Introduction Scalp injection with mesotherapy (LC cell hair essence) helps in anchoring hair follicles and might have good therapeutic efficacy and lower side effects than Botox in the treatment of androgenetic alopecia (AGA). Objective To assess the trichoscopy and the clinical therapeutic response of LC hair essence serum injection vs. botulinum toxin (A) injection in the treatment of androgenetic alopecia. Patients and methods Sixty‐two AGA patients were included in the present study. Group I consisted of 31 patients who were injected with 1 ml of LC hair essence serum diluted with 0.5 ml of 0.9% normal saline once weekly for 8 weeks, and Group II involved 31 patients who were injected with 50 units of botulinum toxin A. Trichoscopic examination and photo documentation were done for every case before starting treatment (baseline) and after treatment with monthly follow‐up to the patients. Results There was a significant difference between baseline trichoscopy findings and at the end of sixth month in Botox group, and the difference was highly significant in LC group; there was a statistically significant increase in the frequency of side effects (irritation and headache) among Group II compared with that of Group I. Conclusion Botox can induce significant results in the treatment of AGA with mild and tolerable side effects but with high cost, while LC hair serum exhibit excellent results with fewer side effects.