Microneedling For Hair Loss: What You Need To Know
Written by Dr. Kris Sifeldeen / Medically reviewed by Dr. Ame Phitwong, DNP, MSN, BSN
- Home use and clinic procedure
- No approved devices for hair loss
1-2 treatments per week
What Is Microneedling?
What Is Microneedling?
Microneedling is a relatively new, minimally invasive procedure that involves puncturing the epidermis (top layer of skin) with very fine needles. Microneedling works by utilizing the natural healing abilities of the skin.
When you go to the gym and lift weights, you create minuscule tears in the muscle, which the body then heals to build muscle that is bigger and stronger than before. Similarly, the idea behind this procedure is to create tiny wounds in the skin or scalp. These stimulate collagen production and other growth factors to heal the skin, make it look younger, and promote hair growth as well. (1)
Microneedling is used both cosmetically to improve skin’s appearance and as a treatment option for a wide range of conditions. These include alopecia (hair loss), surgical and acne scars, and melasma (freckle patches). (1)
More research is being done, but microneedling has been demonstrated to be a safe, effective treatment for multiple conditions, including alopecia. Hair follicles lie just underneath the scalp. Microneedling these areas promotes growth factors to the skin and the follicles, stimulating hair production in places where it had stopped growing. (2)
Microneedling can be done in a professional’s office, usually by a dermatologist or a trained aesthetician using a special machine. “Dermarolling,” which is the rolling of a wheel with hundreds of tiny needles over the skin or scalp, allows for microneedling at home. Dermapens are another option for microneedling, where a pen-like device is used to introduce tiny wounds instead of a dermaroller.
What Is Collagen Induction Therapy?
Collagen Induction Therapy (CIT) is another term for microneedling. The procedure creates tiny holes in the skin or scalp that your body then heals. These wounds induce collagen production that helps create healthier skin or stimulates hair growth. CIT can often be combined with other treatments, such as minoxidil or platelet-rich plasma, to improve the efficacy of these procedures in alopecia patients. (3)
CIT is mainly done in a clinician’s office, usually by a dermatologist or a certified aesthetician. In addition to general aesthetic purposes, this procedure can be used to treat a multitude of conditions like alopecia, freckles, wrinkles, and acne scars!
How Does Microneedling Work?
The rationale behind microneedling is quite simple. Our bodies are amazing in their healing abilities, and microneedling simply puts this to good use! After the upper layer of skin is punctured with hundreds of tiny holes, the body’s natural healing process begins.
In response to the “micro-trauma” caused by the procedure, growth factors like collagen and elastin are produced to heal these wounds. Since new collagen has been formed and growth factors have been secreted, hair follicle growth is stimulated in those with alopecia. (2)
The way microneedling works is synonymous with working out at the gym. When our muscles repeatedly lift weights, we create tiny “micro-tears” that our body regenerates. This process does not simply fix the damage. During the healing process, repaired muscle fibers become bigger, stronger, and more resistant to stress.
The body heals skin and hair follicles in a similar fashion, with brand new collagen and growth factors being made to replace what was lost. The final result can be hair growth and reinvigorated skin!
What Is a Dermaroller?
Microneedling is typically done in a professional’s office with a high-tech machine but can also be done with a device called a dermaroller. When used at the office or at home, this process is usually referred to as “dermarolling.”
If you’re wondering what dermarolling is, you’re simply rolling a wheel with hundreds of needles or spikes by its handle. These needles create tiny punctures in the skin. As they heal, the body produces growth factors that can benefit skin and hair in various ways.
Dermarollers range in price and are produced by many brands, including Environ®, Sdara, Beauty ORA, GloPro®, and Cosmedica. There are also a range of needle lengths, accessories, wheel variations, and conditions that make deciding on a dermaroller tricky, but the overall process remains the same.
It is crucial to be aware that certain needle lengths may be recommended over others based on the specific condition you are treating. The wrong dermaroller can cause more harm than good.
In general terms, at-home dermarollers are not as precise as the devices used by professionals. These tools however are less expensive than an in-office treatment and can be used regularly to treat alopecia and superficial skin problems. They will also yield more modest results as in-office treatments are typically more thorough, and can be combined with other skincare treatments such as serums or lotions. Dermarollers come in a wide range of needle lengths, but a typical device will use needles in the 1 to 2-millimeter range. (4)
Can You Buy an At-Home Dermaroller? Are They Effective?
Dermarollers are widely available for purchase and can range from $40 to over $400 USD, CA$35-$500, or AU$40-300! Cheaper devices in the $10-20 range are also available, but these are knock-offs and do not provide the quality or safety you need.
