Microneedling For Hair Loss
- Best Results6 months+
- Treatment Recovery1-2 days
- Procedure Time20 minutes
- Skin SpecialistNurse
- Duration of ResultsStudies still ongoing
- Back to Work1 day
Microneedling For Hair Loss
Microneedling is a simple, cost effective treatment for male & female pattern hair loss. Combined with medical management, it can deliver fast results. This page will discuss the evidence behind microneedling for various hair loss conditions & guide you through how to DIY microneedle at home (safely).
FactsFacts on Microneedling For Hair Loss
- Microneedling is an effective treatment for male & female pattern hair loss
- It works by stimulation of growth factors, stem cells & increasing blood flow to the scalp
- Clinical studies have shown that this treatment works best with medical management of hair loss
What is Microneedling For Hair Loss?
Microneedling is an established treatment used by dermatologists to provide microchannels in the upper & middle layer of skin & scalp. Microneedles can be delivered using rollers (typically with 128 to 256 needles) or with stamping (typically with 64 to 128 needles). Typical lengths range from 0.2 mm (home use) to 2.5 +mm (clinic use).
Microneedling can also provide heating energy, delivered through radiofrequency. RF microneedling is currently being researched for hair loss conditions, the results to date have been limited. More studies will emerge in the near future.
How does microneedling work?
This treatment works by stimulating hair follicle cells, in addition to improving scalp microcirculation (blood flow) & enhancing the penetration of topicals such as growth factors, minoxidil & finasteride.
Over time, this results in arrest of hair shedding/loss, & conversely increases in hair count & hair shaft diameter in both male & female pattern hair loss.
What forms of hair loss respond best to microneedling?
The majority of research has been on the use of microneedling for male & female pattern hair loss.
Mild to moderate hair loss responds best to this treatment. Microneedling will not regenerate enough hair to cover a bald scalp. In this situation, FUE transplants can be considered.
Scalp microneedling can also be used to treat telogen effluvium & in alopecia areata as it can potentially arrest the sleeping or telogen cycle of hair & stimulate the growth or anagen cycle. Microneedling should be used with extreme caution in lichenoid, inflammatory & scarring hair loss as it can theoretically worsen the disease.
What does the evidence show?
New evidence in 2020/21 has shown that clinical microneedling can –
- Cessation of hair loss
- Markedly increase hair counts for male & female baldness.
- Increases in hair shaft diameter in both sexes
- Females respond slightly better to males
- Male pattern hair loss in the frontal areas respond better to vertex (this is unusual as with most other treatments the reverse applies). 25% inc. in density compared to 17%.
- Females have better response in the vertex (35%) compared to frontal areas (32%).
- In all cases microneedling is adjunctive to medical management of hair loss.
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How is scalp microneedling performed?
Clinical microneedling involved objective documentation of hair growth. Importantly it is not about how you think the treatment is going, but more about what does the objective evidence show?
Candidate selection is paramount, namely this treatment is for early to moderate androgenic alopecia in males & females.
Step 1: Clinical documentation. Standardised photos frontal & temporal scalp. Parietal scalp & hair part vertex.
Step 2: Numbing gel applied over the area for one hour, cleansed with chlorhexidine.
Step 3: Microneedling with dermapen, skin pen, dermastamp, or dermaroller (instrument of choice depending on the length of your hair & thickness of your scalp!). 1.5 to 2.0 mm needles are most regularly used. Procedure time: 15 to 25 minutes.
Step 4: Adjunctive PRP commonly applied (injected & over the area of microneedling)
Step 5: Cleaning & disinfection of the field.
What is the recovery following clinical microneedling?
It depends on the extent, depth of needles & adjuvant treatment.
This treatment is best conducted on a Friday or Saturday. Some patients may have swelling for 24 to 48 hours, our nurses will discuss the expected timeline in detail before any procedure.
What is the difference between home & clinical microneedling for hair loss?
Depth of needling is the biggest difference between home & clinical use. Home use should be limited to 0.2 to 0.25 mm. Deeper needling will result in more pain, bleeding & increases the chances of infection.
In-clinic microneedling typically ranges from 1.5 to 2.5 mm, hence 10 times the depth of home use. This form of needling requires numbing & sterile cleansing post procedure. Bleeding is expected in all cases. The majority of studies has been focused on clinical application of this procedure.
How many sessions will I require?
The current consensus is that clinical microneedling should be conducted every 4 weeks for a total of 6 sessions over 6 months.
Patients can supplement clinical microneedling with home procedures every 1-3 weeks using sensible dermastamping or shallow microneedles via a dermaroller.
Is the procedure painful?
No. Dermatologists use super strength topical numbing creams prior to the procedure. For more extensive work we use a ring block around the scalp.
