Table 2.
Parameter summaries for studies assessing the use of MN on AGA subjects
| Androgenic alopecia (AGA) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Author (year) | Total subjects (sex); alopecia type | Study type | Treatment regimen | MN procedure | No. of MN sessions | Treatment duration | Endpoints | Effectiveness | Adverse events | Jadad score |
| Ramadan et al. [12] | n = 126 (46 m, 80 f); AGA | Combination: PRP, 5% minoxidil, 2.50 mg finasteride (men), 200 mg spironolactone (women) |
Group 1: medications + PRP injections Group 2: medications + MN + topical PRP Group 3: medications |
MN automated pen, 2.00 mm needles, session endpoints marked as three passes followed by PRP application | 6, once every month | 6 months | Hair counts, hair diameters, photographic evaluation |
Yes, in both sexes Hair density increased in group 2 versus group 1; larger effect for groups 1 and 2 versus group 3 |
No serious events reported Twenty-three subjects reported transient pain after PRP |
2 |
| Sohng et al. [13] | n = 29 (24 m, 5 f); AGA | Combination: 5% minoxidil |
Group 1: home-use MN Group 2: home-use MN + 5% minoxidil Group 3: 5% minoxidil |
MN stamp, 0.25 mm spiral needles, endpoint sessions marked as gentle tapping 20 times in target area | 52, twice weekly | 6 months | Hair counts, self assessments | No | No serious events reported; mild and transient pruritus noted in one subject | 2 |
| Burns et al. [14] | n = 11 (f); AGA | Combination: 5% minoxidil + MN added to ongoing hair loss treatments | 5% minoxidil + MN twice per month added to ongoing hair loss treatments | MN automated pen, session endpoints marked as two passes across the frontal, crown, vertex, and upper-parietal scalp | 6, twice every month | 3 months | Photographic evaluation, self assessments |
Yes Investigators noted that 11/11 subjects improved at least 1–1.5 Sinclair scores |
No serious events reported | 1 |
| Gowda et al. [15] | n = 90 (m); AGA | Combination: 5% minoxidil, PRP |
Group 1: 5% minoxidil Group 2: 5% minoxidil + MN Group 3: 5% minoxidil + PRP injections |
MN roller, 1.50 mm needles, session endpoints marked as passes longitudinally, vertically, and diagonally until pinpoint bleeding noted | 4, once every month | 4 months | Hair counts, photographic evaluation |
Yes Hair counts increased in groups 1, 2, and 3; investigators noted improvements in group 3 |
No serious events reported in MN group | 1 |
| Shome et al. [16] | n = 50 (25 m, 25 f); AGA | Combination: intradermal versus MN delivery of growth factor solution |
Group 1: intradermal QR678 Neo(®) Group 2: MN + QR678 Neo(®) topical |
MN roller, 1.50 mm needles, session endpoints marked as 4–5 passes longitudinally, vertically, and diagonally until light erythema noted | 8, once every 3 weeks | 12 months | Hair counts, hair diameters, photographic evaluation, self assessments |
Yes Hair counts and hair diameters increased in groups 1 and 2; no difference in changes to hair counts and diameters in group 1 versus 2 |
No serious events reported; transient scalp itchiness higher in group 2 | 2 |
| Ozcan et al. [17] | n = 62 (m); AGA | Combination: PRP solution |
Group 1: PRP injections Group 2: MN + PRP solution |
MN automated pen, 1.50 mm needles | 4, once every two weeks then once after 1 month | 10 weeks | Hair counts, hair diameters, pull tests, photographic evaluation, self assessments |
Yes Hair counts and hair diameters increased in groups 1 and 2; changes to anagen:telogen hairs increased in group 2 versus group 1 |
No events reported | 2 |
| Yu et al. [18] | n = 40 (m); AGA | Combination: 5% minoxidil, growth factors |
Group 1: saline + MN Group 2: 5% minoxidil + MN Group 3: growth factors + MN Group 4: 5% minoxidil + growth factors + MN |
MN roller | 16, once weekly | 16 weeks | Hair counts, hair diameters, photographic evaluation, self assessments |
Yes Hair density increased in groups 2, 3, and 4 |
No serious events reported Three subjects developed mild erythema which alleviated after 24 hours |
3 |
| Bao et al. [19] | n = 75 (m); AGA | Combination: 5% minoxidil |
Group 1: 5% minoxidil Group 2: MN Group 3: 5% minoxidil + MN |
MN automated pen, 1.00–2.00 mm needles, session endpoints marked as hemorrhage and redness | 8, once every 3 weeks | 24 weeks | Hair counts, hair diameters, photographic evaluation |
Yes Hair counts increased in groups 1, 2, and 3; hair density increased in groups 2 and 3; larger improvements for group 3 versus groups 1 and 2 |
Twelve events related to scalp irritation were noted; all resolved within 4 days; no differences in occurrence across groups | 3 |
| Aggarwal et al. [20] | n = 30 (m); AGA | Split scalp: MN, PRP |
Side 1: MN Side 2: MN + PRP injections |