Dermarollers come in a wide range of styles and needle lengths, but generally are less precise than professional-grade machines and are not typically as adjustable for different areas or skin types. Modest results are still possible, offering a more financially appealing alternative to potentially expensive in-office treatments.
Research is still lacking in the microneedling realm as a whole, and most studies have focused on professional-grade devices with more control and precision than at-home dermarollers. Nevertheless, most users report positive results, so long as expectations were kept realistic and devices were used correctly. (4)
It is important to keep in mind that microneedling tools are medical devices that need to be kept sterile, or they can cause even more issues. Using an inappropriate device or misusing the device can also be detrimental. For example, pressing too hard or using needles that are too long can cause scarring.
In conclusion, purchasing a dermaroller for hair loss or mild skin issues may be worth trying. But given the potential problems that can occur, it’s important to do your research!
Dermaroller Pros and Cons
Using a dermaroller at home can improve hair growth, as seen from increased collagen and growth factor production. Another pro is the vastly reduced price of a handheld tool instead of professional treatment that can be thousands of dollars. At-home dermarolling can also provide an appealing alternative to office visits when treating superficial scars, wrinkles, and fine lines.
Yet another benefit is the safety of these products. Side effects are rare and can be minimized with proper use and hygienic practices. Dermarollers should be sanitized in an alcohol solution before and after use, and it’s also important to keep the treated area clean. Dermarollers should not be pressed into the skin or scalp, or used more often than the manufacturer recommends.
Dermarollers do come with their drawbacks. They are often not as effective as professional microneedling devices, their effectiveness is partly dependent on user knowledge, and it can be difficult to know how much treatment is enough versus too much. They can cause possible side effects which are rare with proper use, but can include:
- Spread of acne to other areas of the skin
- Changes in pigmentation
People with blood disorders, active acne, who are pregnant or breastfeeding, or who have diabetes should speak with a doctor before investing in a microneedling device. (2) If you are thinking about trying dermarolling at home, it may be best to first speak with your dermatologist or family physician.
What Is a Dermapen?
Similar to dermarollers, another tool in the arsenal of microneedling is the Dermapen. As the name suggests, this device is an electric, pen-shaped, automatic microneedling instrument that is much more precise than an average dermaroller. The mechanism of action is identical, as these devices also simply puncture the upper layers of skin with tiny needles, stimulating collagen and elastin production to produce healthier skin and promote hair growth.
However, there is some confusion as “Dermapen” is the name used both for the tool in general and is itself a brand used by professionals (i.e., the Dermapen® system). Other brands on the market include Dr. Pen®, Beauty ORA, and Angel Kiss®. Similar to dermarollers, dermapens can be used both professionally and at home. (4)
Can You Buy an At-Home Dermapen? Are They Effective?
Dermapens, like their dermaroller counterparts, are also widely available on the market for at-home use. Prices of name-brand devices range from $50 to about $200 USD, CA$50-315, and about AU$60-175. Cheap knock-offs can sell for much, much lower ($10-$30), but their lack of quality will reflect in their price.
Similarly to dermarollers, the needle lengths of dermapens vary widely than you would find in a dermatologist’s office. Therefore, the effectiveness of an at-home pen can be less than you would get professionally.
However, these pens are still quite effective when used correctly. They reduce the look of acne scars, wrinkles, fine lines, discoloration, and can combat alopecia! (1) You will want to follow all the manufacturer’s guidelines on using these devices for the best results.
Dermapen Pros and Cons
The benefits of using a dermapen include increased precision and consistent penetration depth. Dermapens can target areas a dermaroller might not be able to, such as around the eyes, mouth, and nose.
The superior precision and penetration of dermapens also mean more effective results when combined with dermatological products such as skin creams or hair growth serums. These products can penetrate the skin at a further depth than when used topically.
The cons of using a dermapen are similar to those of a dermaroller. Side effects such as inflammation, infection, or scarring can still occur, and when using larger needles (around 1.5 millimeters for at-home pens), some pain is to be expected. As dermapens are still microneedling devices, they have the same types of warnings that come with dermarollers. Many dermapens also rely on a motor and need to be plugged in, limiting mobility. Battery-powered devices are available but are sometimes not as powerful as their cabled counterparts. (5)
Dermaroller vs. Dermapen
Dermarollers and dermapens work in the same way. The reason you may decide to use one over the other may simply come down to price, ease of use, favorable reviews, skin type, or condition. When receiving a professional treatment of either kind, the device used will be handled by a trained professional and will usually deliver a more precise treatment. This route can yield better results over at-home devices.
