Table 5.
Overview of studies analyzing microneedling for the treatment of MPHL
| Author/year | N | HN | Mean age, years | Mean duration MPHL, years | Study design | Treatment group | Frequency of microneedling | Needle length, mm | Session, n | Endpoint | Control group | Efficacy assessment | Safety assessment | Results | Follow-up | ||
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| Dhurat et al. 2013 [10] | 100 | III–IV | 28.6 | 4.5 | 3 months, randomized evaluator blinded comparative | Microneedling AND MXD 5% bid | Weekly | 1.5 | 12 | Mild erythema | MXD 5% bid | HC, clinical and self-evaluation | No adverse effects | HC: treatment 91.4 × control 22.2 (p = Q. 039); CE: treatment 100% × control 64% of patients improved (p = NA); SE: treatment 100% × control 61% of patients improved (p = NA) | 8 months: 100% treatment group had a sustainable response | ||
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| Dhurat et al. 2015 [11] | 4 | III–VII | 33 | NA | 6 months, case series | Microneedling (in addition to their existing FIN and MXD treatment) | Weekly (4x), twice a month (11x) | 1.5 | 15 | Mild erythema | NA | Clinical and self-evaluation | NA | CE and SE: 100% of patients improved | 18 months (plus FIN/MXD): 100% of patients had a sustainable response | ||
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| Shah et al. 2017 [13] | SO | III–V | 31 | NA | 6 months, randomized | MXD 5% bid AND microneedling AND PRP | Monthly | 1.5 | 6 | Mild erythema | MXD 5% bid | Clinical and self-evaluation | NA | CE: treatment 100% × control 88% of patients improved (p = 0.004); SE: treatment 100% × control 92% of patients improved (p = Q.0Q6) | NA | ||
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| Jha et al. 2018 [15] | 20 | II–V | 28 | NA | 3 months, case series | Microneedling AND PRP (in addition to their existing FIN and MXD treatment) | Every 3 weeks | 1.5 | 3 | Pinpoint bleeding | NA | Self-evaluation | Mild pain (7 patients) | SE: 18 patients had more than 75% improvement | NA | ||
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| Kumar et al. 2018 (12) | 68 | III–IV | 26 | 3 | 3 months, randomized comparative | Microneedling AND MXD 5% bid | Weekly (4x), twice a month (4x) | 1.5 | 8 | Pinpoint bleeding | MXD 5% bid | HC, self-evaluation | Mild pain | HC: +12.82 treatment group × + 1.89 control group (p < 0.0001): SE: treatment 97% × control 76% of patients improved (p < 0.0001) | NA | ||
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| Jha et al. 2019 [14] | 93 | I–V | 27 | NA | 6 months, randomized comparative | Group I MXD 5% bid AND PRP. Group II MXD 5% bid AND microneedling AND PRP |
Every 3 weeks | 1.5 | 4 | Pinpoint bleeding | MXD 5% bid | Self-evaluation | NA | SE Group I 52% × Group II 77% × control 32% of patients were very satisfied (p < 0.002) | NA | ||
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| Starace et al. 2020 [16] | 14 | NA | NA | NA | 6 months, case series | Microneedling (in addition to their existing systemic and topical hair treatment) | Monthly | 1.5 | 3 | Pinpoint bleeding | NA | HC, hair diameter | No adverse effects | HC(+): vertex male: 17.45%/female 35.88%; HD(+): vertex male: 11.80%/female 529% | NA | ||
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| Bao et al. 2020 [17] | 75 | III–VI | 37 | 8 | 6 months randomized evaluator blinded comparative | Group I microneedling AND MXD 5% bid Group II microneedling | Every 3 weeks | 1–2 | 8 | Hemorrhage and redness | MXD 5% bid | HC, hair diameter | No significant difference of toxicity between the groups | HC Group I +39, 78 × Group II +21.53 × control+1427 (p < 0.001); HD Group I +22.46 × Group 11 + 10.41 × control +18, 7 urn (p = 0.002) | 6 months: Group I and II: 10% lost all the new hair, 70% small amount of hair loss, 20% maintained the increase in hair density × control: 90% lost all the new hair | ||
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| Bao et al. 2020 [18] | 60 | III–VI | 34 | 6.5 | 6 months randomized evaluator blinded comparative | Group I microneedling AND MXD 5% bid Group II microneedling | Twice a month | 1.5–2.5 | 12 | Pinpoint bleeding | MXD 5% bid | HC, hair diameter, clinical and self-evaluation | No significant difference of toxicity between the groups Moderate pain | HC Group I +38.3 × II +23.4 × Control +18.8 (p = 0.002); HD Group I +11.8 × Group II +32 × control +10.7 (p = 0.QQ5); CE: Group I 100% × Group II 89% × control 94% of patients improved (p < 0. 001); SE Group I 100% × Group II 98% × control 100% of patients improved (p < 0.001) | NA | ||
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| Our study | 30 | III–VI | 46 | 13 | 8 months, randomized evaluator blinded comparative | Needling I Roller Group II tattoo cartridge | Monthly | 1.5 | 4 | Pinpoint bleeding | NA | HC, clinical evaluation | Moderate pain | HC Group I: 2.7 × II −1.4 (p = Q.81); CE: Group I 33% × Group II 14% of patients improved | 4 months | ||
HN, Hamilton-Norwood; MXD, minoxidil; FIN, finasteride; PRP, platelet-rich plasma; NA, not available; HC, hair count; HD, hair diameter; SE, self-evaluation; CE, clinical evaluation.