Microneedle Frequency Adjunct to 2% Minoxidil in Female androgenetic alopecia: A Randomized Controlled Trial

Why clinicians should know about it

• Picked for Dermatology (top studies of the week, 8 November 2026): RCT, microneedle adjunct to minoxidil for female AGA

Abstract

BACKGROUND: Microneedling has been proposed as an adjunctive strategy to enhance topical minoxidil delivery in androgenetic alopecia (AGA), but the optimal treatment frequency remains unclear. OBJECTIVE: To evaluate the efficacy and safety of 2% topical minoxidil alone versus minoxidil combined with microneedling in women with mild-to-moderate AGA. METHODS: In this 24-week prospective, randomized, open-label, single-center trial, 245 women with mild-to-moderate AGA (Savin grades D3-D6) were randomized to receive minoxidil alone, minoxidil plus monthly microneedling, or minoxidil plus microneedling every 2 weeks. The primary endpoint was change in target area non-vellus hair count (TAHC) from baseline to week 24. Secondary outcomes included non-vellus hair shaft diameter, vellus hair count, hair density, and cumulative hair shaft diameter. RESULTS: A total of 234 participants completed the study. All groups demonstrated significant increases in TAHC at week 24 (all P < .001), with no significant differences between groups. Secondary outcomes were also comparable across treatments groups. LIMITATIONS: Single-center, open-label design and absence of patient-reported outcome data due to database configuration. CONCLUSION: Microneedling using a 36-needle cartridge at a depth of 500-550 μm every 2 or 4 weeks did not provide additional clinical benefit over 2% topical minoxidil alone after 24 weeks.

Abstract as published, via PubMed.