MN roller, 1.50–2.00 mm needles, session endpoints marked as gentle rolling until pinpoint bleeding | 4, once monthly | 6 months | Hair counts, hair diameters, self assessments |
Yes Hair counts and hair diameters increased in sides 1 and 2; no difference in change of hair counts and hair diameters in side 1 versus side 2 |
No serious events reported | 3 |
| Faghihi et al. [21] | n = 59 (29 m, 30 f); AGA | Combination: 5% minoxidil |
Group 1: 5% minoxidil Group 2: 5% minoxidil + MN 1.2 mm Group 3: 5% minoxidil + MN 0.6 mm |
MN automated pen, 1.20 or 0.60 mm needles, session endpoints marked as pinpoint bleeding | 6, once every 2 weeks | 12 weeks | Hair counts, hair diameters, photographic evaluation, self assessments |
Yes Hair counts and diameters increased in groups 1, 2, and 3; change in hair counts and diameters greater in group 3 versus group 1; change in hair diameters greater in group 2 versus group 1 |
More pain reported from MN in group 2 versus 3 | 2 |
| Starace et al. [22] | n = 50 (14 m, 36 f); AGA, TE | Combination: MN added to ongoing hair loss treatments | MN every 3 weeks added to ongoing hair loss treatments | MN roller, 1.50 mm needles, 20–25 minute sessions, session endpoints marked as eight passes longitudinally, vertically, and diagonally in affected regions or until mild erythema and pinpoint bleeding noted | 3, once every 4 weeks | 6 months | Hair counts, hair diameters, photographic evaluation, self assessments |
AGA: yes, in both sexes TE: yes Hair counts and hair diameters increased |
No serious events reported | 1 |
| Kumar et al. [23] | n = 60 (m); AGA | Combination: 5% minoxidil |
Group 1: 5% minoxidil Group 2: 5% minoxidil + MN |
MN roller, 1.50 mm needles, session endpoints marked as passes longitudinally, vertically, and diagonally in affected regions until pinpoint bleeding noted | 8; four sessions (month 1), two sessions (month 2), two sessions (month 3) | 12 weeks | Hair counts, photographic evaluation, self assessments |
Yes Hair counts increased in group 2 versus group 1; higher self assessment scores in group 2 versus group 1 |
No serious events reported | 2 |
| Yu et al. [24] | n = 19 (m); AGA | Split scalp: 5% minoxidil |
Side 1: 5% minoxidil Side 2: 5% minoxidil + fractional radiofrequency MN |
Fractional radiofrequency MN, 1.50 mm needles | 5, once every 4 weeks | 5 months | Hair counts, hair diameters, photographic evaluation, self assessments |
Yes Hair counts and hair diameters increased in sides 1 and 2; changes to hair counts and diameters greater in side 2 versus 1 |
No serious events reported | 3 |
| Bao et al. [25] | n = 60 (m); AGA | Combination: 5% minoxidil |
Group 1: 5% minoxidil Group 2: MN Group 3: 5% minoxidil + MN |
MN automated pen, 1.50–2.50 mm needles, session endpoints marked as 3–4 passes until redness and/or hemorrhaging noted | 12, once every 2 weeks | 24 weeks | Hair counts, hair diameters, photographic evaluation, self assessments |
Yes Hair counts increased in groups 1, 2, and 3; hair counts, hair diameters, photographic evaluations, and self assessments better in group 3 versus groups 1 and 2 |
No serious events reported; no differences in adverse event reporting across groups | 3 |
| Shah et al. [26] | n = 50 (m); AGA | Combination: 5% minoxidil, PRP |
Group 1: 5% minoxidil Group 2: 5% minoxidil + MN + PRP injections |
MN roller, 1.50 mm needles, session endpoints marked as eight passes longitudinally, vertically, and diagonally in affected regions or until mild erythema | 6, once monthly | 6 months | Photographic evaluation, self assessments |
Yes Photographic evaluations better in group 2 versus group 1 |
No events reported | 2 |
| Dhurat et al. [11] | n = 100 (m); AGA | Combination: 5% minoxidil |
Group 1: 5% minoxidil Group 2: 5% minoxidil + MN |
MN roller, 1.50 mm needles, session endpoints marked as passes longitudinally, vertically, and diagonally in affected regions until mild erythema | 12, once weekly | 3 weeks | Hair counts, photographic evaluation, self assessments |
Yes Hair counts increased in groups 1 and 2; hair counts increased in group 1 versus 2; higher photographic evaluations and self assessments in group 1 versus 2 |
No serious events reported | 3 |
| Lee et al. [27] | n = 11 (f); AGA | Split scalp: growth factor solution |
Side 1: growth factor solution + MN Side 2: saline + MN |
MN automated pen, 0.50 mm needles | 5, once weekly | 5 weeks | Hair counts, self assessments |
Yes Hair counts increased in side 1 versus side 2 |
No events reported | 1 |
A table summarizing all included studies assessing the use of MN on AGA subjects. Each study summary features parameters regarding author, year of publication, total subjects, gender, study type, treatment regimen, MN procedure, number of MN sessions, treatment duration, assessment endpoints, effectiveness, adverse events, and Jadad score