title: Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy.
abstract: BACKGROUND
  The efficacy of conventional therapy viz. finasteride and minoxidil in androgenetic alopecia (AGA) that is based on both preventing hair loss and promoting new hair growth, varies between 30% and 60%. This has led to a large number of patients unsatisfied who demand for a better cosmetic coverage over the scalp. Microneedling has recently been reported to be promising, effective and a safe treatment modality in the treatment of AGA. This augments the response of conventional therapy.
  
  
  METHODS
  Four men with AGA were on finasteride and 5% minoxidil solution since 2 to 5 years. Though there was no worsening in their respective AGA stages with the therapy, they showed no new hair growth. They were subjected to microneedling procedure over a period of 6 months along with their ongoing therapy. Patients were assessed with the use of the standardized 7-point evaluation scale and patients' subjective hair growth assessment scale. The patients were followed up for 18 months post microneedling procedure to assess the sustainability of the response.
  
  
  RESULTS
  All patients showed a response of + 2 to + 3 on standardized 7-point evaluation scale. The response in the form of new hair growth started after 8-10 sessions. The patients' satisfaction was more than 75% in three patients and more 50% in one patient, on patients' subjective hair growth assessment scale. The obtained results were sustained post procedure during 18 months follow-up period.
  
  
  CONCLUSIONS
  Treatment with microneedling showed an accelerated response with addition of microneedling procedure leading to significant scalp density. This is the first case series to report the boosting effect of microneedling with respect to new hair follicle stimulation in patients with androgenetic alopecia who were poor responders to conventional therapy.
authors.affiliation: Department of Dermatology, LTM Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.
authors.forename: Rachita
authors.initials: R
authors.lastname: Dhurat
authors.affiliation: Department of Dermatology, LTM Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.
authors.forename: Sukesh
authors.initials: S
authors.lastname: Mathapati
keywords: Androgenetic alopecia; finasteride; microneedling; minoxidil; new hair growth