Microneedling and Its Use in Hair Loss Disorders: A Systematic Review

December 2021 in “ Dermatology and therapy ”

Robert S. English, Sophia Ruiz, Pedro DoAmaral

microneedling hair loss 5% minoxidil clinical studies adverse events study designs procedures MN Rogaine

From the encyclopedia

technique to create small wounds in skin to activate collagen production and hair growth

An essential vasodilator with some anti-androgenic effects

Studysummary This review reports that clinical studies generally showed favorable results for microneedling as an adjunct therapy for androgenic alopecia and alopecia areata, despite the low quality of existing data.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This systematic review of 22 clinical studies involving 1,127 subjects found that microneedling (MN) is effective in improving hair loss parameters across various hair loss types, particularly when combined with 5% minoxidil. Despite positive outcomes and no serious adverse events, the quality of the data is relatively low due to significant heterogeneity in study designs and procedures. The review calls for more standardized, high-quality research to better understand MN's efficacy and establish best practices.

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37 / 37 results

research Platelet Rich Plasma Application by Dermapen Microneedling and Intradermal Point-by-Point Injection Methods, and Their Comparison with Clinical Findings and Trichoscan in Patients with Androgenetic Alopecia

3 citations , October 2021 in “Dermatologic Therapy”

This study demonstrated that PRP treatment improved hair metrics in androgenetic alopecia, with the dermapen method proving more effective than the point-by-point technique for specific hair growth indicators.

research Microneedling for Hair Loss

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

This study found that microneedling monotherapy significantly increased hair count more than topical minoxidil in androgenetic alopecia, with combination therapy of microneedling and minoxidil being even more effective. Further research is needed to evaluate microneedling's safety and efficacy as a monotherapy.

Evaluation of Efficacy of Intradermal Injection Therapy vs Derma Roller Application for Administration of QR678 Neo Hair Regrowth Formulation for the Treatment of Androgenetic Alopecia—A Prospective Study

research Evaluation of Efficacy of Intradermal Injection Therapy vs Derma Roller Application for Administration of QR678 Neo Hair Regrowth Formulation for the Treatment of Androgenetic Alopecia—A Prospective Study

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

This study found that both intradermal injection and derma roller techniques for QR678Neo® hair regrowth therapy improved androgenetic alopecia symptoms, with intradermal injections showing non-significantly better video-microscopic outcomes but more pain and erythema associated with derma rollers.

research Conflicting Reports Regarding the Histopathological Features of Androgenic Alopecia: Are Biopsy Location, Hair Diameter Diversity, and Relative Hair Follicle Miniaturization Partly to Blame?

1 citations , April 2021 in “Clinical, Cosmetic and Investigational Dermatology”

This review proposes that inconsistent findings in androgenic alopecia research are due to variable biopsy location, hair diameter diversity, and hair follicle miniaturization, and suggests ways to improve study methods.

research Comparative Study of Efficacy of Minoxidil Versus Minoxidil with Platelet-Rich Plasma Versus Minoxidil with Dermaroller in Androgenetic Alopecia

2 citations , February 2021 in “International Journal of Research in Dermatology”

The researchers reported that combining platelet-rich plasma with minoxidil showed the most improvement in androgenetic alopecia compared to other treatment groups, but also had more pain as a side effect.

research Evaluation of Adding Platelet-Rich Plasma to Combined Medical Therapy in Androgenetic Alopecia

5 citations , January 2021 in “Journal of Cosmetic Dermatology”

This study found that adding platelet-rich plasma with microneedling to conventional medical treatment significantly increased hair density and diameter in androgenetic alopecia patients compared to medical treatment alone.

research A Pilot Evaluation of Scalp Skin Wounding to Promote Hair Growth in Female Pattern Hair Loss

3 citations , December 2020 in “International Journal of Women's Dermatology”

Scalp micro-wounding helps promote hair growth in female pattern hair loss.

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

10 citations , September 2020 in “Journal of Cosmetic Dermatology”

In this study, microneedling with a depth of 0.6 mm, alongside minoxidil, significantly improved hair count and thickness in patients with androgenetic alopecia compared to minoxidil alone, and was more beneficial than a 1.2 mm depth.

research Efficacy of Intradermal Minoxidil 5% Injections for Treatment of Patchy Non-Severe Alopecia Areata

4 citations , July 2020 in “Journal of Dermatological Treatment”

This study found that intralesional minoxidil alone has limited efficacy for non-severe patchy alopecia areata, though it may accelerate hair regrowth compared to spontaneous recovery.

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

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

In this study, a home-use microneedle device combined with 5% minoxidil showed potential for enhancing hair growth in pattern hair loss over six months, although the observed improvements in hair count and patient assessments were not statistically significant compared to other treatments.

