Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?

Karan Malhotra, Kallappa C. Herakal


Background: Androgenetic alopecia is the most common cause of chronic hair loss. The FDA approved treatment for male androgenetic alopecia are Finasteride and Minoxidil. But many patients do not respond to these medications. Microneedling is a recent modality that releases several growth factors and enhances penetration of minoxidil, thereby promoting hair growth.

Methods: 60 patients, aged 21-40 years, with androgenetic alopecia were divided into 2 groups. In group A, patients were subjected to microneedling twice monthly, immediately followed by application of topical 5% minoxidil solution over the scalp and then 1 ml twice daily. In group B, patients were treated with application of 1ml of topical 5% minoxidil solution over the scalp twice daily. The results were evaluated based on patient’s and physician’s assessment based on the standardized 7-point evaluation scale.

Results: Patients in group A showed statistically significant improvement (p value<0.05) compared to group B. Headache and erythema were the most common side effects encountered in both the groups.

Conclusions: Microneedling with 5% minoxidil is a safe, simple and cost-effective modality and is a promising treatment option for patients with androgenetic alopecia. It showed much better results when compared to use of topical 5% minoxidil solution alone.


Androgenetic alopecia, Male pattern baldness, Microneedling, Minoxidil

Full Text:



Gkini MA, Kouskoukis AE, Tripsianis G, Rigopoulos D, Kouskoukis K. Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period. J Cutan Aesth Surg. 2014 Oct;7(4):213-9.

Martinez-Jacobo L, Villarreal-Villarreal CD, Ortiz-López R, Ocampo-Candiani J, Rojas-Martínez A. Genetic and molecular aspects of androgenetic alopecia. Ind J Dermatol Venereol Leprol. 2018 May 1;84(3):263-8.

Kumar MK, Inamadar AC, Palit A. 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. J Cutan Aesth Surg. 2018 Oct;11(4):211.

Singh A, Yadav S. Microneedling: advances and widening horizons. Ind Dermatol Onli J. 2016 Jul;7(4):244-54.

Wirya CT, Wu W, Wu K. Classification of male-pattern hair loss. Intern J Trichol. 2017 Jul;9(3):95-100.

Tanaka Y, Aso T, Ono J, Hosoi R, Kaneko T. Androgenetic alopecia treatment in asian men. J Clin Aesth Dermatol. 2018 Jul;11(7):32-5.

Palanisamy T. Minoxidil to treat androgenetic alopecia in men and women: what is it & how does it work. Am J Med Med Sci. 2014;4(6):262-5.

Goren A, Naccarato T, Situm M, Kovacevic M, Lotti T, McCoy J. Mechanism of action of minoxidil in the treatment of androgenetic alopecia is likely mediated by mitochondrial adenosine triphosphate synthase-induced stem cell differentiation. J Biolog Regul Homeo Age. 2017;31(4):1049-53.

Fertig RM, Gamret AC, Cervantes J, Tosti A. Microneedling for the treatment of hair loss?. J Eur Acad Dermatol Venereol. 2018 Apr;32(4):564-9.

Dhurat R, Sukesh MS, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Intern J Trichol. 2013 Jan;5(1):6.