The main differences between these two microneedling devices are in their designs. Dermarollers simply roll over the skin’s surface with hundreds of tiny needles, while dermapens target smaller areas with greater control of depth.
One of the benefits of using a dermapen is increased precision, as needles can be adjusted to different lengths. Also, the dermapen can reach areas a dermaroller cannot (around the eyes, nose, mouth, and areas of the scalp). These needles also penetrate the skin at a perpendicular angle, leaving smaller micro-wounds with less damage.
In contrast, dermarollers enter the skin at an angle and therefore leave wider, often shallow wounds. The increased precision might also mean better absorption of skin or hair products like lotions and serums. Whether dermapens offer better delivery of topical medications or treatments than dermarollers is still being researched, however. (4,5)
What About Other Microneedling Devices?
You may have researched microneedling devices and seen products on Amazon or Alibaba that look like the real deal, but for some reason, are only two dollars. These are knock-offs. When purchasing a microneedling device, it is best to pay a little more money for the reliability of some of the name brands. These devices are produced in a sterile environment, are inspected for quality, and are medical grade. The same cannot be said for cheap imitations, and they may not be safe to use. Some name brands are available on Amazon, so doing your research and reading reliable reviews is key.
Cutting edge devices are also constantly in the works, including combining microneedling devices with radiofrequency (RF). These devices cost roughly $1,300 to $1,700 USD and they work by using both microneedling and by emitting tiny radio waves, heating up the structures underneath the skin and coaxing them to form new collagen and elastin. Their role in hair growth is still being studied, but this combination has shown success in skin. (4)
Another device being developed is known as DermaFrac™. The devices themselves cost between $5,000 to over $11,000 USD! Treatments using this machine at a spa or clinic that operates one however cost around 225 USD. They work by administering a combination of microneedling, microdermabrasion, serum infusion, and LED light therapy! This allows for a great deal of individualization in treatment, as serums can be adjusted for skin type and desired effect. (4)
These newer microneedling devices are still under investigation, and evidence behind their efficacy is still lacking. It will be interesting to see how these novel devices are used for microneedling in the future. For now, dermarollers and dermapens have the most science to back them.
How Effective Is Microneedling?
Does Microneedling Actually Work?
Microneedling is still new to the world of dermatology and research into its effectiveness is ongoing. Those studies that have been done, however, are showing microneedling to be an effective treatment option for alopecia, wrinkles, aging skin, and scars.
A 2015 study looked at patients with androgenic alopecia that had been treated unsuccessfully with conventional therapy. They found that the addition of microneedling caused a significant increase in hair growth in all patients and a more than 75 percent increase in satisfaction! (6) Research as it stands looks promising, and microneedling seems to be a viable option in treating alopecia and a myriad of skin issues. (1)
Does Microneedling Cause Hair Growth?
Microneedling for hair loss is still a developing field, so research is still being done to assess its efficacy as a treatment. So far, microneedling is showing promising results in multiple types of alopecia. There is no consensus on how best to use microneedling nor standardized microneedling treatment protocols, but this procedure has produced real results in improving hair quality, thickness, and density. (7)
It remains to be seen if microneedling the scalp for hair loss should be considered as a monotherapy, combined with established treatments, or used as a delivery system for other drugs. Still, microneedling is considered a promising treatment modality for hair regrowth.
Science seems to answer the question “Can microneedling stimulate hair growth?” with a resounding ‘Yes’. Like building muscle, utilizing the remarkable healing powers of the human body to improve skin and hair is an exciting area of research, with microneedling growing ever more popular. With evidence pointing to its effectiveness, safety, minimal side effects, low invasiveness, and ability to pair with other treatments, it will be interesting to see how microneedling will play a role in treating hair loss in years to come.
Does Microneedling Improve Your Hairline?
Microneedling has been shown to improve hair growth not only in areas of thinning hair but the receding hairlines of people with alopecia! A 2018 case study from Baylor University showed near-complete hair regrowth in an alopecia areata (autoimmune hair loss) patient when microneedling was combined with triamcinolone (a steroid already established as a hair loss treatment) over 6 months. Of course, this is a tiny study, but it shows the potential benefits microneedling has in improving the hairlines of patients who suffer from alopecia. (8)
The best combination therapy using microneedling in the treatment of alopecia is still being researched. How often microneedling for hair should be done, for how long, and which additions will be key aspects of choosing treatment. And despite the promising results from the previously mentioned study, dermapens might be a better choice compared to using a dermaroller on the hairline given their increased precision.
In the United States, the FDA has not approved microneedling as a treatment for hair loss. Still, it’s a promising alternative for those who have tried conventional therapies.
