At-Home Microneedling for Hair Loss

Microneedling (collagen induction therapy) entails wounding and skin disruption to induce hair growth and regeneration. In my prior posts on Follica, people often made informative comments about at-home microneedling and dermarolling for hair growth.

Update: January 5, 2022

New Microneedling and Hair Loss Studies

  • In January 2022, a study from India concluded that microneedling monotherapy increased total hair count more than topical minoxidil 5%. The combination of the two was even more effetive.
  • A June 2021 study of interest, albeit not exactly related to at-home microneedling: Ceria nanozyme-integrated microneedles reshape the perifollicular microenvironment for androgenetic alopecia treatment.
  • In February 2021, a study from Korea found that a newly developed home-use microneedle device enhanced the penetration of 5% Minoxidil. Patient self-assessment scores showed the highest satisfaction in the Minoxidil + Microneedling combination treated group. However, the excess hair count in this cohort after 6 months treatment (twice per week) was not statistically significant.
  • In December 2020, an interesting letter summarized a pilot study on using Follica’s proprietary microwounding device to treat female pattern hair loss (FPHL). The results were very positive, and I covered them in detail here.
  • A September 2020 study from Iran concluded that microneedling at a depth of 0.6 mm was more effective than at a  depth of 1.2 mm. This is quite surprising, since most doctors and hair loss sufferers tend to recommend the higher number. For example, in the below video from 2020, the doctors suggest derma-rolling or micro-needling at a depth of 1-1.5 mm.
  • A June 2020 study from China found Microneedling and Minoxidil combination treatment to be superior to either one by itself. The underlying mechanism involves activation of the Wnt/β-catenin signaling pathway.

Below is a great video from Dr. Gary Linkov. He recommends starting with 0.5 mm needle depth. Consult your doctor if you develop any scarring or other side effects.

December 25, 2019

My original post on using dermarolling in combination with Minoxidil was published all the way back in 2013. More evidence on the benefits of microneedling for hair loss reversal came in 2017, courtesy of Dr. Rachita Dhurat.

At-Home Microneedling for Hair Growth

Intentional scalp injury and wounding has been known to induce follicular neogensis via stimulating the dermis’ natural wound healing process. Over the years, there has been a lot of online discussion about DIY at-home microneedling and dermarolling to treat androgenetic alopecia.

I was planning to write a post on this subject in the past, but kept delaying it till today. For one, there are numerous hair loss forum and Reddit threads on this subject running into 100s of pages. Moreover, when it comes to microneedling for facial skin rejuvenation related applications, there is even more information available online. Including numerous reviews and before and after photos.

According to a summary of  papers on microneedling, the procedure can help numerous dermatological conditions. These include skin rejuvenation (via increases in collagen and elastin); reduction of acne scarring, wrinkles, fine lines, stretch marks and surgical scars; improvement in undesired skin color changes such as melasma; and enlarged pore reduction. Note that in 2016, a Japanese research team found age-related hair loss to be caused by reduced collagen.

An increasingly common use entails using microneedling or skin puncturing for better transdermal drug delivery. In the hair loss world, many doctors and surgeons are using microneedling in tandem with application of hair growth serums, Minoxidil, PRP and Exosomes.

Needle Depth, Device Choice and Safety

Among the key questions when trying out at-home microneedling on the head:

  1.  What is the appropriate depth of needles for microneedling on the scalp for hair growth? For thinner facial skin uses, fine needles of 0.25 mm and 0.5 mm depth seem to be preferred. For thicker scalp skin, many people recommend 1.5 mm to puncture the skin and epidermis sufficiently. Reader “PinotQ” mentioned a possible treatment regimen of 1.5 mm once a week, and 0.5 mm daily for maintenance. A September 2020 study from Iran found a depth of 0.6 mm to be more effective than a depth of 1.5 mm.
  2. What device is the best? There are hundreds of dermarollers and dermapens on sale online. A large number of those seem to have great reviews. It seems like most people prefer dermarollers to dermapens when it comes to the scalp, although the lower price of the former could be a factor. While the dermaroller needles enter the skin at an angle, dermapen needles enter vertically. Each device and delivery method has advantages and disadvantages.
  3. Safety precautions, including: making sure that the needles are sterilized and clean to prevent infection; not using too much force when rolling the device to avoid damaging the dermis; aftercare and cleaning up correctly in case of bleeding or other skin injury.
  4. How often to use the dermaroller or other micro needling device? Can one get away with just once a week treatment? Note that some people may easily bleed or have overly sensitive scalps, making microneedling impractical or even dangerous. For those with seborrheic dermatitis or psoriasis of the scalp, it is best to consult a dermatologist before starting treatment.

