By Christopher Bergland 

Published on November 01, 2023

Microneedling, also known as collagen induction therapy, is a minimally invasive procedure that involves puncturing the outermost layer of skin (stratum corneum) with dozens of tiny sterilized needles attached to a dermaroller, dermastamp, or dermapen. Scalp microneedling for hair loss (alopecia) works by stimulating specialized hair follicle stem cells, which can trigger enhanced hair growth.¹

With proper application, professionally administered scalp microneedling with a medical-grade dermaroller or dermapen can work for many people with certain types of hair loss. That said, scalp microneedling won't work for everyone, and the risks of at-home microneedling for hair loss with needles longer than 0.25 millimeters (mm) outweigh the potential benefits.

Read on to learn what types of hair loss microneedling can help, parts of the head that can be treated with microneedling, how to use a derma roller for hair regrowth at home, when to see a professional, and how often this procedure should be performed.

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Which Types of Hair Loss Could Microneedling Help?

In medical terms, male-pattern baldness and female-pattern hair loss are called androgenetic alopecia or AGA. This is the most common type of hair loss. Microneedling, when used with other hair loss treatments, has been shown to help people with hair loss who don't respond to conventional therapy.²³ Preliminary results suggest microneedling may also help those with telogen effluvium hair loss.⁴

Microneedling won't help other types of hair loss caused by certain drugs (anagen effluvium), such as chemotherapy treatments. It also can't restore hair growth if the hair follicle has been irreversibly destroyed by advanced scarring.⁵ 

Results of Microneedling for Hair Loss: Before and After

Microneedling for hair loss is a relatively new treatment. In the early 2020s, limited high-quality human research with large sample sizes was performed to investigate the "before and after" results of microneedling as a stand-alone treatment (monotherapy).⁶

Animal studies in mice with before- and after-treatment photos suggest that microneedle stimulation alone induces enhanced hair growth, but larger, randomized human studies are needed.⁷

Findings suggest scalp microneedling works best with other hair-loss treatments. Forthcoming large, double-anonymized human studies should help to determine the safety, efficacy, and potential benefits of microneedling for hair loss as a monotherapy.

Some small human studies have shown enhanced hair growth when microneedling is combined with other adjunct therapies, such as the topical hair-growth drug Rogaine (minoxidil) or platelet-rich plasma (PRP) injections. PRP injections are only performed by trained professionals in medical settings.

Can People Using Minoxidil or Finasteride Try Microneedling?

Minoxidil is the only over-the-counter drug approved for male and female pattern hair loss.⁸ Propecia (finasteride) is a Food and Drug Administration (FDA)–approved oral treatment for hair loss available by prescription.

It is safe for people using minoxidil or finasteride to also try microneedling. In fact, research suggests that combining 5% minoxidil with microneedling works better than using it alone.⁹

In 2013, a pilot study found that applying a 5% minoxidil lotion with a derma roller once a week for 12 weeks increased hair counts significantly more than using just minoxidil.¹⁰

A small 2022 study with 18 participants found that microneedling with 5% minoxidil topical solution once a week for six weeks as part of alopecia treatment showed efficacy and safety. Ten weeks after the treatment was completed, 15 study participants (83.3%) said they were "satisfied" with their hair growth results.¹¹ 

Another small 2022 study on the efficacy of platelet-rich plasma injections plus microneedling for the treatment of androgenetic alopecia found that PRP plus microneedling was more effective than PRP alone in men or women with moderate (level 4 on the 1-7 Norwood scale) hair loss.¹²

Parts of Head Treated With Microneedling

Managing expectations is key if you're considering trying microneedling for hair loss. Microneedling as a standalone treatment has yet to be shown to regrow enough hair to cover large bald spots if someone has advanced hair loss.

The best candidates for scalp microneedling are in the early stages of alopecia and have moderate hair loss associated with male or female patterns of androgenetic alopecia. The parts of the head treated with microneedling aren't usually completely bald but rather have lower hair count numbers or thinner strands that have lost some of their volume over time.

For example, someone with a V-shaped widow's peak would start by microneedling hairline recession on both sides of the "V," where there's still some hair, but it's thinning. A woman with female-pattern hair loss, marked by frontal hairline thinning, diffuse thinning over the head's crown, or increased part width, could treat these areas of thinning hair with microneedling.

How to Use a Dermaroller for Hair Regrowth

Microneedles used for do-it-yourself home treatments are usually between 0.1 millimeters (mm) and 0.2 mm long.⁶ Microneedles used on the scalp shouldn't be pressed hard enough to puncture the skin or cause micro-wounds that bleed. At-home derma rollers used for hair loss are safest and most beneficial when gently applying topical minoxidil without rupturing the skin barrier. 

At-Home Microneedling Isn't Always Safe

Aggressive at-home microneedling performed with unsterilized needles that are either too long or pushed too hard into the scalp can cause injury and infection. A derma roller with short needles probably won't have adverse side effects. However, repeated overuse of an at-home microneedling device that creates micro-wounds in the scalp can be harmful.

Deciding to See a Microneedling Professional

The sterilized, medical-grade needles used by professional microneedlers are much longer (0.5 mm to 2.5 mm) than do-it-yourself microneedles. Professional microneedling devices for hair loss are calibrated to puncture scalp skin more deeply. The needles must be long enough to reach a hair follicle niche called the bulge region that contains growth-boosting stem cells.¹³

In most people, the hair follicle bulge containing specialized stem cells resides 1.00–1.80 mm below the skin's surface.¹⁴ However, using needles longer than 0.25 mm at home isn't recommended because it increases the risk of infection, scarring, or permanently damaging your hair follicles.

Because hair follicle stem cells that trigger hair regrowth are relatively deep beneath the skin's surface, it's hard to reach them using an at-home microneedling device without the risk of injury or adverse complications. See a professional for best results.

How Often to Do Microneedling for Hair Loss

There isn't an evidence-based consensus on how often to do microneedling for hair loss. Some studies recommend doing it once a week, while others have found results with monthly sessions. Because longer needles cause deeper micro-wounds that take more time to heal, the frequency between treatments should be spread out to accommodate the healing process.

When it comes to microneedling for hair loss, doing it more often isn't necessarily better. The scalp needs time between treatments to heal. Doing scalp microneedling too often increases the risk of adverse side effects such as infection or scarring.¹⁵

Summary

Some research supports the use of microneedling for hair loss. Still, large-scale randomized controlled human studies are needed to see how well it works as a standalone treatment and establish best practices regarding needle depths and treatment frequency.

More evidence-based research is needed to determine how many weeks or months it takes until someone sees results or how long microneedling results last. Available studies suggest microneedling works best when combined with other hair-loss treatments, such as a topical 5% minoxidil solution.

At-home microneedling can be unsafe. It's important to speak to a healthcare provider, such as a dermatologist, about what type of hair loss you're experiencing and if professional microneedling would be worth it.