Persistent Alopecic Patches Following Dutasteride Mesotherapy for Female Androgenetic Alopecia: A Case Series

Androgenetic alopecia (AGA) is the most common cause of hair loss. To minimize systemic adverse effects of 5-alpha-reductase inhibitors, dutasteride mesotherapy has gained popularity. Although generally considered safe, alopecia at injection sites has been increasingly reported. We describe three cases of persistent alopecia following dutasteride mesotherapy in women with AGA.

Three female patients with AGA underwent mesotherapy with dutasteride (0.025–0.05%). Case 1: A 44-year-old woman developed multiple alopecic patches 1 month after a single session, with trichoscopic and histologic features of scarring alopecia. Only partial improvement occurred, and surgical correction was later required. Case 2: A 30-year-old woman developed 4 alopecic patches after 2 sessions. Trichoscopy revealed mixed features of cicatricial alopecia and follicular miniaturization, with limited regrowth despite optimized medical therapy. Case 3: A 48-year-old woman developed numerous alopecic patches 3 months after a single session. Follicular openings were preserved, and miniaturized hairs predominated. Alopecia persisted long-term despite corticosteroids and adjunctive treatments.

Reported cases of alopecia after mesotherapy include both scarring and non-scarring patterns, suggesting diverse mechanisms, such as mechanical injury, cytotoxicity from solvents, inflammation, or infection. In this series, none of the patients experienced full regrowth, highlighting the potential for lasting aesthetic sequelae. Published cases show similar variability but often lack detailed trichoscopic or procedural information, limiting interpretation. These findings underscore the importance of proper counseling, careful technique, and close follow-up when using dutasteride mesotherapy. This complication may be underrecognized, and clinicians should maintain vigilance for early detection and management.  .