Do At-Home Dermarollers Work?
Dermarolling at home is another addition to the list of “at-home anti-aging treatments” sweeping the market. The number and variations of dermarollers available for purchase are ever-growing. This can cause some confusion about which device is best and whether the one you decided on really works.
As it stands, at-home dermarolling efficacy seems to correlate with complexity and therefore cost. The most expensive dermarollers are professional-grade and are only available to licensed practitioners. These tend to be the most effective.
At-home dermarollers are cheaper, but buyers should manage their expectations as these devices have shorter needles which may not be as “pinpoint” as the higher-end devices. Research shows that at-home dermarolling can provide modest results in treating acne scars, fine lines, wrinkles, and alopecia with proper use. (5)
Microneedling Combination Treatments
Is Dermarolling Effective When Paired With Minoxidil?
Dermarolling is extremely effective when paired with minoxidil (commonly known as Rogaine®), stimulating hair growth in patients with alopecia. Minoxidil acts as a vasodilator, which means it widens the blood vessels and allows for more blood flow to target areas. Most research on microneedling has used this combination, and the results show promise.
A 2013 study showed precisely that. 100 men with androgenic alopecia were split into two groups; one that received microneedling plus minoxidil, and one that received only minoxidil. Hair counts in the microneedling plus minoxidil group improved to 91.4 follicles per cm² as compared to 22.2 follicles per cm² in the minoxidil-only group, a dramatic difference!
This study showed that minoxidil plus microneedling for hair loss results in a substantial improvement. In this case, microneedling plus minoxidil was four times more effective than minoxidil alone. (9)
Just be aware that not all studies have shown such dramatic results. The same researchers conducted a follow-up experiment where men who were already taking 5 percent minoxidil and finasteride without success tried microneedling. The men reported a subjective improvement of 50-75 percent after six months, not as dramatic as the previous study. (10)
The best serum after dermaroller treatment is still up in the air since vitamins, medications, and even certain hair creams can all have their benefits. However, in general, combination treatments show good effectiveness.
What Other Hair Loss Treatments Can Be Combined With Microneedling?
There are a range of treatments hair loss patients can choose from, including oral medications, topical agents that go directly on the scalp, hair follicle transplants, injections, and more. The efficacy of these treatments varies, so new add-on treatments are continuously being researched.
Many of these treatments also come with side effects. Minoxidil, known more commonly as Rogaine®, is a very common treatment for pattern hair loss. Even when used as a topical foam, it is associated with adverse effects such as itching, redness, irritation of the scalp, and even transient hair loss. (7)
In contrast, microneedling is safe, effective, and has very minimal side effects. These effects are usually expected and include redness, mild swelling, potential infection, and skin flaking in the treated area, which typically only last a few days.
Because microneedling is so safe, it can be used in combination with virtually all other hair loss treatments as an adjuvant (enhancing) therapy. It can even be used as a delivery system to allow treatments to penetrate deeper into the scalp, getting “more bang for your buck”. Hair loss medications, like topical minoxidil, topical finasteride (a hormone blocker), and triamcinolone (a topical steroid used to treat alopecia areata, an autoimmune type of hair loss), can likely be enhanced with the addition of microneedling.
The medical literature also supports this. In a 2019 study, microneedling was found to improve hair growth in patients with male-pattern baldness when combined with platelet-rich plasma and minoxidil lotion.
87.1 percent of patients who received minoxidil lotion, platelet-rich plasma (PRP), and microneedling were shown to retain their hair during a “hair pull” test, which is pulling on the hair to determine how much comes out. Only 64.5 percent in the group receiving PRP and minoxidil alone retained their hair during this test, and this declined to 48.4 percent for the control group, who only received minoxidil lotion. (11) More research is being done, but microneedling is proving to be safe and effective when used in conjunction with traditional hair loss treatments.
Microneedling Safety and Side Effects
Is Microneedling Safe?
Microneedling is seen as an incredibly safe, well-tolerated, non-invasive procedure for the treatment of many dermatological conditions. No procedure comes without its possible side effects, however. Those for microneedling are generally mild and disappear within a day or two and include redness, possible infection, swelling, flaking, and irritation (4).
Since microneedling only affects the top layer of skin, the risks of these adverse events are low to begin with. They decline further when used correctly and with sanitized equipment.
Clean your microneedling device by either submerging your dermaroller in a 70 percent isopropyl alcohol solution or dispose of dermapen needles after use in a proper, puncture-proof container. Keeping your skin clean and free of irritants is also essential. It is recommended to not wash your face or exercise for a few hours following microneedling to reduce the chance of bacteria entering one of the wounds created by the microneedling process. (4)
What Side Effects Occur After Microneedling?
