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Combined microneedling and minoxidil therapy improves hair count, thickness, and patient satisfaction in androgenetic alopecia, with minimal side effects.
In a systematic review and meta-analysis, combining microneedling with minoxidil offered markedly better outcomes for individuals with androgenetic alopecia (AGA) when compared to minoxidil monotherapy. The study synthesized evidence from randomized controlled trials (RCTs) to explore both the efficacy and safety of this combined approach, with additional insights into how microneedling parameters—such as needle depth, treatment duration, and device type—might influence results.
Investigators executed an extensive literature search across 6 major databases, including Cochrane Library, PubMed, and Embase. Notably, 12 RCTs comprising 631 AGA sufferers were identified, and data from 11 of these trials were eligible for quantitative analysis. Patients receiving microneedling + minoxidil experienced a remarkably greater increase in hair count when compared to those treated with minoxidil alone. The standardized mean difference (SMD) was 1.32, indicating a notable effect size in favor of the combination therapy.
However, considerable variability among the studies was observed (I² = 88%), suggesting differences in study designs, populations, or interventions may have contributed to the heterogeneity. In addition to hair count, 6 RCTs monitored changes in hair diameter, which also significantly improved with microneedling + minoxidil (SMD 0.34). Notably, this outcome showed no heterogeneity (I² = 0%), underscoring the consistency of this benefit across trials.
To comprehend whether specific microneedling parameters influenced treatment outcomes, the investigtaors performed subgroup analyses. Results indicated that differences in microneedling needle depth (≤1 mm vs. >1 mm), treatment duration (≤12 weeks vs. >12 weeks), and microneedling technique (electrodynamic device vs. manual roller) did not markedly alter the effect on hair count. Furthermore, both investigator-rated and patient self-assessment scores consistently favored the combination therapy, reinforcing its clinical relevance and perceived benefits.
While adverse events were reported more frequently in the microneedling + minoxidil group (74 events) compared to minoxidil monotherapy (59 events), these were typically mild or self-limiting. Overall, the findings suggest that the addition of microneedling to minoxidil therapy boosts hair growth outcomes in AGA, without introducing serious safety concerns. The lack of influence from varying microneedling parameters further supports its use as a flexible and promising adjunctive treatment strategy for those seeking improved hair regrowth.
Archives of Dermatological Research
Evaluating the efficacy and safety of combined microneedling therapy versus topical Minoxidil in androgenetic alopecia: a systematic review and meta-analysis
Khalid M. A. Ahmed et al.
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