What You Need to Know About Microneedling for Hair Loss
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After trying countless shampoos that claim to thicken your fine locks, serums designed to combat your excessive shedding, and even outlandish at-home hair growth treatments from TikTok — all to no avail — you might be looking to take your anti-hair-loss efforts to the next level. One option: A microneedling treatment for your scalp, performed in-office by a hair care pro. But what does the procedure involve, exactly, and can it actually help you get the Rapunzel-like locks you've been longing for?
Here, experts break down everything you need to know microneedling for hair loss — including the benefits, risks, and the treatment process — before you book an appointment.
What is microneedling for hair loss?
A microneedling for hair loss treatment is exactly what it sounds like: A hair care professional will run a manual or motorized device equipped with fine, tiny needles across the scalp, which will penetrate just into the upper portion of the dermis — the layer of skin where the hair follicle lies, says Rae Lynne Kinler, M.D., an expert hair restoration surgeon and the clinical director of Ziering Medical of Greenwich, Connecticut. All that puncturing can help stimulate blood flow and collagen production, but more significantly, it creates "microchannels" that enable topical treatments for hair loss, such as minoxidil and finasteride, to be more effective, she says. "It helps the absorption of topical treatments to be a little bit better because they're not being blocked by the skin," she explains. "...It actually gets into the level of the hair follicle and can potentially make it start thickening up the existing hair, putting it into an active growth phase, making it stronger, getting it longer, and making it a little bit darker in color." (FTR, the color change is extremely subtle, if detectable at all — you won't arrive as a blonde and leave as a brunette.)
The minimally invasive procedure is also believed to cause the scalp to release platelets and hair growth factors in the traumatized areas, which help thicken the existing follicles, adds Andrew Kashian, the founder of Solve Clinics, a hair transplant clinic in Chicago. "With microneedling, people think, 'Oh, there's new follicles growing,' but oftentimes that's not the case," he says. "It's the thin follicles in that area that are getting thicker and back to their normal, healthy state, so it gives off the aesthetic of new growth when in reality it's just a thickening of what's already there." To enhance the process, some clinics will also combine the treatment with injections of a patient's own platelet-rich plasma, which is thought to release growth factors needed in the wound healing process and, in turn, may promote hair growth, says Kashian. "The end result is your hair gets thicker faster, and the treatment outcome is significantly more substantial," he says. (Related: This Is Why You're Losing Your Hair During Quarantine)
Who could benefit from microneedling for hair loss?
If you're dealing with general hair loss or thinning, or you're suffering from androgenetic alopecia — a genetic hair loss disorder that's caused by an excessive response to the hormones androgens — a microneedling treatment might do you some good, says Kashian. "A lot of times we use it where there's those little, fine, miniaturized hairs — or baby hairs — that are on their way out," adds Dr. Kinler. "Essentially, they're the ones getting ready to be lost permanently, [but] we can turn that around and make it a fuller, stronger, thicker hair."
People who have already lost all their hair in a particular area or on the entire scalp aren't going to see much, if any, benefit, she says. In those cases, the bulbs of the hair follicles — which receive signals to form a new hair and grow it up out of the scalp — may not be producing hair, or they might have "shriveled up and died" entirely, says Dr. Kinler. Since microneedling increases the density of existing hair — but doesn't stimulate brand new follicle growth — doing the treatment in a bald area is "a lost cause," adds Kashian. Instead, hair transplant surgery, which involves removing small pieces of scalp with hair follicles from a donor site and grafting them on a bald or thinning area of the scalp, is your best bet, agree Dr. Kinler and Kashian. (Related: Everything You Need to Know About Hair Loss — Like How to Stop It)
Unsurprisingly, microneedling isn't recommended for folks who already have a full head of hair, says Dr. Kinler. "You can actually damage the hair that's on the outside of the scalp and you can damage the hair follicles underneath the scalp, especially if the needle depth is too much," she explains. (FTR, the needles usually penetrate 1.5 millimeters into the skin, says Kashian.)
What are the risks of microneedling for hair loss?
As with any procedure that involves cutting the skin and creating an open wound, microneedling for hair loss does come with the risk of infection, says Kashian. That said, "the risk of infection for microneedling is extremely small," he explains. "The size of those incisions is so little that, in our years doing thousands of these in our clinic, we've never seen an infection from one of our patients."
A larger concern, particularly if you receive the treatment at a medical spa or a clinic that doesn't specialize in microneedling for hair, is permanent hair damage and loss, says Dr. Kinler. Providers who aren't trained in the procedure may increase the needle depth too much, which can cause damage to the hair bulb when it enters the scalp, she explains. "I have seen patients come in with superficial breakage of the hair shaft at the scalp, which obviously takes a while to regenerate," she says. "But I've also seen patients with areas of patchy, permanent loss where the needle has penetrated [too deep] and actually knocked off the hair bulb so it's no longer able to regenerate a new hair shaft. Then they have patchy areas of baldness that they didn't have before, and then there's really nothing much you can do with that other than transplantation to fix those areas."
