Cetirizine 1% Cream for Androgenetic Alopecia

A study published in the Journal of Cosmetic Dermatology, investigated the tolerability and efficacy of topical cetirizine 1% in male patients diagnosed with androgenetic alopecia (AGA), the most common form of alopecia in males.¹ Male AGA (MAGA) is an androgen-dependent condition unlike female (FMAGA) where the androgen role is not fully understood.

Cetirizine is a second-generation histamine (H)1 blocker that is known for its anti-inflammatory properties and its ability to decrease prostaglandin D2 (PGD2) production. Currently, only one report has shown that topical use of cetirizine at 1% strength induced hair grow in mild to moderate cases of AGA and decreased the densities of vellus hair.

The study enrolled 60 male patients between the ages of 22 and 55 years with different severities of AGA. The severity was based on the Hamilton‐Norwood classification and the patients were randomly assigned into 2 cohorts. Patients in group A applied 1 mL of 1% topical cetirizine daily for 6 months. Group B patients applied 1 mL of a placebo solution as a control. Patients were given identical non-labeled bottles with a code that both the doctor and patient were blinded to. 

Patients that were diagnosed with systemic diseases, suffering from chronic scalp conditions, using any medications that can potentially induce hair loss within 3 months before the study were all excluded. 

Data was reported in the number of regrowing hairs per cm². A photographic assessment was used and put on a 4-grade scale (no improvement, mild improvement, moderate improvement, and good improvement). Also, a subjective assessment for the amount of improvement in hair quality on a number scale. This was defined as (-1, worse; 0, no change; 1, mild improvement; 2, moderate improvement; 3, good improvement; and 4, excellent improvement). Any adverse events (AEs) were recorded.

In group A, 17 patients (56.7%) demonstrated no new hair growth per dermoscopy, 6 patients (20%) showed 1 new hair growing per dermoscopic field, 5 patients (16.7%) had 2 growing hairs per field, and 2 (6.7%) showed 3 growing hairs per field. None of group B achieved growing hair per dermoscopic evaluation.

Similar results were shown in the self-assessment. In the control cohort, more than 86% reported no improvement and about 13% reported worsening of their condition. Compared to the treatment group, about 56% reported no improvement, 23.3% reported mild improvement, 16.7% reported moderate improvement and 3.3% reported good improvement.

Although this study shows cetirizine 1% as a potential treatment for AGA, study investigators note that more trials are needed to confirm or refute such early findings. 

Reference:

1. Zaky MS, Khodeir HA, Ahmed H-A, Elsaie ML. Therapeutic implications of topical cetirizine 1% in treatment of male androgenetic alopecia: A case-controlled study. Journal of Cosmetic Dermatology. 2021;20(4):1154-1159. doi:https://doi.org/10.1111/jocd.13940