How do dermatologists combine microneedling with medical therapy for hair loss?
As reflected in the literature, medical therapy should ideally be combined with microneedling- both in clinic & at home.
For male pattern hair loss, treatment options include topical minoxidil 5%, either as a stand alone or with topical finasteride 0.1 to 0.25%. Other options include oral minoxidil 1 to 3.5 mg & or oral finasteride or dutasteride.
For female pattern hair loss, treatment options include minoxidil 5% topically or minoxidil 1 mg orally. Other oral agents include cyproterone acetate orally for 7-10 days of the month. Finasteride orally or topically can be useful, at the discretion of your treating dermatologist.
Supplementation with vitamins, minerals & extracts can be considered if there are nutritional deficiencies. Refer to the section on supplements & hair loss.
Why is microneedling & PRP a good option for hair loss?
This combination of clinical microneedling & PRP can give faster results. PRP or platelet rich plasma is an extract of concentrated platelets & growth factors obtained from your blood. Research has shown that a 4.5 to 5.5X concentration of platelets, injected monthly for 3 months can markedly improve both male & female pattern hair loss.
Both procedures are conducted at the same time as it makes sense to inject PRP in the areas treated with microneedling. By-products of PRP known as platelet poor plasma can be applied over microneedled areas as adjunct.
How do I conduct microneedling at home?
The use of home DIY microneedling can be useful as an alternative to clinical microneedling, however it is best employed as adjunctive therapy. Here is a guide-
- Consider 0.2 to 0.25 mm needles as safety is paramount.
- Derma Roller or Dermastampers can be purchased online for a few dollars.
- Stamp or roll every 2 weeks to the areas of concern. Spend approximately 5 minutes to treat the scalp. Ideally you should have someone help you.
- This method is safe with minimal bleeding & pain.
- Microneedling can increase the absorption of topicals like growth factors, minoxidil & finasteride. The flipside is that it can cause irritation – usually to the propylene glycol in solutions. On this basis, using a PG free foaming lotion may be better.
What does a simple DIY home routine for hair loss look like?
Here’s the go- you really don’t need to see a “Hair Loss Centre” for results. Try this combination:
- Microneedling 0.25 mm every two weeks.
- Minoxidil 5% topically daily (skip a day when you are microneedling).
- Saw palmetto daily supplementation.
As simple as that. This will, at minimum halt hair loss due to androgenic alopecia, & at best give you some regrowth. Review your own before and after photos at 3,4 & 6 months.
Will microneedling grow back hair in a bald area?
Unlikely, however in most cases there will be a demonstrable change in hair counts. For bald areas in men, the use of follicular unit extraction hair transplantation gives the most predictable results.
Microneedling is best used in early to moderate onset hair loss & not for long standing advanced cases of baldness.
What is FUE & when is this procedure useful?
FUE or follicular unit extraction is a procedure that transfers hair follicles from the back of the scalp to the frontal & crown areas. It is most commonly used for treating long standing hair loss in males. This procedure can yield good results to improve hair counts & density in sparsely populated areas.
Microneedling (& PRP) are commonly used in areas of early hair loss. It can be combined before or 6 to 8 week after FUE. This combination is not used during the transplantation process because microneedling can damage the hair grafts & place stress in both the donor & recipient areas.
Who do I see to start a course of microneedling?
Book in with the nurses at Clinic Cutis for microneedling. Alternatively book an appointment with a medical dermatologist for diagnosis & specialist management.
Dermatologists have an additional 4 years of specialist training in the management of all hair loss conditions, including male/female pattern hair loss as well as super rare conditions affecting adults, children & newborns.
Disclaimer: I do not see cases of hair loss for medical management as my work is procedural.
Davin’s Viewpoint on Microneedling
This basic treatment can be highly effective in the management of many skin disorders including scarring, rejuvenation & hair loss. Despite a plethora of high-tech laser devices, I find myself performing manual microneedling on a daily basis- most often in the context of scar remodelling.
Evidence of microneedling for hair loss disorders is relatively new, namely studies over the past decade. To date, this procedure is most useful for the management of male & female pattern baldness followed by telogen effluvium (incl. Chronic Telogen Effluvium) & alopecia areata.
Most of our combinations at Cutis involve the use of PRP (platelet rich plasma) with 1.5 to 2.0 mm microneedles. In most cases we add LLLT or low level laser therapy 24 hours post treatment as this accelerates healing from the day prior, as well as adds to stimulation of hair follicles. The majority of my colleagues combine medical therapy with these treatments as it has been shown in the literature that multimodality treatments are most useful.
With more studies over the next few years, we will have a better understanding of optimal combinations, timing, needle depth & intervals. For now, microneedling is a useful & safe modality for many dermatological conditions.
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