Hair loss, particularly androgenetic alopecia (AGA) and alopecia areata (AA), affects a large portion of the population and often resists standard therapies. Microneedling (MN), a minimally invasive procedure that creates micro-injuries in the skin, has gained attention for its potential to stimulate hair regrowth.

By initiating a wound-healing response and possibly enhancing transdermal drug delivery, MN could offer a new pathway in hair restoration (Gupta et al., 2022; English et al., 2022).

Microneedling appears to function by stimulating stem cells and increasing expression of hair growth-related genes such as Wnt3a, β-catenin, Wnt10b, and VEGF, as demonstrated in murine models (Kim et al., 2016). These genes are integral to the hair growth cycle and are activated during wound healing. The most effective results in animal studies were observed with microneedles of 0.25–0.5 mm applied in 10 cycles, suggesting that specific parameters can optimize efficacy while minimizing skin trauma.

Clinically, microneedling combined with 5% topical minoxidil outperformed minoxidil alone, with significantly greater increases in hair count and visual improvement scores (Dhurat et al., 2013). Systematic reviews report that, across 22 clinical studies and over 1,100 subjects, microneedling improved hair outcomes in both AGA and AA cases, especially when paired with adjunct therapies such as platelet-rich plasma (PRP) or growth factor solutions (English et al., 2022).

Despite encouraging results, studies vary in methods, needle lengths (0.5–2.5 mm), frequencies, and adjunct treatments. While no serious adverse effects were reported, most clinical trials were small and short-term. There is also concern that overly aggressive microneedling could cause perifollicular fibrosis, which might counteract the benefits.

Still, early evidence points to microneedling as a potentially effective and safe complementary treatment for certain hair loss conditions.