A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study.

Int J Trichology. 2013 Jan;5(1):6-11. doi: 10.4103/0974-7753.114700.
A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study.
Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P.

Department of Dermatology, L.T.M. Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

INTRODUCTION:
Dermal papilla (DP) is the site of expression of various hair growth related genes. Various researches have demonstrated the underlying importance of Wnt proteins and wound growth factors in stimulating DP associated stem cells. Microneedling works by stimulation of stem cells and inducing activation of growth factors.
MATERIALS AND METHODS:
Hundred cases of mild to moderate (III vertex or IV) androgenetic alopecia (AGA) were recruited into 2 groups. After randomization one group was offered weekly microneedling treatment with twice daily 5% minoxidil lotion (Microneedling group); other group was given only 5% minoxidil lotion. After baseline global photographs, the scalp were shaved off to ensure equal length of hair shaft in all. Hair count was done in 1 cm(2) targeted fixed area (marked with tattoo) at baseline and at end of therapy (week 12). The 3 primary efficacy parameters assessed were: Change from baseline hair count at 12 weeks, patient assessment of hair growth at 12 weeks, and investigator assessment of hair growth at 12 weeks. A blinded investigators evaluated global photographic response. The response was assessed by 7- point scale.
RESULTS:
(1) Hair counts - The mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively). (2) Investigator evaluation - Forty patients in Microneedling group had +2 to +3 response on 7-point visual analogue scale, while none showed the same response in the Minoxidil group. (3) Patient evaluation - In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment.
CONCLUSION:
Dermaroller along with Minoxidil treated group was statistically superior to Minoxidil treated group in promoting hair growth in men with AGA for all 3 primary efficacy measures of hair growth. Microneedling is a safe and a promising tool in hair stimulation and also is useful to treat hair loss refractory to Minoxidil therapy.

Full Study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

A real shame they used minoxidil in this study, nevertheless interesting. I would use something natural instead.

CS: what would be a natural minoxidil alternative?

peppermint oil is suppose to be a stimulator to some degree. Haven't really tried it myself though.

some suggest castor oil and vitamin b12 topically

There are various types of "minoxidil-like" substances.

For example, a combination of minerals and vitamins and amino acids can duplicate the effect that minoxidil has on potassium channels without poisoning the system (or the side-effects), or causing the massive minoxidil shed that often plagues users after they quit.

Potassium, chloride, magnesium and sodium all found in this formula discussed here:
http://longevitypost.com/salting-away-your-anxiety/

Then there is a suitable complex such as this:

http://www.iherb.com/Thorne-Research-B-Complex-12-60-Veggie-Caps/18126

Adding Carnitine or ALC will further boost things by stimulating
Rather than use minoxidil, taking Acetyl L-Carnitine (ALC) instead boosts cardiolipin levels. Cardiolipin supports the function of the hair follicle in a similar manner to minoxidil.

Cardiolipin levels decline with age along with the efficiency of the mitochondria. The role of cardiolipin supports oxygen and energy conversion. Acetyl L-Carnitine assists in increasing levels of cardiolipin. When used along with Stabilized R-Lipoic Acid, it becomes a potent booster of both glucose and fatty acid metabolism. Something minoxidil will not do.

CausticSymmetry wrote:There are various types of "minoxidil-like" substances.

For example, a combination of minerals and vitamins and amino acids can duplicate the effect that minoxidil has on potassium channels without poisoning the system (or the side-effects), or causing the massive minoxidil shed that often plagues users after they quit.

Potassium, chloride, magnesium and sodium all found in this formula discussed here:
http://longevitypost.com/salting-away-your-anxiety/

Then there is a suitable complex such as this:

http://www.iherb.com/Thorne-Research-B-Complex-12-60-Veggie-Caps/18126

Adding Carnitine or ALC will further boost things by stimulating
Rather than use minoxidil, taking Acetyl L-Carnitine (ALC) instead boosts cardiolipin levels. Cardiolipin supports the function of the hair follicle in a similar manner to minoxidil.

Cardiolipin levels decline with age along with the efficiency of the mitochondria. The role of cardiolipin supports oxygen and energy conversion. Acetyl L-Carnitine assists in increasing levels of cardiolipin. When used along with Stabilized R-Lipoic Acid, it becomes a potent booster of both glucose and fatty acid metabolism. Something minoxidil will not do.

Great post, thanks CS. In the first link you provided, are you referring to 40,000 Volts? Also, excuse my ignorance, but I know next to nothing about Minoxidil - I thought it was a topical application, whereas, what you're talking about is internal, right?

CS, i am wondering the same thing. Are you suggesting that consumption of 40,000 volts (the electrolyte solution) will mimic the effects of minoxidil? do you have any suggestions for topical application?

can anyone give a good recommendation for a dermaroller? this is enough evidence for me to get this into the regimen.

sanderson wrote:can anyone give a good recommendation for a dermaroller? this is enough evidence for me to get this into the regimen.

http://www.hairlosstalk.com/interact/showthread.php/25910-Skin-Needling/page15

http://www.hairlosstalk.com/interact/showthread.php/25910-Skin-Needling/page24

http://www.hairlosstalk.com/interact/showthread.php/71434-Dermaroller-30-day-results-with-microscopic-pictures-Good-results-so-far!?p=1146139

http://www.hairlosstalk.com/interact/showthread.php/69374-New-Dermaroller-Study-Thoughts-comments?p=1144189

Really read the fourth one....

