SYSTEMATIC REVIEW article
Front. Med.
Sec. Dermatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1632139
This article is part of the Research TopicUnderstanding Hair Disorders: Clinical Challenges and Emerging SolutionsView all articles
Comparing Minoxidil-Finasteride Mixed Solution with Minoxidil Solution Alone for Male Androgenetic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Provisionally accepted
- 1Capital Medical University, Beijing, China
- 2Qingdao Jimo People's Hospital, Qingdao, Shandong Province, China
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Background: This meta-analysis aimed to evaluate the efficacy of topical minoxidil-finasteride combination (MFX) versus minoxidil monotherapy (MNX) for male androgenetic alopecia (AGA). Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception through May 2025.Methodological quality was assessed using Cochrane Risk of Bias 2.0 tool, with statistical analyses performed using RevMan 5.3 and evidence certainty evaluated through GRADEpro GDT. CRD420251054497 Results: This meta-analysis of seven RCTs (N=396) demonstrated superior efficacy of topical minoxidil-finasteride combination (MFX) over monotherapy (MNX) for male androgenetic alopecia. Pooled analyses showed clinically meaningful improvements in hair density (MD=9.22, p=0.04), hair diameter (MD=2.26, p=0.005), and global photographic assessment (MD=0.79, p<0.00001), all exceeding minimal clinically important thresholds. The treatment effect followed a hierarchical pattern, with MFX showing strongest benefits for marked improvement (OR=3.29, p=0.015) and more variable results for moderate outcomes. While primary outcomes demonstrated robust effects with moderate certainty evidence, observed heterogeneity in some endpoints and sample size limitations suggest the need for standardized assessment methods and larger confirmatory studies to strengthen these conclusions. Conclusion: Topical minoxidil-finasteride combination therapy demonstrates superior efficacy over monotherapy for male AGA, supporting its clinical adoption. However, larger, standardized trials are needed to confirm long-term outcomes and optimize treatment protocols.
Keywords: Minoxidil, Finasteride, Androgenetic Alopecia, combination therapy, randomized controlled trials, Meta-analysis
Received: 27 May 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Li, Huang, Zhou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhongbao Zhou, 346894383@qq.com
Yong Zhang, doctorzzb@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.