Efficacy and Safety of Combinational Therapy Using Topical Minoxidil and Microneedling for the Treatment of Androgenetic Alopecia: A Systematic Review and Meta-Analysis

September 2023 in “ Archives of Dermatological Research ”

Parsa Abdi, Christian Awad, Michelle Anthony, Christopher Farkouh, Bret Kenny, Howard I. Maibach, Boluwaji Ogunyemi

topical minoxidil microneedling androgenetic alopecia hair count hair diameter adverse events scarring Rogaine

TLDR Using minoxidil with microneedling increases hair count for hair loss without serious side effects.

A systematic review and meta-analysis of ten randomized controlled trials involving 466 patients found that combination therapy using topical minoxidil and microneedling significantly increased total hair count in patients with androgenetic alopecia compared to using minoxidil alone (SMD 1.76; 95% CI 1.26–2.26; P < 0.00001). However, there was no significant increase in hair diameter (SMD 0.82; 95% CI − 0.01 to 1.65; P = 0.05). No serious adverse events or scarring were reported. The study suggests that this multimodal therapeutic approach is effective, but notes that variations in factors like microneedling methods and treatment areas may have caused confounding. Further large-sample trials with rigorous methodologies are recommended for a more comprehensive understanding of treatment efficacy.

View this study on link.springer.com →

Discuss this study in the Community →

Cited in this study

32 / 32 results

research Does Topical Minoxidil at Concentrations Higher Than 5% Provide Additional Clinical Benefit?

4 citations , November 2022 in “Clinical and Experimental Dermatology”

Using more than 5% minoxidil can help hair growth more, but results vary and side effects may increase.

research Randomized Trial of Microneedling Combined With 2% Minoxidil Topical Solution for the Treatment of Female Pattern Hair Loss in a Chinese Population

1 citations , October 2022 in “Journal of Cosmetic Dermatology”

research Efficacy and Safety of 5% Minoxidil Alone, Minoxidil Plus Oral Spironolactone, and Minoxidil Plus Microneedling on Female Pattern Hair Loss: A Prospective, Single-Center, Parallel-Group, Evaluator-Blinded, Randomized Trial

2 citations , July 2022 in “Frontiers in Medicine”

research Randomized Trial of Electrodynamic Microneedling Combined with 5% Minoxidil Topical Solution for Treating Androgenetic Alopecia in Chinese Males and Molecular Mechanistic Study of the Involvement of the Wnt/β-Catenin Signaling Pathway

10 citations , February 2022 in “Journal of Dermatological Treatment”

Microneedling with 5% minoxidil improves hair loss in Chinese men by activating Wnt/ß-catenin pathway.

research SULT1A1 (Minoxidil Sulfotransferase) Enzyme Booster Significantly Improves Response to Topical Minoxidil for Hair Regrowth

1 citations , January 2022 in “Journal of Cosmetic Dermatology”

Enzyme booster SULT1A1 greatly enhances hair regrowth with minoxidil.

research Microneedling for Hair Loss

9 citations , October 2021 in “Journal of Cosmetic Dermatology”

research Minoxidil: A Comprehensive Review

16 citations , July 2021 in “Journal of Dermatological Treatment”

Minoxidil effectively treats hair loss, especially androgenetic alopecia, but needs more research for better understanding.

research Combination Therapy with Topical Minoxidil and Nano-Microneedle-Assisted Fibroblast Growth Factor for Male Androgenetic Alopecia: A Randomized Controlled Trial in Chinese Patients

6 citations , April 2021 in “Chinese Medical Journal”

research Microneedling in Androgenetic Alopecia: Comparing Two Different Depths of Microneedles

10 citations , April 2021 in “Journal of Cosmetic Dermatology”

Deeper microneedling boosts hair growth, with 0.6mm needles and minoxidil being most effective.

research Efficacy and Safety of a New 10% Topical Minoxidil Versus 5% Topical Minoxidil and Placebo in the Treatment of Male Androgenetic Alopecia: A Trichoscopic Evaluation

14 citations , February 2021 in “Journal of Dermatological Treatment”

10% minoxidil solution better promotes hair growth and reduces hair loss without significant side effects.

research The Effectiveness of Combination Therapies for Androgenetic Alopecia: A Systematic Review and Meta-Analysis

11 citations , July 2020 in “Dermatologic Therapy”

Combination therapies work better than single treatments for hair loss.

research Usefulness of Home-Use Microneedle Devices in the Treatment of Pattern Hair Loss

11 citations , June 2020 in “Journal of cosmetic dermatology”

Home-use microneedle devices might safely boost 5% minoxidil's effectiveness for hair growth.

research Sulfotransferase SULT1A1 Activity in Hair Follicle: A Prognostic Marker of Response to Minoxidil Treatment in Androgenetic Alopecia

January 2020 in “Postepy Dermatologii I Alergologii”

Sulfotransferase SULT1A1 activity may predict minoxidil treatment success for hair loss.

research Sulfotransferase Activity in Plucked Hair Follicles Predicts Response to Topical Minoxidil Treatment in Brazilian Female Pattern Hair Loss Patients

4 citations , January 2020 in “Dermatologic Therapy”

Hair enzyme activity predicts minoxidil success in Brazilian women with hair loss.

research Minoxidil And Its Use In Hair Disorders: A Review

117 citations , August 2019 in “Drug Design Development and Therapy”

Minoxidil effectively treats hair loss, but use cautiously and monitor side effects.

research Evaluation of Long-Term Efficacy of Finasteride in Korean Men with Androgenetic Alopecia Using the Basic and Specific Classification System

11 citations , February 2019 in “Journal of Dermatology”

Finasteride effectively treats hair loss in Korean men for at least 5 years, with V type responding better.

