title: A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study.
abstract: BACKGROUND
  Dermal papilla (DP) is the site of expression of various hair growth related genes. Various researches have demonstrated the underlying importance of Wnt proteins and wound growth factors in stimulating DP associated stem cells. Microneedling works by stimulation of stem cells and inducing activation of growth factors.
  
  
  METHODS
  Hundred cases of mild to moderate (III vertex or IV) androgenetic alopecia (AGA) were recruited into 2 groups. After randomization one group was offered weekly microneedling treatment with twice daily 5% minoxidil lotion (Microneedling group); other group was given only 5% minoxidil lotion. After baseline global photographs, the scalp were shaved off to ensure equal length of hair shaft in all. Hair count was done in 1 cm(2) targeted fixed area (marked with tattoo) at baseline and at end of therapy (week 12). The 3 primary efficacy parameters assessed were: Change from baseline hair count at 12 weeks, patient assessment of hair growth at 12 weeks, and investigator assessment of hair growth at 12 weeks. A blinded investigators evaluated global photographic response. The response was assessed by 7- point scale.
  
  
  RESULTS
  (1) Hair counts - The mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively). (2) Investigator evaluation - Forty patients in Microneedling group had +2 to +3 response on 7-point visual analogue scale, while none showed the same response in the Minoxidil group. (3) Patient evaluation - In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment.
  
  
  CONCLUSIONS
  Dermaroller along with Minoxidil treated group was statistically superior to Minoxidil treated group in promoting hair growth in men with AGA for all 3 primary efficacy measures of hair growth. Microneedling is a safe and a promising tool in hair stimulation and also is useful to treat hair loss refractory to Minoxidil therapy.
authors: Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.
authors: Rachita
authors: R
authors: Dhurat
authors: Ms
authors: M
authors: Sukesh
authors: Ganesh
authors: G
authors: Avhad
authors: Ameet
authors: A
authors: Dandale
authors: Anjali
authors: A
authors: Pal
authors: Poonam
authors: P
authors: Pund
keywords: Androgenetic alopecia; Microneedling; dermaroller; hair re-growth; signaling pathways
references: J Drugs Dermatol. 2010 Nov;9(11):1412-9
references: 21061765
references: Mech Dev. 2001 Sep;107(1-2):69-82
references: 11520664
references: Arch Dermatol. 2010 Oct;146(10):1141-50
references: 20956649
references: Development. 2012 Apr;139(8):1522-33
references: 22434869
references: Br J Dermatol. 2004 Feb;150(2):186-94
references: 14996087
references: Expert Opin Pharmacother. 2009 Apr;10(6):1017-26
references: 19364249
references: J Invest Dermatol. 2008 Feb;128(2):262-9
references: 17657240
references: J Drugs Dermatol. 2011 Nov;10(11):1308-12
references: 22052313
references: Nature. 2008 Jan 17;451(7176):340-4
references: 18202659