No procedure is free from side effects. Microneedling is no exception, and patients most commonly report some redness, mild swelling, and flaking, which subsides within a few hours.
Rarer but more severe side effects can include:
- An allergic reaction
- Infection from unclean equipment or skin
- Changes in pigmentation
- The spread of active acne or infection
This is the reason microneedling is not recommended for those with active skin infections like acne or herpes. Microneedling can spread the organisms causing infection (like bacteria in acne or virus in herpes) further away and infect other areas.
Microneedling can stimulate the release of growth factors as well as melanin, which can cause hyperpigmentation. The risk is higher in people with darker skin tones, as these individuals have more melanin-producing cells. Most of the time, the side effects of microneedling are mild and well-tolerated, but these are important to keep in mind. (4)
- Ramaut, L., Hoeksema, H., Pirayesh, A., Stillaert, F., & Monstrey, S. (2018). Microneedling: Where do we stand now? A systematic review of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery, 71(1), 1–14.
- Hou, A., Cohen, B., Haimovic, A., & Elbuluk, N. (2017). Microneedling: A Comprehensive Review. Dermatologic Surgery, 43(3), 321–339.
- Aust, M. C., Fernandes, D., Kolokythas, P., Kaplan, H. M., & Vogt, P. M. (2008). Percutaneous Collagen Induction Therapy: An Alternative Treatment for Scars, Wrinkles, and Skin Laxity. Plastic and Reconstructive Surgery, 121(4), 1421–1429.
- Yadav, S., & Singh, A. (2016). Microneedling: Advances and widening horizons. Indian Dermatology Online Journal, 7(4), 244.
- McCrudden, M. T., McAlister, E., Courtenay, A. J., González-Vázquez, P., Raj Singh, T. R., & Donnelly, R. F. (2015). Microneedle applications in improving skin appearance. Experimental Dermatology, 24(8), 561–566.
- Dhurat, R., & Mathapati, S. (2015). Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy. Indian Journal of Dermatology, 60(3), 260.
- Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug Design, Development and Therapy, Volume 13, 2777–2786.
- Asad, U., Wallis, D., & Tarbox, M. (2020). Ophiasis alopecia areata treated with microneedling. Baylor University Medical Center Proceedings, 33(3), 413–414.
- Dhurat, R., Sukesh, M., Avhad, G., Dandale, A., Pal, A., & Pund, P. (2013). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. International Journal of Trichology, 5(1), 6.
- Dhurat, R., & Mathapati, S. (2015). Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy. Indian journal of dermatology, 60(3), 260–263.
- Jha, A. K., Vinay, K., Zeeshan, M., Roy, P. K., Chaudhary, R. K. P., & Priya, A. (2019). Platelet‐rich plasma and microneedling improves hair growth in patients of androgenetic alopecia when used as an adjuvant to minoxidil. Journal of Cosmetic Dermatology, 18(5), 1330–1335.
- Bao, L., Zong, H., Fang, S., Zheng, L., & Li, Y. (2020). Randomized trial of electrodynamic microneedling combined with 5% minoxidil topical solution for treating androgenetic alopecia in Chinese males and molecular mechanistic study of the involvement of the Wnt/β-catenin signaling pathway. Journal of Dermatological Treatment, 1-11.
- Starace, M., Alessandrini, A., Brandi, N., & Piraccini, B. M. (2020). Preliminary results of the use of scalp microneedling in different types of alopecia. Journal of cosmetic dermatology, 19(3), 646-650.
- Lee, Y. B., Eun, Y. S., Lee, J. H., Cheon, M. S., Park, Y. G., Cho, B. K., & Park, H. J. (2013). Effects of topical application of growth factors followed by microneedle therapy in women with female pattern hair loss: a pilot study. The Journal of dermatology, 40(1), 81-83.
- Aggarwal, K., Gupta, S., Jangra, R. S., Mahendra, A., Yadav, A., & Sharma, A. (2020). Dermoscopic assessment of microneedling alone versus microneedling with platelet-rich plasma in cases of male pattern alopecia: A split-head comparative study. International Journal of Trichology, 12(4), 156.
- Sohng, C., Lee, E. H., Woo, S. K., Kim, J. Y., Park, K. D., Lee, S. J., & Lee, W. J. (2021). Usefulness of home‐use microneedle devices in the treatment of pattern hair loss. Journal of Cosmetic Dermatology, 20(2), 591-596.
Last updated July 2021