Scalp Microneedling – £150 per session

How does it work?

Microneedling is a minimally invasive dermatological procedure, also known as percutaneous collagen induction, that utilizes multiple fine needles rolled over the skin to create micropunctures. This treatment was first used for cosmetic purposes to promote an increase in collagen and elastin formation and is now used in scalp microneedling a wide range of dermatologic conditions, including hair disorders.

The mechanism of action of microneedling consists in creating numerous micro-wounds within the epidermis and papillary dermis in order to initiate the wound healing response. The microwounds create microinflammation, trigger the response of platelets, which release platelet-derived growth factors, and activate the hair bulge. Increased expression of Wnt pathways, namely Wnt3a and Wnt10b, is also an evident consequence of microneedling. All these processes have been demonstrated to activate dermal papillae stem cells and hair growth.

Microneedling may also facilitate transdermal drug delivery through the creation of micropores that reach different levels of the skin depending on the needle size. There are recent studies that show how involving a greater microneedle length increased drug penetration, whereas rollers without microneedles failed. These results suggest that microneedling could be a valid way for increasing the delivery of topical medications.

Efficacy Assessment

Most studies on microneedling in hair diseases focus on the use of this procedure in androgenetic alopecia (AGA). The first study, run by Dhurat et al., compared treatment with twice daily application with 5% minoxidil alone and the same concentration of minoxidil in conjunction with weekly microneedling sessions.

After 12 weeks of treatment, the microneedling plus minoxidil group showed a higher hair count than the other group [3]. The same authors evaluated the use of microneedling in four men who were unsuccessfully using minoxidil 5% and oral finasteride. With the addition of microneedling, all patients showed higher improvement than with the medical therapy alone [4].

Another study by Farid et al. involving 40 female AGA patients compared 5% minoxidil monotherapy with microneedling plus platelet-rich plasma (PRP). Both groups showed a significant increase in hair count, but hair growth occurred faster with minoxidil therapy alone. The authors suggested minoxidil as the first-line therapy [5].

A paper by Sasaki studied the effect of the combination of microneedling and PRP in AGA, with a final significant improvement in hair growth [6].

Lee et al. ran a pilot study where the subjects were treated on half the scalp with microneedling plus topical growth factor, and the other half with a saline solution followed by microneedling. The growth factor-treated side of the scalp showed more than a 10% increase of hair count compared to the control side [7].

All these studies suggest a significant role of microneedling in combination with other established therapies such as minoxidil or finasteride.

Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013;5(1):6–11.
Dhurat R, Mathapati S. Response to microneedling treatment in men with androgenetic alope- cia who failed to respond to conventional therapy. Indian J Dermatol. 2015;60(3):260–3.
Farid CI, Abdelmaksoud RA. Platelet rich plasma microneedling versus 5% topical minoxidil in the treatment of patterned hair loss. J Egypt Women’s Dermatol Soc. 2016;13:29–36.
Sasaki GH. Microneedling depth penetration, presence of pigment particles, and fluorescein- stained platelets: clinical usage for aesthetic concerns. Aesthet Surg J. 2017;37:71–83.
Lee YB, Eun YS, Lee JH, et al. Effects of topical application of growth factors followed by microneedle therapy in women with female pattern hair loss: a pilot study. J Dermatol. 2013;40:81–3.

Indications:

Hair loss
Thinning areas

Contra-indications:

- Anti-coagulant therapy – increases potential for bleeding – coagulation status should be checked to confirm normal clotting/bleeding profile.
- History of keloid scarring.
- History of radiation therapy within the application area (6mths post chemo & radiotherapy).
- Raised moles or warts.
- Pregnant or breastfeeding.
- Skin cancers – melanoma.
- Skin infections; wounded, sunburned, excessively sensitive skin; inflammatory acne within the application area.
- Uncontrolled diabetes.
- Unrealistic expectations

Possible side effects:

Skin redness and flushing, tightness, itching, tenderness, stinging, swelling and some pinpoint bleeding.
Effects will usually typically resolve within hours, but some people may react differently and may experience these reactions for longer.
There is a small risk of side effects causing the skin to turn very red, blister, swell, peel and later scab and crust.
Micro needle therapy procedure may cause areas of bruising although this would not normally be expected to occur.
There is a small risk that hyperpigmentation of the skin can occur after the procedure, although this is not normally expected as the epidermis of the skin is not removed as a result of the procedure.
As with the use of any product, there is also a small risk of a reaction to the mesotherapy products.

How many treatments/sessions do you need?

Treatment plans depends on the problem each patient has, but the standard would be 1 session per week during 4 to 8 weeks, followed by one maintenance session every 3-6 months.
Results vary from person to person