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Androgenic Alopecia is a gendered pattern of hair loss caused by the hormone dihydrotestosterone. This post outlines a protocol that a home dermaroller user can use to stimulate hair growth and improve the efficacy of minoxidil, even if minoxidil has failed to work for them previously.

This protocol is written based on the research performed on the efficacy of microneedling for alopecia. I’ve written about this research before in a post that summarizes and compares three academic papers on the subject. That post is here: Microneedling and Androgenic Alopecia.

The Protocol – Dermarolling for Androgenic Alopecia

Dermarolling the scalp has some different considerations from dermarolling the face or body skin, and I’ll try to be very detailed about places that you might need to deviate from the directions outlined other places on this site.

What you need

• a 1.5mm dermaroller*. Don’t buy an expensive one, because you need to replace it every 6-8 uses.
• a 5% minoxidil product– it comes in liquid* and foam* – you can get this pretty  from Amazon (linked), Costco or a drugstore. There’s no compelling reason to buy a name brand.
• Your usual hygiene stuff. If you happen to use one of the shampoos with minoxidil in it, buy an inexpensive shampoo without any active ingredients to use the day that you dermaroll

Before your first time

Patch test your dermaroller. You don’t need to use hyaluronic acid serum to treat alopecia, so ignore that part of the directions in that post. Before patch testing on your scalp, be sure to shampoo your hair with a simple shampoo. Do not use conditioner.

What to do

Each time that you dermaroll, skip your minoxidil the day of and the day after (so, you’re skipping four applications, two morning and two night, regardless of what time you do your treatment).

There are two basic protocols in the research for alopecia, and almost everyone who does it at home chooses the second one.

Option one:

Treat your scalp with the dermaroller as directed in this post twice a month. Remember to discontinue the minoxidil the day of and day after treatment! I suggest the 1st and the 15th, but the 2nd and the 16th will do, or whatever you choose with the same spacing. Doing it this way (as opposed to every other Sunday) enables you to move a treatment 1-2 days forward or backwards without you having to skip a treatment to prevent them being too close together.

This protocol is sustainable pretty much indefinitely. Two hours per month, plus the five minutes total per day you spend putting the minoxidil on.

Option two:

Option two ends up the same as option one, but it starts you off with a short kick-start period. This is supported in the research conducted on men who did not respond to minoxidil alone. In option two, you will start with four weekly treatments before shifting towards treating your scalp twice a month as described in option one. So, your first few treatments will go like this: (dates are hypothetical)

• Sunday March 10
• Sunday March 17
• Sunday March 24
• Sunday March 31
• Monday April 15
• Wednesday May 1

and so on. Four weekly treatments, on the same day each week, then reverting to a twice-monthly schedule.

Starting off with a weekly treatment gives you a kick-start, and it’s been demonstrated successful on even those who didn’t respond to minoxidil alone, but you don’t want to do it indefinitely, because each dermarolling treatment requires you to skip four minoxidil applications. So, ultimately ending up in a twice-monthly schedule is necessary.

Special considerations for microneedling the scalp

You’ll still follow the same directions laid out in my How to Use a Dermaroller at Home post. Instead of a gentle cleanser, use a gentle shampoo (without conditioner) before and after your roll. The literature does not reference using lidocaine to numb the scalp, so you may be best off with oral painkillers.

You can roll the scalp as if you’re rolling a large rectangle–long “tracks” from the hairline to behind the crown (or to the back of the neck if you so choose), then perpendicular short “tracks” from above one ear to above the other. The most efficient way to do this is to have someone else do it for you, though I realize that isn’t an option for everyone. If you do it yourself, do your best to keep the roller flat on the scalp so you don’t get scratched.

Whether you roll the entire scalp or just the thinned patch is a matter of personal preference and may depend on how large the section is and how thin the hair is; you may find that if you roll the whole scalp the thin patch looks worse before it looks better because the thicker hair thickens at the same rate. Perhaps a solution to this problem would be to roll only the thinning patch until you feel it has nearly caught up to the surrounding hair, and then to begin rolling the entire scalp.

And a quick note for women–

The research on microneedling for alopecia is all on men. The actual physical microneedling part has no effect on the hormones, but the minoxidil does. Even if you’re already using minoxidil, the increased product penetration might have a different effect on you. (Hormones! Joy!) You should consider patch testing the minoxidil + microneedling combination in the same way that I suggest for patch testing skincare actives.