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The treatment for androgenetic alopecia involves using finasteride and minoxidil with intense exercise and cold exposure to boost metabolism and reduce androgenic effects, potentially leading to hair regrowth. This approach may activate biological pathways for improved hair and overall health.

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

A 32-year-old man has been treating his hair loss with daily oral finasteride (1.25g), twice-daily topical minoxidil, weekly ketoconazole 2% shampoo, and weekly microneedling for almost three months, with no side effects from finasteride. He started with a Hamilton Norwood scale rating of 5 and has seen improvement without experiencing pain by using a 0.8mm needle length for microneedling.

Microneedling is effective for hair growth, especially when combined with finasteride and minoxidil, but concerns exist about potential long-term skin damage. Users report increased collagen and elastin deposition, but the long-term effects on the scalp remain uncertain.

Microneedling with needle lengths of 1.5mm to 2.5mm to stimulate hair follicle stem cells for potential hair growth. Using needles longer than 2.5mm is not recommended due to risk of puncturing veins in the scalp. A dermastamp is suggested over a roller.