Efficacy and safety of combinational therapy using topical minoxidil and microneedling for the treatment of androgenetic alopecia: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 37665358 · doi:10.1007/s00403-023-02688-1
What was done
A systematic review and meta-analysis following PRISMA guidelines searched Scopus, Cochrane, Embase, and NLM/PubMed through January 20, 2023. Randomized controlled trials evaluating combination therapy (microneedling plus topical minoxidil) versus topical minoxidil alone in clinically diagnosed androgenetic alopecia were screened, selected, and appraised with the Cochrane risk of bias tool by two independent reviewers.
What was found
Ten randomized controlled trials (466 total patients) met inclusion criteria, and eight studies were meta-analyzed: - Total hair count: Statistically significant increase with combination therapy (standard mean difference [SMD] 1.76; 95% CI 1.26 to 2.26; P < 0.00001). - Hair diameter: No statistically significant difference (SMD 0.82; 95% CI -0.01 to 1.65; P = 0.05). - Safety: No scarring or serious adverse events were reported in any study.
Why it matters
This meta-analysis demonstrates that adding microneedling to standard topical minoxidil improves hair count outcomes in androgenetic alopecia compared to minoxidil alone.
Limits
The overall sample size was small across the 10 included trials (466 total patients). Significant procedural heterogeneity existed in microneedling techniques, treatment scalp areas, and measurement scales. The effect on hair diameter was not statistically significant.
Cited by
- supports Studies have shown that combining microneedling with topical minoxidil can produce up to four times greater hair regrowth results compared to minoxidil alone.