Ümit AKPINAR, Ekrem CİVAŞ, Yıldız HAYRAN, Neslihan FİŞEK İZCİ
Cyprus Journal of Medical Sciences - 2026;11(4):315-322
BACKGROUND/AIMS: Adjunctive multimodal therapies incorporating iontophoresis-assisted growth factor delivery have emerged as potential non-invasive treatment options for hair loss; however, real-world clinical evidence remains limited. This study evaluated the feasibility, tolerability, patient-reported hair shedding, symptom response, and treatment satisfaction associated with this treatment approach in patients with androgenetic alopecia (AGA), telogen effluvium (TE), and mixed AGA + TE. MATERIALS AND METHODS: This single-center, retrospective, uncontrolled, real-world observational study included 46 patients who had completed a standardized four-session adjunctive multimodal treatment protocol incorporating iontophoresis-assisted growth factor delivery alongside standard-of-care management; they were selected from 78 consecutively screened individuals. Outcomes included patient-reported daily hair shedding, symptom response, procedural tolerability, and treatment satisfaction. RESULTS: Daily hair shedding decreased significantly after treatment (p<0.001). After Bonferroni correction for the three diagnostic subgroup comparisons (adjusted alpha=0.0167), the reduction remained statistically significant in TE (p=0.002), whereas AGA (p=0.030) and mixed AGA + TE (p=0.025) did not meet the corrected significance threshold. No patients remained in the >=200 hairs/day shedding categories after treatment. Patients with TE showed greater symptom improvement than those with isolated AGA (p=0.016). Reduction in hair shedding was positively correlated with treatment satisfaction (r=0.48, p=0.004). No severe adverse events were documented in the medical records. CONCLUSION: Adjunctive multimodal therapy incorporating iontophoresis-assisted growth factor delivery was associated with reduced patient-reported hair shedding and high treatment satisfaction. However, because of the retrospective, uncontrolled design, the concomitant standard-of-care therapies, and the multimodal nature of the intervention, these findings should be considered hypothesis-generating. Prospective, randomized, sham-controlled studies incorporating objective outcome measures and longer follow-up are warranted.
