Comparison of the efficacy of valproic acid 8.3% and minoxidil 5% topical solutions in the treatment of androgenetic alopecia

Background and Aim: Hair loss is one of the most common problems among the skin and hair related diseases. Hair loss can lead to anxiety, depression, low self-esteem and dissatisfaction with appearance.   Methods: Patients with androgenetic alopecia who met the eligibility criteria entered the study. Participants were asked to randomly apply a solution of valproic acid 8.3% or a solution of minoxidil 5% on the affected areas according to the treatment protocol (twice a day). Before and 2 months after treatment, the participants were evaluated. The studied indices included the number of hair follicles in the specified area, the number of velus hairs, the number of terminal hairs, the average hair thickness, and the percentage of hairs in the anagen and telogen phases, as well as the skin reactions in the area. Hairs were examined at the beginning of the study and at 2 months after treatment using Foto Finder-trichoscale device.   Results: Two months after treatment compared to baseline in the valproic group, anagen hair count index (P=0.02), general hair count index (P=0.03), and terminl hair count index (P=0.012) showed significant changes. While telogen hair count (P=0.059) and vellus hair count (P=0.097) did not show significant changes. These changes were more significated in minoxidil group. Conclusion: 8.3% valproic acid solution showed positive effects in increasing the number of hairs and decreasing the percentage of telogen hairs. Due to the delayed mechanism of valproic acid, the duration of treatment with this compound should be considered longer than minoxidil as a positive control.