What is micro-needling?
Micro-needling is fairly, relatively, a new procedure in dermatology, plastic surgery, and cosmetic surgery. In the 1990s, dermatologists and plastic surgeons first started a technique called subcision, where they took a hypodermic needle and created a little bit of wound within an acne scar which helped the skin and also the skin beneath the scar i.e. the dermis to start to generate new collagen and fill the scar which eventually led to the development of micro-needling devices.
Micro-needles make little punctures that help things to enter in and that is equally applicable with the hair as well. Micro-needling or collagen induction therapy is effective for the skin. Issues like melisma, skin rejuvenation become better with micro-needling.
The same thing applies to hair as well. The skin that covers the scalp is somehow similar to the skin that covers the face. The skin on our scalp also loses collagen as we grow older, which results in slower hair growth and the hair follicles also turn dormant.
There are two general mechanisms of micro-needling. One is the increment of the growth factors in the vicinity of where the micro-needling has been done and if it is combined with Platelet Rich plasma also known as (PRP), then the added benefit of the actual platelets they are put back to the scalp which is opened up to increase their growth factors is achieved.
But even without PRP, it is seen that the growth factors in that area increase with micro-needling as the body looks to repair itself.
The other mechanism is the activation of stem cells in the hair bulge area that is where the stem cells live. The actual follicle of the hair also increases with the help of micro-needling.
Micro-needling has been shown to produce new hair follicles in mice. And then in humans, when we look at the actual zoomed-in pictures of the hair, the overall thickness of the hair tends to increase. Also, there are fewer miniature hairs which are called vellus hairs and they become more terminal hairs, which are essentially mature hairs, with the micro-needling. It is very uncommon that the actual density of the hair is increased. The actual diameter of the hair shaft is increased along with turning the finer hairs into more mature hair.
Micro-needling can be done alone as monotherapy or can be combined with other modalities like minoxidil, steroid, vitamins, PRP (Platelet Rich Plasma).
It is found to be effective in cases of Androgenic Alopecia which is the male pattern hair loss or the female pattern hair loss. It is also done in the case of Alopecia Areata, where people get one spot on the scalp or on the beard which is bald. Micro-needling helps with the recovery of those bald spots. Telogen Effluvium can also be treated with the help of micro-needling.
Typically, micro-needling is to be done while PRP is done with the help of tiny little 30 gauge needles. Once PRP is placed into the scalp, tiny needles are used around the scalp manually and do that throughout the scalp.
It is not something that is to be done at home. It is not at all like something done on the face. So, the more standard ways of doing it are either with Derma roller which is the device that is passed back and forth in multiple directions that produce little micro punctures on the skin surface. The problem with the Derma roller is that it can break the strands of hair. It kind of cuts the hair. They will ultimately grow back, but if someone is not looking for a haircut, it will thin out their hair.
Another alternative is the Derma pen which punches vertically with the needles onto the skin. It is the more recommended method. The better thing to use is a Derma pen if possible. It is done vertically and creates stamps and then also avoids the breakage of the hair
There is no true consensus on this at the moment. Studies show that the needles have a length ranging between 0.5-1.5 mm.
The deeper the needles go, the more painful the process is. There has been some data to show that hair growth varies based on the size of the needle and the number of times that the skin was rolled over. So, usually the longer the needle, the deeper the needles go and the more times the skin is rolled over to get better results. But the problem is, if the needles go too deep and it is done it too often, then there is the risk of getting scarred, which can hurt the ability to grow hair.
As far as actually applying the needle is concerned, it can be painful. So, there are different ways to numb up the area around the place where the needles are used. It is advisable to use topical anesthetic like BLT or Betacaine lidocaine tetracaine. A prescription is needed for that because there is some toxicity risk of using too much of it or leaving it on the scalp for too long. So, the treatment provider will take care of these things.
There is also injected anesthesia and that can be used in an entire area before the treatment. People may not use anesthesia as well. But, for deeper needling, some kind of anesthesia is needed. If the doctor needs to disinfect the area before getting started, that could be done with something like a Betadine solution. There are different aseptic sprays as well. It is also about how many applications or how many times the same area is gone through.
The average number of times is usually 3 but again it is more about looking for the desired endpoint rather than the number of times rolling over to get the desired endpoint. The desired endpoint is when there is pinpoint bleeding along with mild to moderate redness. Once the endpoint is achieved, the treatment is stopped. It is typically safe to wash the hair at least 6 hours after the treatment.
For the scars to heal, it might take 6 months to 1 year while the results of micro-needling are visible in 4 to 6 weeks after the treatment is done. The body takes time to build healthy collagen.
There are not so severe side effects of micro-needling. These are the minor side effects:
1. Inflammation on the skin
5. Stinging sensation
Some other possible difficulties are like micro-needling are not suited for everyone. Micro-needling may take a very long time to show the results in some people and some people may also find it very expensive.
Micro-needling is a hair loss treatment method that is easily accessible and promotes hair growth naturally when done properly with the help of an experienced professional. Do not perform this procedure yourself at home to avoid infection and to get better results.