AT A GLANCE

A systematic review of 13 controlled trials assessed the efficacy of non-prescription monotherapies for androgenetic alopecia, with agents like procyanidin and cetirizine demonstrating modest improvements in hair growth parameters. While adverse events were minimal, further rigorous studies are needed to confirm long-term benefits and guide clinical use.

With patients increasingly turning to over-the-counter options for hair loss, this systematic review investigates the clinical performance of non-prescription treatments for androgenetic alopecia (AGA). Researchers examined 13 investigator-blinded, controlled trials evaluating topical and oral agents such as procyanidin, cetirizine, caffeine, rosemary oil, pumpkin seed oil, and others. Improvements were noted across various parameters—including total hair density, terminal hair counts, and shaft diameter—with procyanidin and cetirizine supported by the most robust RCT data. Adverse events were infrequent and mild, suggesting a favorable safety profile.

Despite these encouraging findings, the studies reviewed were heterogeneous in design, dosing, and outcome measures, limiting the generalizability of results. Few trials included long-term follow-up, and none directly compared non-prescription agents to FDA-approved therapies like minoxidil or finasteride.

"Despite promising preliminary results, further large-scale, high-quality randomized trials are necessary to confirm the long-term efficacy and safety of these non-prescription treatments, both as standalone therapies and in conjunction with established pharmacologic optionsm," write the authors.

Learn more on the Management of Hair Disorders in the Scholars in Medicine curriculum.