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. 2022 Dec 23;9(2):104–110. doi: 10.1159/000527782

Table 1.

Summary of studies examining the efficacy of combined therapy versus monotherapy

Reference Patient population Experimental groups Assessment Results
Ferrara 2021 [16] 21 men with AGA 12 min of LLLT followed by topical minoxidil application (1 mL of 5% solution), to the affected scalp two times per day for 6 months. LLLT devices were modified such that the left half emitted light, and the right half did not Efficacy assessed by blinded analyses of clinical photos and automated phototrichograms (TrichoScan) taken before treatment and after 3 and 6 months of treatment In combined treatment group, the number of total hairs was significantly increased after 3 (p < 0.001) and 6 months (p = 0.001)
An increase was observed on the minoxidil-only side, at both 3 (p < 0.001) and 6 months (p < 0.001)
No statistically significant differences were detected between sides (p > 0.05)

Mahe 2021 [17] 135 volunteers with alopecia Group A: 45 patients received full-head exposure of 0.1 J/cm2 once per day for 70 s and used minoxidil 2% twice daily for 5 straight days per week for 6 months
Group B: 45 used minoxidil 5% twice daily for 5 consecutive days per week for 6 months
Group C: 22 patients who received no treatment
Change in hair density measured by Tiff counting method
Tiff counting method: phototrichogram photograph from pre-shaved area of the scalp of 1 cm2
New photographs are taken of the same precisely delineated area after 1.5, 3, 4, and 6 months of treatment
Similar increase in hair density in the combined treatment group and the 5% minoxidil treatment group compared to control
At 6 months, the rate of increase in hair growth began to decrease in the 5% minoxidil group but was sustained in the combination group

Liu 2021 [14] Ninety women (age between 18 and 60 years old) with FPHL Group A: 30 patients received a 30-min laser helmet treatment with iHelmet device (650 nm) at home every other day for 6 months
Group B: 30 patients used 5% minoxidil twice daily for 6 months
Group C: 30 patients received a combination of both 5% minoxidil twice daily and iHelmet device (650 nm) 30 min every other day for 6 months
Hair density (n/cm2) and hair thickness evaluated by standardized phototrichograms recorded at baseline, 3 and 6 months
The levels of scalp oil secretion assessed by TrichoScan digital image analysis conducted at baseline and 6 months
Global macroscopic photographs taken at baseline and 6 months were assessed by 3 blinded experts
Hair microscopy and global photographs showed hair density and hair diameter of the three groups were significantly improved (p < 0.05)
Sebum secretion significantly decreased in group A (LLLT) and group C (minoxidil and LLLT combination groups), but not in group B (minoxidil)
Hair density: improvement of hair density in the combined group was higher than that in minoxidil Group (p = 0.036) and LLLT group (p = 0.012)
Minoxidil group improved hair density to a higher degree than the LLLT group; difference was not statistically significant (0.409)

Esmat 2017 [13] 45 female patients with FPHL randomly divided into three equal groups Group A: 15 patients applied topical minoxidil 5% twice daily
Group B: 15 patients received LLLT using the iGrow helmet device for 25 min 3 days weekly
Group C: 15 patients received a combination of both topical minoxidil 5% twice daily and LLLT for 25 min 3 days weekly for 4 months
Evaluation was done according to clinical, dermoscopic, and UBM parameters The combination (group C) was best regarding Ludwig classification and patient satisfaction
UBM and dermoscopic findings showed significant increase in the number of hair follicles at 4 months in all groups
UBM showed such significant increase at 2 months in the combination group (C) only
UBM at 4 months showed significant increase in the number of hair follicles detected in both groups B and C
A nonsignificant increase in the hair diameter was also documented in the three groups

Faghihi 2018 [15] 50 patients with AGP The patients were randomly divided into a control and a treatment group Group A received topical minoxidil 5% solution plus
LLLT twice per day Group B
Topical 5% minoxidil and a laser comb system that was turned off to act as a placebo
Changes in patients' hair density and diameter and overall regrowth as well as their satisfaction with the treatment were assessed at months 0, 3, 6, 9, and 12 Group A showed a significant increase in recovery percentage at 6, 9, and 12 months after the intervention (p < 0.001) compared to group B
Mean hair count was higher in group A compared to group B at 9 and 12 months (p < 0.001)
Group A showed an increase in hair diameter at 12 months compared to group B (p = 0.045)
Mean increase in hair count was higher in group A compared to group B (78.3% versus. 51.3%; p < 0.001)
Mean increase in hair diameter was higher in group A compared to group B (45.4% vs. 32.3%; p = 0.002)

UBM, ultrasound biomicroscopic.