Microneedling

A consensus of experts identified seven recommended interventions for AGA, including oral and topical finasteride, dutasteride, and minoxidil, while identifying 17 interventions that are not recommended.

Combination therapy of topical minoxidil and microneedling significantly increases total hair count compared to minoxidil alone, though it did not show a statistically significant increase in hair diameter.

Oral dutasteride demonstrates better efficacy than finasteride for AGA with similar tolerability, while topical delivery methods like microneedling or mesotherapy may reduce systemic adverse events.

Standard treatments like topical minoxidil and oral finasteride are established, while newer modalities like PRP, LLLT, and oral minoxidil show encouraging results but lack standardized protocols.

Dissolving microneedles offer superior drug loading and simpler fabrication/disposal compared to coated or hollow microneedles, with potential applications in hair and scalp disorders.

The review outlines various current and emerging therapies for hair loss, including pharmacological agents, devices, and cellular therapies.

Microneedling serves as an effective adjunct therapy for androgenic alopecia when paired with minoxidil, growth factors, or PRP, and shows promise as a standalone therapy for alopecia areata.

The review discusses the pathophysiology and various emerging treatments such as microneedling, LLLT, and autologous fat transfer for female pattern hair loss.

Microneedling monotherapy is more effective than 5% topical minoxidil alone, and combining microneedling with 5% minoxidil provides a significant additional increase in total hair count compared to microneedling monotherapy.

Fractional laser and microneedling, especially when combined with topical agents, show promise for promoting hair regrowth in alopecia areata based on limited small studies.

PRP shows promise for promoting hair regrowth and improving skin quality, particularly when combined with microneedling or laser therapies, although standardized treatment protocols are lacking.