Microneedle frequency adjunct to 2% minoxidil in female androgenetic alopecia: A randomized controlled trial

Microneedling has been proposed as an adjunctive strategy to enhance topical minoxidil delivery in androgenetic alopecia, but the optimal treatment frequency remains unclear.

To evaluate the efficacy and safety of 2% topical minoxidil alone versus minoxidil combined with microneedling in women with mild-to-moderate androgenetic alopecia.

In this 24-week prospective, randomized, open-label, single-center trial, 245 women with mild-to-moderate androgenetic alopecia (Savin grades D3-D6) were randomized to receive minoxidil alone, minoxidil plus monthly microneedling, or minoxidil plus microneedling every 2 weeks. The primary endpoint was change in target area nonvellus hair count from baseline to week 24. Secondary outcomes included nonvellus hair shaft diameter, vellus hair count, hair density, and cumulative hair shaft diameter.

A total of 234 participants completed the study. All groups demonstrated significant increases in target area nonvellus hair count at week 24 (all P < .001), with no significant differences between groups. Secondary outcomes were also comparable across treatments groups.

Single-center, open-label design and absence of patient-reported outcome data due to database configuration.

Microneedling using a 36-needle cartridge at a depth of 500-550 μm every 2 or 4 weeks did not provide additional clinical benefit over 2% topical minoxidil alone after 24 weeks.