Dermarollers and Dermapens

Microneedling Dermaroller Device
A Dermaroller for Microneedling.

Note: Dermarollers are very cheap on Amazon. However, sizes range from needle depths of 0.25 mm to 0.5 mm to 1.5 mm. The rolling drum size can also vary significantly. You will need to read the comments to this post before deciding on the best product (s) for scalp hair growth purposes.

Dermapen Microneedling Pen for Hair Growth
Dr. Pen Dermapen.

Many people also use handheld motor powered dermapens (more expensive) for microneedling. These are also known as micropens. An alternative product that some people praise is called the dermastamp (or derma stamp).

For more information, see this article on dermaroller versus dermapen. These two devices are also sometimes termed as microneedling roller v/s microneedling pen.

User Reviews on Microneedling at Home

Ultimately, the point of this post is to benefit from crowd-sourced reader comments about this subject matter all in one place. I might even start microneedling myself in 2020 if I get more motivated after reading about people’s experiences.

Follica’s recent statement seems to indicate that many kinds of wounding and skin injury can regenerate hair. Follica’s tried and tested in-office version and device will likely be the most effective. But for the time being, at-home use will have to suffice.

If you find any links to microneedling before and after hair growth photos, please post them in the comments.

Estrogen Therapy and Hair Growth

For the male readers of this blog, estrogen (also known as oestrogen) is not something that one would consider to be of interest. For one, estrogen is largely a female sex hormone. What male would want to start taking estrogen and develop female secondary sexual characteristics such as breast enlargement?

Having said that, estrogen does have some properties that benefit overall health. Among these include heart protection (less atherosclerosis); strengthening of immunity; and reduction of inflammation. High levels of estrogen are though to be one of the reasons behind why females outlive males. The main negative of  high estrogen is a greater chance of developing breast cancer.

Update: December 24, 2021

Estrogen Monotherapy for Hair Growth

Since I originally wrote this post, I have become increasingly fascinated by estrogen’s hair growth properties. In my 2021 updated post on Male-to-Female (MTF) transgender persons, some of the before and after transformations are astounding.

Most transgender females take estrogen (typically in the form of estradiol, aka “E2”) as well as Finasteride or Dutasteride. Many also add anti-androgens such as spironolactone or cyproterone acetate into the mix. This is known as hormone replacement therapy (HRT).

What I am most curious about is non-transgender men who only use topical estrogen (cream, lotion, patch or spray) to regrow their hair. I would have never though that this would be a very effective solo hair loss treatment. Moreover, some amount of topical medication always gets absorbed into the bloodstream. So the feminizing side effects are likely to be significant, even if perhaps less so than with injected or oral estrogen supplementation.

Reddit to the Rescue

What encouraged me to re-examine subject matter is Reddit. In recent months, I have seen a number of threads by people focused on using estrogen monotherapy to treat hair loss. In many cases, the “monotherapy” is ultimately supplemented with Minoxidil or Finasteride, but this is still okay by me.

I do not frequent Reddit more than twice a week, and rarely go to the transgender related subreddits. So I likely missed dozens of  other threads in 2021. Thankfully, I bookmarked the below ones. I hope to ultimately find more such testimonials from males who are definitely not transgender. In the comments, feel free to post links to any that you find interesting. And they need not just be limited to Reddit.

