Dermarolling study -- my thoughts and questions

Sorry for the book I'm about to write below, but I have been doing a lot of thinking about the newly popular dermarolling study and would love to get more discussion going. Study link: http://www.ijtrichology.com/article.asp?issn=0974-7753;year=2013;volume=5;issue=1;spage=6;epage=11;aulast=Dhurat

This research is very encouraging, but before we get too caught up in the excitement and attempt to replicate this experiment on our own, we need to think about HOW the researchers got the results they did... especially when considering others have used dermarollers on hair loss forums in the past (w/ and w/o minox) with negligible results. We have to remind ourselves that this was the first and only real study using dermarollers to treat AGA. As expected, the last line of the study states that they don't how "different sizes of needles of the dermaroller, frequency, duration and end point of the procedure" would change the outcome. Here are some questions which I believe are worthy of discussion:

1. Was the 12-week study simply longer than others have tried dermarolling their scalp for in the past?

Most people don't stick with hair loss treatments long enough to truly determine if they would help/hurt longterm. There is always a new "flavor of the month" when it comes to hair loss treatments on forums, making it frustrating for someone to stick to a regimen when they don't see results in a month.

2. Why did they choose to use a 1.5 mm dermaroller once per week for the study?

They didn't use 0.5, 0.75, 1.0, or 2.0 mm rollers... but 1.5 mm. Typically, 1.5 mm dermarollers penetrate up to 1.3 mm deep... but pressing down softer while rolling will change this depth. The study states they rolled the scalp only until mild erythema (redness) was observed. Some people have noted bleeding and intense pain on the scalp while rolling with 1.5 mm dermarollers. Since such effects were not noted in the study, I am led to believe the researchers may not have fully pressed down while rolling (unless a numbing agent, such as lidocaine, was used but not mentioned in the study... which I doubt).

Many experts believe using a 1.5 mm dermaroller should only be used once every 3-4 weeks. Dermarolling initally creates inflammation in the skin… it can't recover from a 1.5 mm dermaroller in a mere week (this is another clue that they may not have pressed down completely on the scalp while rolling). Researchers are definitely smart enough not to overlook something so crucial... unless they meant to on purpose (overusing a dermaroller can have a plumping effect on the skin through continued inflammation).

I can't imagine there was any particular reason for choosing a 1.5 mm dermaroller over, say, a 1.0 mm one -- they just wanted to make sure it would go deep enough to have an effect on miniaturized hairs (but 0.5 mm might not be deep enough, and 2.0 mm might be a bit too brutal). As with all things, moderation is key.

3. Could dermarolling have a different mechanism for hair regrowth than what's discussed in the study?

The study credits the dermaroller's ability to trigger hair regrowth through platelet activation and wound regeneration where the following occurs: (a) beneficial growth factors are released, (b) bulge area stem cells are activated, and (c) hair growth related genes are over-expressed.

Normally dermarolling is done with the intent of building collagen but, interestingly, "collagen" is not mentioned at all in the study! Many people report thinning/tightening scalps as hair loss progresses. You guys have been discussing research pointing to higher DHT to estrogen conversion ratios in the tight galea regions of the scalp due to hypoxia. Perhaps dermarolling is a powerful way to restore the scalp to its pre-balding environment.

4. How were such great results achieved so quickly?

Hair loss usually takes years to manifest itself through progressive miniaturization, which is why it's surprising that such good results have occurred in a 12-week study. Even "FDA-approved" products for AGA often take 6-12 months to even notice improvement... often after huge sheds. How dermarolling works so quickly is still slightly mysterious… would love to here some idea about the timeline (shedding was not noted in the study).

5. Why was the dermarolling group using minoxidil at all?

I wish the study had further isolated the variables by either (a) not having the dermarolling group use minox, or (b) adding a third group who ONLY dermarolled (without minox). I realize the dermaroller+minox group didn't apply minox for 24 hours after dermarolling... but all that does is further complicate the implications we are drawing from the study. What we don't know is whether the minox in some way enhanced the effects of dermarolling, the dermarolling somehow enhanced the effects of minox, or if dermarolling alone would have been enough to achieve the results they did.

6. Could topicals be a good addition to dermarolling, enhancing hair regrowth even more?

From the looks of it, this study used no topical treatments before/after dermarolling. However, many people take advantage of the increased absorption ability in the skin immediately following dermarolling by using special vitamin/antioxidant serums to help with inflammation and improve desired results. I wonder if Rejuveplex+AHK-Cu would be good add-on?

7. What happens (longterm) to the regrown hair after dermarolling is discontinued?

All participants reported a "sustainable response" after 8 months of the study's completion, but an important question is how many of them continued using dermarollers and/or minox (or started using other things, such as finasteride) on their own after the study? If the majority of participants used nothing and continued to keep their hair, then this study is possibly the most significant piece of research ever published regarding AGA.

Whew! That's a long post haha… let me know your thoughts!

Are people still dermarolling? Any success? If so, could you please detail how often you do it, what needle length, and what other topicals you use?

Thanks!

Years ago (2004) I had regrowth start within a month with free hand syringe deep puncture ( but not to bleeding level ) with minoxidil . I even posted pictures on another forum. I saw some a few fast response full diameter hairs shoot out also. I know this kind of regrow time is possible with no shed. I stopped because I was not sure how much of the regrow was due to minox, and I was not going to stay on minox. A hair transplant seemed a fine alternative at the time.
When I started my DT-CPR method of hard pressure massage, the post treatment scalp soreness was very similar. This is why I had the confidence and expectation that the DT-CPR method was a good direction, and the results so far have exceeded expectations for speed and area regrowing.

may be dermaroller can help to get the traped oil so no need to bleed ..but that will need a sqweez after rolling ....scaryyyy

cdto2012 ..do you remember what you get after this needle ..i mean oil/glow or nothing?

Freehand needling does not release or squeeze out much beyond a little blood if you are not careful. The soreness is reduced over time as the scalp gets healthier, I think needling is great to trigger a regeneration response, induce bloodflow, and make the skin healthier. I wondered if it had the ability to also unclog pores and follicles. I was using so much other junk like minox and prepping with alcohol that it is hard to notice finer things like oils. I would say include DT massage if you want to press out oils and reach the deeper tissue for detox and stimulation.