Dermoscopic evaluation of the efficacy of combination of topical spironolactone 5% and minoxidil 5% solutions in the treatment of androgenetic alopecia: A cross sectional‐comparative study

Abstract Background Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women. Aim To assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes. Patients and Methods One hundred and twenty patients diagnosed with AGA were divided into three groups; each group is composed of 40 patients. Group A ( n = 40) were treated with a 5% topical minoxidil solution, group B ( n = 40) were treated with a 5% topical spironolactone solution, and group C ( n = 40) were treated with a 5% topical minoxidil and spironolactone combination. Results Following the initiation of treatment and at 6 weeks (midterm), reduction in all dermoscopic features was observed in all groups; however, it was not statistically significant except for vellus hair reduction ( p = 0.033). On the contrary, upright regrowing hairs were insignificantly increased in all groups ( p = 1.088). The pattern of dermoscopic features remained to insignificantly decrease toward the end of 12 weeks treatment (full term) in all studied groups except for vellus hair that showed further significant reduction toward the end of the study ( p = 0.011). Conclusion Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice‐daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages.