Abstract:
Background: Androgenetic alopecia is a genetically predisposed androgen induced
pattern of progressive hair loss. Dermal papilla (DP) is the site of expression of
various hair growth related genes. According to various studies Wnt proteins and
wound growth factors help in stimulating DP associated stem cells. Microneedling
works by stimulation of stem cells and inducing activation of growth factors.
Minoxidil causes increased expression of VEGF mRNA and activates β-catenin
activity in the DP cells.
Objectives: Objective of this study was to study the effect of microneedling
technique along with topical minoxidil versus minoxidil in male androgenetic
alopecia.
Materials and method: Sixty eight men with grade III and IV androgenetic alopecia
(AGA) were recruited into 2 groups. After randomization one group was offered
weekly microneedling treatment with twice daily 5% minoxidil lotion (study group);
other group was given only 5% minoxidil lotion (control group). Baseline global
photographs were taken. Dermoscopic images were taken from a 1 cm targeted fixed
area at baseline and at end of therapy (week 12) from where hair count was done. The
2 primary efficacy parameters assessed were: Increase from baseline hair count at 12
weeks and patient self assessment of hair growth at 12 weeks. Two blinded
investigators evaluated response on computer screen using dermoscopic images.
Patient‟s self perception regarding hair growth was assessed by 10 inch long visual
analogue scale.
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Results: (1) Hair counts – The mean increase in hair count at week 12 was
significantly greater for the study group compared to the control group (12.52 vs 1.89
respectively). (2) Patient evaluation – In the study group, 4 (12.9%) patients reported
50% improvement versus none in the control group.
Conclusion: Dermaroller along with Minoxidil treated group was superior to
minoxidil treated group in promoting hair growth in men with AGA for 2 primary
efficacy parameters of hair growth, the response achieved is not cosmetically
significant. However, the total number and frequency of sessions and long-term
sustainability of response of microneedling need to be evaluated within a larger
population. Microneedling in combination with minoxidil is a safe and a promising
therapy to treat hair loss refractory to minoxidil monotherapy.