research A Pilot Split-Scalp Study of Combined Fractional Radiofrequency Microneedling and 5% Topical Minoxidil in Treating Male Pattern Hair Loss

25 citations , October 2018 in “Clinical and Experimental Dermatology”

Combined microneedling and minoxidil improves hair growth more than minoxidil alone.

research A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil Plus Microneedling Versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia

24 citations , October 2018 in “Journal of Cutaneous and Aesthetic Surgery”

research Review of Applications of Microneedling in Dermatology

108 citations , August 2017 in “Clinical, Cosmetic and Investigational Dermatology”

Microneedling is promising for treating various skin issues but needs more research to confirm its effectiveness and safety.

research The Effectiveness of Treatments for Androgenetic Alopecia: A Systematic Review and Meta-Analysis

178 citations , July 2017 in “Journal of The American Academy of Dermatology”

Minoxidil, finasteride, and low-level laser light therapy effectively treat hair loss.

research Micro-Needling Depth Penetration, Presence of Pigment Particles, and Fluorescein-Stained Platelets: Clinical Usage for Aesthetic Concerns

49 citations , January 2017 in “Aesthetic Surgery Journal”

Micro-needling effectively improves wrinkles, scars, and hair growth, but proper technique and safety are important.

research A Comparative Study of Microneedling with Platelet-Rich Plasma Plus Topical Minoxidil (5%) and Topical Minoxidil (5%) Alone in Androgenetic Alopecia

48 citations , January 2017 in “International Journal of Trichology”

Microneedling with platelet-rich plasma and minoxidil improves hair growth more than just minoxidil in men with hair loss.

research Minoxidil Dose Response Study in Female Pattern Hair Loss Patients Determined to Be Non-Responders to 5% Topical Minoxidil

4 citations , October 2016 in “PubMed”

Increasing the dosage of minoxidil can help hair regrowth in women who didn't respond to the standard treatment.

research Demographics of Women with Female Pattern Hair Loss and the Effectiveness of Spironolactone Therapy

26 citations , October 2015 in “Journal of The American Academy of Dermatology”

Spironolactone may effectively treat female hair loss, especially with hyperandrogenism signs.

research Combined Treatment with Oral Finasteride and Topical Minoxidil in Male Androgenetic Alopecia: A Randomized and Comparative Study in Chinese Patients

32 citations , September 2015 in “Dermatologic Therapy”

Finasteride and minoxidil together work best for male hair loss.

research Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy

68 citations , May 2015 in “Indian Journal of Dermatology”

Microneedling can effectively promote new hair growth in men with hair loss who didn't improve with traditional treatments.

research Cause of Androgenic Alopecia

17 citations , October 2013 in “Plastic and reconstructive surgery. Global open”

Male pattern baldness may be caused by scalp pressure on hair follicles, which increases with age and leads to a cycle of hair loss. This process is not directly determined by genes.

research A Randomized Evaluator Blinded Study of Effect of Microneedling in Androgenetic Alopecia: A Pilot Study

136 citations , January 2013 in “International Journal of Trichology”

research Male Androgenetic Alopecia: Population-Based Study in 1,005 Subjects

41 citations , July 2009 in “International Journal of Trichology”

58% of men aged 30-50 have hair loss, with severity increasing with age.

research An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia

71 citations , January 2004 in “Dermatology”

Oral finasteride works better than topical minoxidil for hair growth, both are safe.

research A Randomized Clinical Trial of 5% Topical Minoxidil Versus 2% Topical Minoxidil and Placebo in the Treatment of Androgenetic Alopecia in Men

269 citations , September 2002 in “Journal of The American Academy of Dermatology”

5% minoxidil works better for hair growth and density, with minor irritation.

research Hair Pain (Trichodynia): Frequency and Relationship to Hair Loss and Patient Gender

48 citations , January 2002 in “Dermatology”

Hair pain is more common in women with hair loss, but it's not linked to the cause or severity of hair loss.

9 / 9 results

research Oral Minoxidil Treatment for Hair Loss: A Review of Efficacy and Safety

59 citations , March 2021 in “Journal of The American Academy of Dermatology”

Oral minoxidil promotes hair growth but may cause side effects; needs monitoring.

research A Pilot Split-Scalp Study of Combined Fractional Radiofrequency Microneedling and 5% Topical Minoxidil in Treating Male Pattern Hair Loss

25 citations , October 2018 in “Clinical and Experimental Dermatology”

Combined microneedling and minoxidil improves hair growth more than minoxidil alone.

research Effectiveness of Once Daily 5% Minoxidil Topical Foam in the Treatment of Women with Thinning Hair Due to Female Pattern Hair Loss

May 2015 in “Journal of The American Academy of Dermatology”

5% minoxidil foam helps women with thinning hair.

research 5% Minoxidil: Treatment for Female Pattern Hair Loss

8 citations , November 2014 in “PubMed”

research Medications and Hair Transplantation

November 2009 in “Cambridge University Press eBooks”

Minoxidil and finasteride combined can effectively treat hair loss.

research Understanding and Management of Female Pattern Alopecia

30 citations , November 2008 in “Facial Plastic Surgery”

The conclusion is that the best approach for treating Female Pattern Hair Loss is a combination of different treatments.

research Androgenetic Alopecia in Adolescents

12 citations , February 2003 in “PubMed”

research Effect of Minoxidil on Hair Growth in Androgenic Alopecia in Women

1 citations , September 2002 in “PubMed”

Minoxidil helps stimulate hair growth and reduce hair loss in women with androgenic alopecia.

research A randomized trial of minoxidil in chemotherapy-induced alopecia

127 citations , July 1996 in “Journal of The American Academy of Dermatology”

Minoxidil shortens baldness from chemotherapy by 50.2 days without significant side effects.