For that same reason, Dr. Kinler cautions against giving yourself an at-home microneedling treatment for hair loss. "There's a higher risk of causing damage to the hair, so I don't recommend that option," she says. "I prefer for it to be done in a qualified, trained physician's office who deals specifically with hair." (Wait, should you be dermarolling your face at home?)
Given the potential risks and the availability of "superior" hair loss treatments, Dr. Kinler generally steers clear of microneedling for hair loss or thinning. Instead, she often recommends KeraLase, a laser treatment available at dermatologists and hair restoration clinics that creates those same beneficial microchannels by disrupting the water bonds in your scalp — no needles required. "It doesn't disrupt the hair follicle, it doesn't disrupt the bulb, and it doesn't disrupt the external hair shaft," she says. "...It's a very popular treatment that we offer, and we don't see any of that risk of damaging the external hair or the hair follicle. We don't see any patchy hair loss or permanent hair loss with this treatment."
Compared to microneedling, Dr. Kinler says KeraLase is easier to tolerate, particularly in the sensitive areas of the scalp, such as the front hairline and the sides of the head. The treatments take about the same amount of time to complete, though KeraLase is given more regularly; the first four treatments are spread four weeks apart, and your provider may recommend additional treatments roughly a year later, she explains.
What to Expect During a Microneedling for Hair Loss Treatment
If you chat with a hair loss expert and decide microneedling is your best course of action, there are a few things you'll want to know ahead of your appointment. Before your microneedling for hair loss treatment, make sure your scalp is freshly cleaned and free of any hair products, as they may get into the wounds and potentially cause an infection, says Kashian. At the clinic, your hair care professional might apply a topical or local anesthetic to ease any pain, then start running the roller over the affected areas to create microtrauma, says Dr. Kinler. The needles will feel similar to a rubber band snapping against your skin, and you'll experience some redness and bleeding, says Kashian. All in all, the procedure typically takes just 20 to 30 minutes, adds Dr. Kinler. A microneedling treatment with PRP injections, however, might take 45 to 60 minutes, says Kashian.
If your provider recommends applying a topical hair growth treatment, you'll wait 24 hours after the procedure to do so, as the retinoic acid in those products can cause irritation if applied before the scalp is healed, says Dr. Kinler. You'll also want to ditch the shampoo, conditioner, and alcohol-based hair products for two to three days following a microneedling treatment, she says. "We want to give the skin a chance to heal, and we don't want to introduce anything that may be detrimental to that," she explains. "We also want to give the growth factors a chance to get fully absorbed into the scalp." It's also key to keep your scalp out of direct sunlight, as it could lead to hypersensitivity and hyperpigmentation, she adds.
Most importantly, remember that this isn't a one-and-done treatment. "Consistency is key — this isn't an overnight fix," says Kashian. "You can't microneedle once, wait a month, and think your hair is basically going to get thick. You have to stick with it." For the first six to eight months, you'll likely need to get a treatment every four to six weeks, then once every six to 12 months after that, says Dr. Kinler. How long you continue the treatment after those first eight months is entirely up to you. "We'll take photographs so we can see the changes that the patients are having, but sometimes they either just don't feel like they're getting enough of a result and then they opt to discontinue the treatment, while some patients come in once a year — they feel like the benefits of the treatment are lasting that long," she says.
Regardless of how many rounds of microneedling you receive, you may not see an improvement in your hair loss or thinning if you don't apply those topical growth treatments, such as minoxidil or finasteride. "The only time I've ever really seen microneedling help is when you combine it with grow factor therapy, which is something that is external that is applied to the scalp topically after the little microchannels are created," says Dr. Kinler. And research has yet to show the treatment's effects without these topicals: While a 2016 study on mice found that microneedling on its own increased hair growth, the available human studies that demonstrate the procedure's benefits all involved treating participants simultaneously with microneedling and topical growth factor treatments.
So, should you get microneedling for hair loss?
If you're dealing with hair loss or thinning, microneedling can be an effective way of boosting your locks' thickness and giving you the look of a full, luscious head of hair, says Kashian. That said, the treatment doesn't resolve the issue at the root of your hair loss, and neither microneedling or KeraLase will stop the progression of it, adds Dr. Kinler. "These things are helpful to improve the existing hair on the head — make it fuller, make it thicker," she explains. "They just give [the patient] a little bit more confidence, either as they wait for surgery or to become a candidate for surgery. Even if they say they never want to have a procedure, [these treatments can] help move them along in terms of improving their confidence and the appearance of their hair."
