < 0.001), and larger diameter (p = 0.02) compared to females. Adverse events were mild and well-tolerated, with the most common being redness (22.9%).

CONCLUSION

In conclusion, topical Stemoxydine demonstrated significant clinical benefits in treating AGA, enhancing hair density with minimal adverse effects.