Researchers pulled together 12 separate randomized trials covering 631 people with pattern hair loss, then looked at all of those results as one combined picture. Randomized means each person was put into their group by chance, which is what keeps the two groups fair to compare. One group used topical minoxidil on its own. The other group used minoxidil plus microneedling, the technique that creates controlled micro-injuries in the scalp.

The group doing both ended up with more hairs in the treated area and slightly thicker hairs than the group on minoxidil alone. Both the researchers reviewing the photos and the patients looking at their own heads rated the combination as the more improved of the two. Side effects showed up a bit more often in the combination group, 74 times compared to 59, and the authors described them as mild and clearing up on their own. The authors also flagged two limits on their own work. The hair count results swung widely from study to study rather than landing in a tight range, and none of the included trials had Caucasian participants, which limits how far the numbers can be carried across hair types.

Here's the study: Ahmed KMA, Kozaa YA, Abuawwad MT, et al. Evaluating the efficacy and safety of combined microneedling therapy versus topical Minoxidil in androgenetic alopecia: a systematic review and meta-analysis. Archives of Dermatological Research, 2025. Read it here

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