Topical Melatonin in the Treatment of Hair Loss (Alopecia): A Comprehensive Scientific Review

Abstract

Hair loss (alopecia), particularly androgenetic alopecia (AGA), affects a substantial proportion of adults worldwide and is associated with significant psychosocial burden. Although conventional therapies such as topical Minoxidil and oral finasteride remain standard treatments, their variable efficacy and potential adverse effects have motivated the search for alternative or adjunctive therapeutic options. Topical melatonin has gained recent interest due to its antioxidant, anti-inflammatory, and hair follicle–modulating properties.
Methods
A structured literature search was performed in PubMed, Scopus, and Web of Science for studies published up to 2026. Eligible studies included experimental research, mechanistic investigations, and clinical trials examining the effects of topical melatonin on hair growth or hair loss. Following duplicate removal, titles and abstracts were screened, and full texts of relevant articles were reviewed. Data from included studies were qualitatively synthesized to evaluate the efficacy, mechanisms, and safety of topical melatonin in alopecia management.
Results
Clinical evidence indicates that topical melatonin formulations (0.0033–0.1%, applied once daily) may increase hair density, prolong the anagen phase of hair growth, and reduce hair shedding, while demonstrating a generally favorable safety profile. Mechanistic studies suggest that melatonin exerts its effects via MT1 and MT2 receptors and through modulation of key intracellular signaling pathways, including Wnt/??catenin and AKT/GSK3?, which are essential for follicular proliferation and survival. Preclinical models further support melatonin’s antioxidant and Cytoprotective actions within the hair follicle microenvironment.
Conclusion
Topical melatonin appears to be a promising, well?tolerated adjunctive therapy for alopecia management. Nevertheless, the current evidence remains limited by heterogeneity among studies, small sample sizes, and a lack of large-scale randomized controlled trials. Future rigorously designed RCTs with standardized dosing and outcome measures are needed to determine its definitive clinical efficacy and optimal use.