Microneedling for hair loss

What it is

Microneedling uses a tool covered in fine needles. The most common types are:

• a roller (often called a dermaroller): a small drum covered in needles, rolled over the skin
• a stamp: a flat head of needles pressed straight down
• a pen: a powered device with a needle tip that moves up and down quickly, used mainly in clinics

The needles make many tiny punctures in the scalp. They are small enough to close within hours, but large enough for the skin to notice.

Why it might help hair

Nobody knows for sure. There are two main ideas. The first is that small, controlled injuries make the skin release wound-healing signals and growth factors, which may wake up or support hair follicles. The second is that the tiny channels help minoxidil get into the skin, so more of it reaches the follicles.

Both ideas fit the results so far, which come almost entirely from trials that combined microneedling with minoxidil. On its own, there is very little evidence that microneedling grows hair.

What the trials show

The trial that made microneedling popular was a 12-week study in Mumbai.⁴ It included 100 men with pattern hair loss. All used minoxidil 5% twice a day; half also had weekly microneedling with a 1.5 mm roller. Of those who completed the trial:

• hair counts in the target area rose by an average of 91 with microneedling plus minoxidil, against 22 with minoxidil alone
• 82% of the microneedling group said they had improved by more than half, against 4.5% on minoxidil alone

These are large differences, but the study was small, short and done in one centre, so treat them as an early signal rather than a typical result.

Since then, several trials have been pooled. A 2025 analysis combined 12 randomised trials with 631 patients and found that microneedling plus minoxidil gave clearly higher hair counts than minoxidil alone.¹ Hair thickness also improved a little. A 2023 analysis of 10 trials with 466 patients came to a similar conclusion on hair counts.²

The trials also have limits:

• They varied a lot. The size of the effect differed widely from trial to trial, which makes the average harder to trust.¹
• They were short, mostly three to six months.
• Most were in men. We know less about women.
• Blinding was hard. People always know when needles are used, so expectations may affect self-rated results.

Interestingly, the 2025 analysis found that needle length, how long treatment lasted and the type of device did not change the effect on hair counts.¹ Longer needles did not clearly do better.

Where it fits

The 2017 European guideline made no formal recommendation on microneedling and said more studies are needed.³ Since then the pooled evidence has grown, and many dermatologists now suggest it as an add-on.

A fair summary: if you already use minoxidil and want to add something low-cost, microneedling has some of the better evidence among add-ons. It is not a replacement for minoxidil or finasteride, and it does not change the hormone DHT that drives pattern hair loss.

123456Little to seeTrials judged it at 3 to 6 months

Home or clinic

You can microneedle at home with a roller or stamp, or have it done at a clinic, usually with a pen.

Home microneedling is what most people do, and it is what several trials used. The main risks at home are infection from a tool that is not clean, and pressing too hard. Our step-by-step guide covers how to do it safely: microneedling at home.

Side effects and risks

In trials, side effects were more frequent with microneedling than without, but mostly mild.¹ The 2023 analysis found no scarring or serious side effects.² Expect:

• redness and soreness for a day or so
• small spots of bleeding, especially with longer needles
• stinging if you apply products straight afterwards

Rarer risks include infection, a rash or a flare of a skin condition, and marks from rough technique.

If you are not sure what kind of hair loss you have, see a doctor first. Read when to see a doctor.