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Microneedling

A safe DIY medical treatment (if you’re careful)

Many people who are trying to regrow their hair might have come across microneedling as a possible treatment to do on their own. It’s advised that most medically related procedures not be done as DIY projects, but there are positive results from research studies that involve at-home microneedling.

Based on this, microneedling can be considered a viable medical therapy. The treatment was first demonstrated to be effective in treating scars and skin laxity and, interestingly for us, microneedling has been used to improve hair growth.

It can be used either on its own or in combination with other therapies, like minoxidil, steroids, vitamins, or PRP (platelet-rich plasma), a way in which it has even better results. 

What is microneedling?

Microneedling (MN), or as it is also called percutaneous collagen induction (PCI), consists of using multiple fine needles to create micro punctures in the skin.

You can do the microneedling alone or you can combine it with other modalities. If it's combined with PRP, you get the added benefit of the actual platelets that you're putting back into the scalp opening up and spilling their growth factors. 

Why does hair grow back with MN?

There are two general reasons why hair grows back with microneedling.

  • The first is that growth factors in the area where microneedling was done increase as the body repairs itself.
     
  • The other mechanism is the activation of stem cells in the hair bulge area, which is the area where most hair follicle stem cells reside.

What types of hair loss can you use MN for?

  • Microneedling has been shown to help with recovery of bald spots that occur with alopecia areata, where you get a balding spot on the scalp or the beard. 
  • Microneedling helps with androgenic alopecia, which is the big one - that's the most common male pattern or female pattern hair loss.  
  • Another hair condition that can also be helped with MN is telogen effluvium - a temporary form of hair loss that follows stressful events.

How to microneedle?

For microneedling at home, you can use a dermapen or a dermaroller, but which is better?

The problem with dermarollers is that they can break the strands of hair, consequently cutting the hairs. They'll ultimately grow back, but if you're not looking for a haircut, this could be an issue.

A dermapen is a device that punches vertically with needles onto the skin. It is the better option, since the needle is coming in vertically, and you are able to avoid breakage of the hairs. 

When it comes to needle length, it is advised to start with the most shallow depth, and that is typically 0.5 millimeters.

It's a tolerable depth for most people and it can still yield results. You want to be effective in your delivery, or else what's the point of doing it, but you don't want it to be harmful and potentially cause unnecessary pain and risk of scarring.

The other interesting point to mention is that alopecia, specifically androgenic alopecia, results in the scalp thinning as it progresses.

You have to adjust for that by decreasing needle length over time.

How often should you MN and for how long?

I would start with monthly treatments. From a monthly treatment, you can slowly increase it to every three weeks, then every two weeks, and then you might even do it weekly if you can tolerate it. Definitely don't do it every day!

How many times should you go over the same area?

I would start with one application until you're more comfortable and can move on to something closer to two or three applications. However, it's more about looking for the desired endpoint rather than focusing on how many times you're going over an area. The desired endpoint is pinpoint bleeding and/ or mild to moderate redness. Once you reach that end point, you should stop.

 

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What are the possible negative consequences?

  • Some itching and redness. The erythema (redness) can last for a long period of time. 
  • Hair shedding is possible, especially in the first few months.
  • Infection is always a risk because you're making all these tiny pokes in the scalp.
  • Some people can have a reaction to the local anesthesia. Anesthesia is something that you would have applied by a doctor, under proper medical guidance, not something you'd be doing at home, but even then, there are different potential toxicities.
  • If you go too deep and do this too often, then you risk scarring. Scar tissue formation can hurt your ability to grow hair.

When can you expect results?

Give it about six months before giving up, unless, of course, there are complications or reasons to stop.

It is best to talk to a doctor about these regimens before starting and definitely continue to check in with your doctor to make sure that you're continuing to have good results, safely.

Sources:

https://www.clarionmedical.com/Clario... 

https://www.ishrs-htforum.org/content... 

 

The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.

Written by Aleksandra Božović | Edited by Dr. Gary Linkov
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