Microneedling and Minoxidil Combination Effective for Female Pattern Hair Loss

A better therapeutic effect was seen in patients treated with microneedling plus topical 2% minoxidil than minoxidil alone.

A combination of topical minoxidil and microneedling was more effective than minoxidil only for female pattern hair loss, investigators reported in a study published in the Journal of Cosmetic Dermatology.

The single-center, randomized controlled trial assessed the efficacy and safety of 2% minoxidil combined with microneedling in 40 Chinese women aged 18 to 50 years who were diagnosed with female pattern hair loss. Data were obtained from January 2018 to December 2019.

The participants were randomly categorized into 2 groups of 20 patients each. Group 1 (control group) received topical 2% minoxidil solution twice a day, 1 mL each time. Group 2 (combined treatment group) received weekly microneedling (needle length of 260 µm) for 24 weeks in addition to the daily minoxidil. The participants were asked to use topical minoxidil daily for an additional 12 weeks after the treatment period. Follow-up occurred every 4 weeks from treatment initiation and for another 12 weeks from the end of treatment by the same independent treatment-blinded investigator.

The 2 primary efficacy parameters were investigator assessment of hair growth at 24 weeks and change from baseline hair counts at 24 weeks.

Microneedling combined with minoxidil therapy was safe and effective.

Group 1 participants had a mean age of 30.05±5.46 years with a mean disease duration of 6.9±2.75 years. Group 2 had a mean age of 31.68±4.93 years with a mean disease duration of 7.42±3.08 years.

No significant difference in the modified Sinclair scale score at session 0 was observed between the 2 groups (P =.83). After treatment, the Sinclair scale score for group 2 was lower than that of group 1 (P <.01).

Group 2 had a clinical efficacy rate of 85%, which was significantly greater than the rate of 45% in group 1 (P <.01). A decrease in the Sinclair scale of 1 grade or more was regarded as clinically effective.

Hair counts at session 24 for both groups were significantly increased vs session 0, and those in group 2 (121.90±19.47) were significantly higher than those of group 1 (96.35±16.02) (P <.01).

Regarding adverse events, 2 patients in group 2 had an occasional headache after the first 2 sessions of microneedling treatment, and 10 patients in group 2 had hairy symptoms in other parts of the body during treatment. In group 1, a total of 7 patients had scalp itching and a transient increase in hair loss within the first 4 weeks of treatment, compared with 1 patient in group 2.

“The pain and other adverse events caused by nanomicroneedling were mild, and patients could tolerate microneedling treatment,” the study authors concluded. “In general, no serious adverse reaction time was observed in the 2 groups. Microneedling combined with minoxidil therapy was safe and effective.”


Zhang Y, Sheng Y, Zeng Y, et al. Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population. J Cosmet Dermatol. Published online October 10, 2022. doi:10.1111/jocd.15424