40-60 % get Good Improvement — Donovan Hair Clinic
Study from China Supports Microneedling for AGA
Microneedling for treating hair loss continues to be popular. The mechanism by which MN helps hair is unknown.
Studies based on animal models and clinical data suggest MN therapy may promote Wnt/β-catenin signaling pathway and stimulate dermal papillae stem cell proliferation. Some theories propose it helps angiogenesis. Some theories propose it simply helps drug penetration and absorption into the skin. Other theories suggests MN likely enhances the efficacy of topical minoxidil by upregulating follicular sulfotransferase enzymes located in the human scalp, which convert minoxidil into a bioactive metabolite, minoxidil sulfate
Before we talk about a new study from China published recently in the Journal of Cosmetic Dermatology, it’s important to understand the 2013 landmark paper by Dhurat and colleagues.
Dhurat et al Microneedling Study of 2013.
It is important for anyone studying microneedling in hair loss to have a good understanding of the 2013 Dhurat study. Dhurat took 100 patients with mild to moderate (III vertex or IV) androgenetic alopecia (AGA) and divided them into 2 groups with randomization. One group was offered weekly 1.5 mm microneedling treatment with twice daily 5% minoxidil lotion (MN+MINOX group). The second group was given only 5% minoxidil lotion (MINOX only group). The response was assessed by 7- point scale as well as hair counts
Key Results: The mean change in hair count at week 12 was significantly greater for the MN + MINOX group compared to the MINOX only group (91.4 vs 22.2 respectively). Investigators felt that 40 % of patients in the MN + MINOX group and really good results (+2 to +3) compared to none in the MINOX only group. Patients themselves had a similar view of their results. 82 % of patients felt they had a 50 % or more improvement compared to 4.5 % of patients in the MINOX only group.
Lingling Jia et al 2022
A new study from China set out to evaluate the benefits of microneedling in 18 patients with androgenetic alopecia. This group included 10 females and 8 males. Mean age was 37 with range 19 to 52. Most males were Hamilton Norwood II and IIIv and most females were Ludwig I.
For the MN procedure, a dermaroller device with 1.5 mm sized needles was used to roll over the target areas in a longitudinal, vertical, and diagonal directions until desired pinpoint bleeding was noted. 5% minoxidil was topically used right after MN procedure, The treatment area was massaged for 3 min to promote the absorption of minoxidil. All patients received a total of six sessions at one-week intervals and were instructed to apply 5% minoxidil twice daily for 6 weeks.
Scoring was based on the same system used in the Dhurat study – namely with a -3 to +3 system: -3 being a significant worsening and +3 being a significant improvement
In the current study by Lingling Jia et al, all patients benefitted from microneedling. When physicians were asked to rank the improvement, 61 % of patients were said to have a mild improvement, 33 % with moderate and 5.5 % with significant or ‘obvious’
When patients were asked to rank the improvement, 39 % of patients were said to have a mild improvement, 55.5 % with moderate and 5.5 % with significant or ‘obvious’
Overall, 50 % of the patients were moderate or greatly satisfied with their outcome with 11. 1 % being greatly satisfied, 44 % being moderately. 27.8% were slightly satisfied and 16.7 % were unsatisfied.
This study lacks a comparator group but data are very similar to the 2013 Dhurat study. About 40-50 % of patients have good or very good results with micro needling.
Lingling Jia et al. Effects of microneedling with 5% minoxidil topical solution combination therapy in treatment of androgenetic alopecia. J Cosmet Dermatol. 2022 Jul 21.
Rachita Dhurat et al. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013 Jan;5(1):6-11.