Efficacy and Safety of Fractional Laser Therapy for Androgenetic Alopecia: A Systematic Review and Meta-Analysis

To systematically evaluate the efficacy and safety of fractional laser therapy in the treatment of androgenetic alopecia.

A comprehensive literature search was conducted in PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) from inception to November 2025. Eligible studies were selected according to the PICOS framework. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Meta-analysis was performed using R software.

A total of 15 studies involving 1097 patients were included. Meta-analysis demonstrated that fractional laser therapy significantly improved hair density compared with control interventions (mean difference [MD] = 13.88, 95% confidence interval [CI]: 6.87-20.90, p < 0.001). Subgroup analysis revealed no significant difference in efficacy between ablative and non-ablative fractional lasers (p = 0.7792), nor between different wavelengths (1565 nm, 1550 nm, 1927 nm; p = 0.7014). Combination therapy with laser and other treatments (e.g., minoxidil) showed a certain advantage over other treatments alone (MD = 9.74, p = 0.001). Adverse events were predominantly mild to moderate, including erythema, pain, and pruritus, all of which resolved spontaneously.

Fractional laser therapy demonstrates marked therapeutic efficacy and a favorable safety profile in the treatment of androgenetic alopecia, making it a viable clinical treatment option. Future high-quality studies are warranted to further validate its long-term effectiveness and optimal treatment parameters.