Their idea of what the cause of baldness is, is kind of wrong & shit but there are a couple studies on there that are cool... Not to mention the whole forum is complying and nearly EVERYONE is regrowing hair everyehere on their heads including the temples and hairline. One guy there, Casperz, was slick/shiny bald for 15-20+ years and he is growing a whole bunch of terminal hairs on his hair line.... He claims he is recovering his (juvenile hairline)

Honestly, Detumescence therapy/Maliniak massage is the KEY here if you don't want to keep wounding yourself for the rest of your life. Dernarolling's mail role here is creating new VASCULARITY & minox is a nitrous oxide agonist with vasodilator properties that can promote blood straight to those new "networks" In fact, there was a guy on there that said he had a HT done on his hairline and hairs under the TP area were growing.... This is because of the new vascularity. I'd say Dermarolling is the fast way out but you HAVE TO LOOSEN THE SCALP. I've seen way to much evidence on the fourth thread suggesting that these guys desperately need to loosen their scalps.... Not to mention none of them know about why the Botix study or any other Galea studies... The closest one they know of is the Detumescence study and after one guy tried it he was confused about how he got rid of "fibrosis" with just that massage LOL. A whole bunch of guys also mention how they don't bleed the first couple of times in the balding areas or why the sides of their heads don't accumulate as much DHT as the too does...

Anyways, at least they're getting a lot done. I believe if we had more guys willing to do some of the GOOD manual methods that we speak if on here we would be blowing these guys away with progress. I'm already close to having full, thick coverage without Dermarolling.

Mybad if I misspelled anything or whatever.... I've been working my online job & cleaning up the house from yesterday's party the whole day today lol... Shit, it's got me EXAUHSTED.... Hard work will pay off big time once the money rolls in =] Hope you found that helpful though, Sanderson.

Complexx wrote:Mybad if I misspelled anything or whatever.... I've been working my online job & cleaning up the house from yesterday's party the whole day today lol... Shit, it's got me EXAUHSTED.... Hard work will pay off big time once the money rolls in =] Hope you found that helpful though, Sanderson.

yes man.. that did help very much. that's pretty crazy that other people have had that some success.. def. seems important to add it in.. from going through those threads and others as you have done lots of research into this.. what would you recommend for a good dermaroller?

I think you are OK with any, if the needles are long enough, thin enough, and disinfected regularly. Also you dont want cheap PVC needles; stainless steel and or titanium alloys should perform better.  Ideally would be some very expensive material, but i don't seem to find any product with surface silver/gold on it.




This or something similar would be it, but you can always start with shorter needles to see how it's going since price is not too much.

http://www.ebay.co.uk/itm/540-Dermaroller-Titanium-Skin-Roller-Micro-Needle-Microneedle-Treatment-Therapy-/270938773053?pt=UK_Health_Beauty_Skincare_PP&var=&hash=item3f1535963d

or

http://www.ebay.co.uk/itm/SODACODA-540-TITANIUM-Micro-Needles-Derma-Roller-build-beautiful-healthy-skin-/261338262496?pt=UK_Health_Beauty_Skincare_PP&var=&hash=item3cd8f96be0

Would apply something to fasten the regeneration/keep away inflammation as with emu oil, rejuveplex, or plenty internals such with vit A, E, C, bone broth,... Also would think LLLT after dermarolling session would be benefitial as well (to fasten the results), as well as violet ray application before the session... Thinking of giving it a try...

Beebrox - Wouldn't be inflammation good in this case - you provoke neogenesis and scalp heals itself and release growth factors.

Biffy wrote:Beebrox - Wouldn't be inflammation good in this case - you provoke neogenesis and scalp heals itself and release growth factors.

Inflammation is produced with needling and it's side effect is the part you are after. If one has problems with health and handling inflammation from wounds, regeneration capabilities are is probably an issue, so taking some help with topicals and internals is what i thought. I think MPB has pathogens involved, but pathogens themself are not necesairly to be the trigger and reason. Anyway, creating more inflammation with wounding might not be so good idea for somebody with let say low thyroid/adrenals/thymus, and high various poisoning...

You can create little wounds on your hands and treat one with topical as with emu oil and the others should let be alone. You will be able to create an opinion of what's worthy. This is what created main.

[quote="Beebrox"]

Biffy wrote:Anyway, creating more inflammation with wounding might not be so good idea for somebody with let say low thyroid/adrenals/thymus, and high various poisoning...
.

can someone explain to me why wounding wouldnt be good in case of thyroid issues?

I can totally get behind the notion that there is some kind of microvascular insufficiency in the scalp. I think there has been evidence presented here before that could support that, especially a lot of the CCSVI stuff and calcification of the soft tissues. 

But is there any evidence that a tight galea is what is creating the vascular insufficiency? Its been shown here that the veins and the arteries of the skin don't communicate with the hair by "pushing" up through the galea, rather they climb the sides of the head superiorly.

So how does a tight scalp cause the problems? I'm not asking to be a smart ass, I really would like to know what the consensus is on how that happens.

I've mentioned before that it could be a loss of subcutaneous fatty layer, making the environment more abrasive, like the surface of the galea and the dermis are pressing on it from above and below? Or the heat theory? Or compression forces?

The thing is, other people, such as those on hairlosstalk, could be totally in agreement that it is vascular insufficiency but not agree that it is a tight scalp and treating it in each of those views would look pretty differently. You could be saying iron overload is creating the vascular problems, or other heavy metals, or oxidative stress from blood sugar and growth factors in the blood.