Background: Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women. Aim and objectives; The objective of the research was to assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes. Subjects and methods: This was a cross-sectional comparative study. From February 2021 to March 2022, cases have been collected from al-Azhar University Hospital's dermatology outpatient clinic. Patients divided into three groups, each group is composed of 40 patients as: Group A was given a 5% topical Minoxidil solution. Group B was given a 5% topical spironolactone solution. Group C was given a 5% topical spironolactone solution and a 5% topical Minoxidil solution. Result: There was no statistically significant difference between (yellow dots, peripilar sign, and honeycomb hyperpigmentation) before, during, & after three months of treatment in group C. The difference between (hair shaft diversity, vellus hair, follicular unit with only one emerging hair, and upright re-growing hair) is statistically significant before, during, & after three months of treatment in group C.
Conclusion: Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice-daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages. Keywords: Dermoscopic; Efficacy; Topical Spironolactone; Minoxidil; Treatment; Androgenetic Alopecia.