  • Yesterday, someone posted a question titled “Can estradiol mono-therapy help grow back your hairline”? Several of the responses are quite encouraging.
  • Three days ago, someone posted this amazing transformation from using just Finasteride and Oestrogel for two years. She claims that this is all her real hair.
  • One month ago, someone posted a very interestingly titled thread with six before and after photos (make sure to swipe right of each image). According to this person’s theory, an artificial selective estrogen receptor modulator (SERM) would be almost as good as a hair loss cure. Provided it is combined with an oral Minoxidil and an anti-androgen. Note that most people prefer an anti-androgen and DHT blocker combination. But oral Minoxidil is becoming a lot more popular too.
  • Earlier in 2021, someone posted phenomenal before and after results from using just estrogen plus Minoxidil as a hair loss treatment. I would guess that the vast majority of this transformation is due to the estrogen.

February 25, 2015

Estrogen Hormone Therapy and Hair Growth

The reason I decided to write a post on estrogen is because I recently read an extremely interesting 2012 interview with Dr. George Cotsarelis. While the main part of the interview is devoted to the oft discussed PGD2, there are several other interesting subjects discussed. The second page of the interview is what really surprised me in a good way.

In the first part of this interview, Dr. Cotsarelis discusses the old and well known Dr. James Hamilton study from the 1950s. In this research, it was found that men who were castrated before puberty (eunuchs) never went bald. However, upon being given testosterone, those with a family history of baldness still started to loose hair.

The second part of the interview is more interesting. It covers the fact that even after someone has lost much of his hair due to androgenic alopecia, he can regrow a lot of it when given estrogen (after castration)!

This point is supposedly verified by many studies on Male-to-Female (MTF) transitioning transgender persons. Such patients show hair regrowth after their being castrated and getting on estrogen hormone replacement therapy (HRT). Usually with the addition of an anti-androgen such as Spironolactone.

While I do not think any of us men want to get castrated or take estrogen (estradiol), this is still an incredible finding. One of the best examples is in the before and after image below from this study.

Estrogen Treatment Hair Growth
Estrogen (Estradiol) Treatment Hair Regrowth. Source: Journal of the American Academy of Dermatology.

Note that both estrogen and progesterone extend the anagen growth phase cycle of hair follicles. In contrast, testosterone and dihydrotestosterone (DHT) do the opposite and shorter the hair growth phase. Make sure to also read my post on how finasteride impacts testosterone and estrogen levels.

Hair Regrowth Difficulties

Over the years, I have read a number of articles in which doctors and professionals seem to suggest that once hair is gone (turns vellus), it can never return. This is also why Finasteride and Minoxidil virtually never bring back any significant amount of hair for someone who is mostly or entirely bald. However, it seems like hair can regrow in fully bald areas of the scalp in some instances.

There have been anecdotal reviews on Dutasteride actually regrowing long dormant hair. But these have been few and far between. Over a decade ago, Dr. Marty Sawaya caused an insane level of excitement on hair loss forums when she reported that one of her older patients gained back most of his lost hair when on Dutasteride. But that whole episode was controversial and not replicated.

More recent research suggests that a balding scalp still has all the follicle stem cells intact. But certain progenitor cells have become depleted. Basically, the cells are there, but the activity is not there. Dr. Cotsarelis has suggested that perhaps blocking PGD2 will allow the stem cells to make progenitor cells again. However, this is not a certainty, and neither is hair regrowth guaranteed once PGD2 is inhibited.

I suspect that this powerful impact of estrogen on hair regrowth is still not strong enough to grow back all of one’s lost hair. This is because many older balding MTF transsexuals seem to get hair transplants even after getting castrated and beginning estrogen therapy.

Finally, for men who take Finasteride (Propecia, Proscar), one potential side effect is increased estrogen levels. This sometimes results in the dreaded gynecomastia (male breast enlargement), along with fat gain in other parts of the body. Their are numerous complaints on hair loss forums about this side effect. Most studies indicate that the chances of developing gyno from taking 5-alpha-reductase inhibitors is extremely low.

Hair loss news blog. Hair cloning for baldness.