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

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 , May 2020 in “Journal of Dermatological Treatment”

This study found that combining microneedling with 5% minoxidil improved hair growth in Chinese men with androgenetic alopecia, possibly through activating the Wnt/β-catenin signaling pathway.

research Microneedling Improves Minoxidil Response in Androgenetic Alopecia Patients by Upregulating Follicular Sulfotransferase Enzymes

2 citations , April 2020 in “PubMed”

research Platelet-Rich Plasma in Alopecia Areata: Intradermal Injection Versus Topical Application with Transepidermal Delivery via Either Fractional Carbon Dioxide Laser or Microneedling

5 citations , January 2020 in “Acta dermatovenerologica Alpina, Pannonica et Adriatica (Tiskana izd.)”

This study found that PRP was effective for treating alopecia areata with similar improvement across groups, while topical delivery via fractional CO2 laser or microneedling reduced injection pain.

research Dermoscopic Assessment of Microneedling Alone Versus Microneedling with Platelet-Rich Plasma in Cases of Male Pattern Alopecia: A Split-Head Comparative Study

5 citations , January 2020 in “International Journal of Trichology”

This study found that both microneedling and microneedling with platelet-rich plasma improved hair thickness and density in male pattern alopecia, but no additional benefit was observed with the addition of platelet-rich plasma.

Combination of Photodynamic Therapy with 5-Aminolaevulinic Acid and Microneedling in the Treatment of Alopecia Areata Resistant to Conventional Therapies: Our Experience with 41 Patients

research Combination of Photodynamic Therapy with 5-Aminolaevulinic Acid and Microneedling in the Treatment of Alopecia Areata Resistant to Conventional Therapies: Our Experience with 41 Patients

14 citations , August 2019 in “Clinical and Experimental Dermatology”

This study suggests that combining microneedling with ALA-photodynamic therapy may be a promising treatment option for moderate to severe alopecia areata, achieving significant hair regrowth in some patients.

research Preliminary Results of the Use of Scalp Microneedling in Different Types of Alopecia

24 citations , June 2019 in “Journal of Cosmetic Dermatology”

This study found that microneedling improved hair density and thickness with minimal side effects in patients with androgenetic alopecia and telogen effluvium.

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

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

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

This study found that combining fractional radiofrequency microneedling with 5% topical minoxidil improved hair count and thickness more than minoxidil alone in Chinese men with male pattern hair loss.

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 , January 2018 in “Journal of Cutaneous and Aesthetic Surgery”

This study found that combining microneedling with topical minoxidil was more effective than minoxidil alone in increasing hair count and improving patient satisfaction for men with androgenetic alopecia, though the cosmetic impact was not significant.

Randomized Trial of Electrodynamic Microneedle Combined with 5% Minoxidil Topical Solution for the Treatment of Chinese Male Androgenetic Alopecia

research Randomized Trial of Electrodynamic Microneedle Combined with 5% Minoxidil Topical Solution for the Treatment of Chinese Male Androgenetic Alopecia

28 citations , October 2017 in “Journal of Cosmetic and Laser Therapy”

This study found that combining microneedle treatments with 5% minoxidil topical solution led to the greatest increase in hair density among Chinese men with androgenetic alopecia.

research Review of Applications of Microneedling in Dermatology

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

This review highlights microneedling's promise as an adjuvant therapy for enhanced drug delivery in dermatology, especially for conditions like atrophic scars and pigmentation disorders, though its efficacy for vitiligo is limited.

research Alopecia Areata: A Comprehensive Review of Pathogenesis and Management

99 citations , July 2017 in “Clinical Reviews in Allergy & Immunology”

This review noted that alopecia areata is an autoimmune disease impacting hair follicles and offered insights into its complex pathogenesis involving immune responses, while highlighting ongoing research into new treatments such as Janus kinase inhibitors and other immunomodulatory drugs.

research Androgenetic Alopecia: A Review

153 citations , March 2017 in “Endocrine”

This review examines recent advances in understanding the pathophysiology and molecular mechanisms of androgenetic alopecia, highlighting two major genetic risk loci, but does not report new clinical findings.

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

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”

This study found that combining microneedling with PRP and topical minoxidil (5%) significantly improved hair growth in men with androgenetic alopecia compared to using minoxidil alone.

