Microneedling for Hair Loss
Microneedling is a cosmetic treatment that uses very tiny needles to puncture the skin and stimulate collagen production. It’s sometimes called dermarolling, micropuncturing, or percutaneous collagen induction therapy (PCIT).
Microneedling has long been used to improve the appearance of wrinkles, scars, and stretch marks. More recently, microneedling is being used as a treatment for hair loss. In this article, we review the theory behind microneedling for hair loss, including the science supporting it and the available microneedling devices on the market.
How Does Microneedling Promote Hair Growth?
Microneedling for hair loss is based on the theory of wound healing. When the skin is wounded, it goes through a complex repair process that involves three main phases:
Inflammation: In this phase, blood vessels dilate and inflammatory cells are recruited to the site of injury. This increased blood flow helps to clean up the area and prepare it for healing.
Proliferation: In this phase, new cells are generated to replace the damaged tissue.
Remodeling: In this phase, the new tissue is matured and remodeled to match the surrounding tissue.
The needles in the microneedling device create tiny injuries in the skin, which triggers inflammation. This leads to the recruitment of new cells and the growth of new blood vessels. The new cells help to repair the damaged tissue and this can stimulate hair growth in some people.
Microneedling for Androgenetic Alopecia
Androgenetic alopecia (sometimes called androgenic alopecia) is the most common type of hair loss, affecting both men and women. It’s also known as male-pattern baldness or female-pattern hair loss.
Androgenetic alopecia is thought to be caused by a combination of genetic and hormonal factors. The main hormone involved is dihydrotestosterone (DHT). DHT is a byproduct of testosterone that has been shown to shrink hair follicles and inhibit hair growth.
Common prescription medications to treat hair loss, including topical minoxidil and finasteride, can help reduce hair thinning associated with androgenic alopecia by directly reducing DHT production. Microneedling on the other hand, may not have a direct impact on DHT production, yet still has been shown to stimulate new hair growth in multiple clinical studies.
Microneedling Effects on Hair Follicles
The needles in a microneedling device create tiny injuries to the skin, which can stimulate the growth of new hair follicles. This is thought to occur through a couple of mechanisms:
Stimulation of Wnt/β-Catenin Signaling Pathway
The Wnt/β-catenin signaling pathway is important for hair follicle development and regeneration. In one study, microneedling increased the expression of genes involved in this pathway, which led to the growth of new hair follicles.
Release of Growth Factors
Microneedling can also lead to the release of growth factors from the skin, which can promote the growth of new hair follicles. Growth factors are proteins that play an important role in cell growth and regeneration.
One study found that microneedling increased the levels of epidermal growth factors and vascular endothelial growth factor (VEGF) which are directly associated with hair regeneration.
Dermal Papilla Stem Cells
When the small needles of a microneedling device puncture scalp skin, they cause a healing cascade that stimulates the production of Hair Follicle Stem Cells in the “hair bulge” area underneath the hair follicle. This is believed to be one of the reasons why microneedling for hair growth can be effective.
Microneedling vs. Topical Minoxidil
Microneedling and minoxidil are two popular treatments for hair loss. Both have been shown to be effective in stimulating new hair growth, but there are some key differences between the two.
Minoxidil is a topical medication that is applied to the scalp twice daily. It can take several months to see results from minoxidil lotion. In contrast, microneedling is a quick and easy procedure that can be done in-office by a trained professional.
A review study published in the Journal of Cosmetic Dermatology in 2022 compared the effectiveness of microneedling and topical minoxidil in patients with androgenic alopecia. The study found that in general, there were more hair count increases in the microneedling group compared to the minoxidil group. The researchers further observe that the patients who received microneedling for hair loss, while also receiving topical minoxidil showed the best hair regrowth outcomes. This suggests that topical medications like minoxidil can be combined with a microneedling session to deliver overall more effective hair loss treatments.
Platelet Rich Plasma vs. Microneedling
Platelet rich plasma (PRP) is another popular treatment for hair health. Platelet rich plasma is made from a patient’s own blood and contains high levels of cells and proteins associated with hair regrowth.
Microneedling therapy and PRP therapy have both been clinically shown to be effective treatments for male and female pattern hair loss. Microneedling treatment for hair loss is often done as a standalone procedure – however, many clinicians perform microneedling and delivery PRP injections simultaneously when treating hair loss disorders.
One small study compared the efficacy of microneedling as a hair loss treatment with and without the addition of platelet rich plasma. This study found that patients who received PRP and microneedling for hair loss showed more hair regrowth than the patients who just received a microneedling treatment. If you want to learn more about PRP for hair loss – check out this guide.
Microneedling for Alopecia Areata
Alopecia areata (AA) is an autoimmune disorder that results in patchy hair loss. Unlike some other forms of alopecia, the exact mechanism of action between AA and hair loss is not fully understood. The hair loss associated with this condition is believed to be related to a variety of factors, including the immune system, stress, and genetics.
While there is limited research on microneedling for alopecia areata, there are some promising case studies. This 2014 study showed success in treating two patients with alopecia areata who were not responding to more traditional therapies. After multiple scalp microneedling procedures were performed, both patients were able to regrow hair in their previously patchy bald spots.
Who Can Perform Microneedling Procedures?
Microneedling for hair loss should only be performed by a licensed medical professional. While microneedling is considered to be safe, there is always a risk of infection or other complications when needles are involved.
At Home Microneedling Devices
There are a variety of at home skin roller and microneedling devices that can be purchased online. These devices typically come with a needle depth of either 0.5 mm or 1.0 mm. Although these needle lengths can be effective for increasing hair density, longer needle lengths are typically only found in professional microneedling devices.
While at home microneedling devices may seem like a convenient option, it’s important to remember that these devices should only be used under the supervision of a licensed medical professional. It’s also worth considering that, regardless of needle length, most microneedling devices marketed to consumers likely don’t have medical grade needles like those used by FDA-cleared microneedling devices. This is important, because although microneedling is a minimally invasive procedure, it does come with some serious side effect risks.
Microneedling Risks and Side Effects
Microneedling is considered a relatively safe cosmetic procedure with minimal risk for serious side effects. However, as with any medical procedure, there are some risks associated with microneedling – particularly if the procedure is not performed correctly. For this reason, it is important to only have microneedling for hair loss done by a licensed and certified professional.
One of the potential risks of microneedling is atrophic scarring – also known as “ice pick scars.” Atrophic scarring can occur when the needles penetrate too deeply into the skin, causing injury to the underlying tissue. This type of scarring is typically seen in patients who have had multiple sessions of microneedling or who have undergone treatments with a higher needle density.
Another potential complication of microneedling is infection. While the risk of infection is low, it is still important to have the procedure done by a licensed professional in a sterile environment.
Microneedling can also cause hyperpigmentation – or darkening of the skin. This side effect is more common in patients with darker skin tones. Hyperpigmentation can typically be treated with over-the-counter lightening creams or prescription medications.
How Much Does Microneedling Cost?
The cost of microneedling will vary depending on the provider and the location of the treatment area. In general, microneedling treatments can range from $100 to $500 per session.
Is Microneedling for Hair Loss Covered by Insurance?
Microneedling for hair loss is not typically covered by medical insurance. However, some insurance plans may cover the cost of microneedling if it is considered a medical necessity – such as in the case of patients with alopecia areata who have not responded to other forms of treatment.
What to Expect After a Microneedling Hair Loss Treatment
After a microneedling treatment, your skin will be slightly red and tender. You may also experience some mild swelling, bruising, or itching. These side effects are normal and should resolve within a few days.
You should avoid exposure to sunlight and excessive heat for at least 24 hours after the procedure. Additionally, you should avoid using makeup or skincare products that contain retinol or other exfoliating ingredients for at least 24 hours.
It is also important to avoid picking or scratching at the treated area as this can cause irritation and lead to infection. If you experience any persistent side effects or if your skin becomes excessively red or swollen, you should contact your provider.
How Many Microneedling Sessions are Necessary?
The number of microneedling treatments will vary depending on the individual. In general, most patients see the best results after 3-6 treatments. These treatments are typically spaced 4-6 weeks apart. However, some patients may consider more treatments for enhanced hair growth.
Additionally, some patients may need additional treatments in order to maintain results. Maintenance treatments are typically done every 2-3 months.
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