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

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

49 citations , August 2016 in “Aesthetic Surgery Journal”

This study found that micro-needling with cosmeceuticals or platelet-rich plasma significantly improved wrinkles, skin laxity, scar softening, and hair growth over 12 months, with minimal side effects, and that the best results occur with pigment and platelet massaging between 5 to 30 minutes post-treatment.

research Repeated Microneedle Stimulation Induces Enhanced Hair Growth in a Murine Model

55 citations , January 2016 in “Annals of Dermatology”

This study found that repeated microneedle stimulation in mice promoted hair growth and increased the expression of hair-growth-related genes, suggesting potential therapeutic uses for alopecia.

research Telogen Effluvium: Is There a Need for a New Classification

18 citations , January 2016 in “Skin appendage disorders”

The paper suggests improving diagnosis and treatment of telogen effluvium but does not recommend a new classification system.

research Novel Enzymatic Assay Predicts Minoxidil Response in the Treatment of Androgenetic Alopecia

27 citations , November 2013 in “Dermatologic Therapy”

This study suggests that a hair follicle enzyme assay may predict response to minoxidil treatment for androgenetic alopecia with high sensitivity and specificity in a preliminary analysis.

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”

This study found that adding microneedling to minoxidil treatment significantly improved hair growth in men with androgenetic alopecia compared to minoxidil alone across all assessed measures.

Effects of Topical Application of Growth Factors Followed by Microneedle Therapy in Women with Female Pattern Hair Loss: A Pilot Study

research Effects of Topical Application of Growth Factors Followed by Microneedle Therapy in Women with Female Pattern Hair Loss: A Pilot Study

34 citations , October 2012 in “Journal of Dermatology”

This pilot study suggests that using growth factors followed by microneedle therapy may benefit women with female pattern hair loss.

Morphometric Analysis of the Human Scalp Hair Follicle: Practical Implications for the Hair Transplant Surgeon and Hair Regeneration Studies

research Morphometric Analysis of the Human Scalp Hair Follicle: Practical Implications for the Hair Transplant Surgeon and Hair Regeneration Studies

51 citations , November 2010 in “Dermatologic Surgery”

This study measured the lengths and depths of different portions of occipital scalp hair follicles and suggested cutting below 1 mm for hair regeneration procedures to avoid damaging the bulge zone.

Photodynamic Therapy with Methyl 5-Aminolevulinate Acid Might Be Ineffective in Recalcitrant Alopecia Totalis Regardless of Using a Microneedle Roller to Increase Skin Penetration

research Photodynamic Therapy with Methyl 5-Aminolevulinate Acid Might Be Ineffective in Recalcitrant Alopecia Totalis Regardless of Using a Microneedle Roller to Increase Skin Penetration

27 citations , May 2010 in “Dermatologic surgery”

This study found that photodynamic therapy with methyl 5-aminolevulinic acid was ineffective for treating alopecia totalis, even with microneedle rolling to enhance drug delivery.

Long-Term Treatment with Finasteride 1 mg Decreases the Likelihood of Developing Further Visible Hair Loss in Men with Androgenetic Alopecia

research Long-Term Treatment with Finasteride 1 mg Decreases the Likelihood of Developing Further Visible Hair Loss in Men with Androgenetic Alopecia

20 citations , December 2008 in “PubMed”

In this study, treatment with finasteride 1 mg/day for five years significantly reduced the likelihood of further visible hair loss in men with androgenetic alopecia compared to placebo.

research Wnt-Dependent De Novo Hair Follicle Regeneration in Adult Mouse Skin After Wounding

829 citations , May 2007 in “Nature”

Hair follicles can regrow in wounded adult mouse skin using a process like embryo development.

research Effect of 5α-Dihydrotestosterone and Testosterone on Apoptosis in Human Dermal Papilla Cells

58 citations , January 2006 in “Skin Pharmacology and Physiology”

This study found that testosterone and 5α-dihydrotestosterone induced apoptosis in dermal papilla cells from nonbalding scalp regions, suggesting a high androgen stimulus can trigger cell death related to androgenetic alopecia.

research Prevalence of Male and Female Pattern Hair Loss in Maryborough

193 citations , August 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This study found that the prevalence of androgenetic alopecia increases with age among both men and women in Maryborough, Australia, with 57% of women and 73.5% of men aged 80 and over affected.

research Identification of Androgen-Inducible TGF-β1 Derived from Dermal Papilla Cells as a Key Mediator in Androgenetic Alopecia

78 citations , June 2003 in “Journal of Investigative Dermatology Symposium Proceedings”

TGF-β1 from dermal papilla cells suppresses hair growth, and targeting it may help treat androgenetic alopecia.

Androgen-Inducible TGF-β1 from Balding Dermal Papilla Cells Inhibits Epithelial Cell Growth: A Clue to Understanding Paradoxical Effects of Androgen on Human Hair Growth

research Androgen-Inducible TGF-β1 from Balding Dermal Papilla Cells Inhibits Epithelial Cell Growth: A Clue to Understanding Paradoxical Effects of Androgen on Human Hair Growth

190 citations , October 2002 in “The FASEB journal”

In this study, androgen did not affect keratinocyte growth in coculture with androgenetic alopecia-derived dermal papilla cells, but did significantly suppress keratinocyte growth when androgen receptor was overexpressed in the papilla cells.