This article will outline how to use a dermaroller to stimulate new hair growth. This method can help with diffuse thinning hair, or the typical receding hairline also known as pattern baldness.
You will need to know how to use this technique properly. Dermarollers are generally very safe devices, but if not used properly, you risk damage to your scalp.
- What is A Dermaroller?
- How Does the Dermaroller Help With Thinning Hair?
- Microneedling Can Treat Androgenetic Alopecia
- Microneedling Without Minoxidil
- Different Types of Microneedling Devices – Which Is Best?
- How To Use The Dermaroller
- What Size Needles?
- How Often?
- Tips For Optimal Regrowth
- Common Mistakes
What is A Dermaroller?
A dermaroller is a simple, handheld device that makes tiny pinpricks in the skin.
The pricks penetrate into the dermal layer, just deep enough to stimulate new cell production and boost circulation, but without causing permanent damage (1).
The process is also known as ‘microneedling‘.
The dermaroller has been used as a medical and cosmetic device for decades.
How Does the Dermaroller Help With Thinning Hair?
The History of Microneedling
Microneedling is a relatively recent invention. Doctors in the 1990s accidentally discovered that microneedling could help reduce the appearance of scars after cosmetic surgery (2).
This initial discovery led clinicians to explore microneedling a treatment modality for various conditions. Today, microneedling is one of the most exciting and promising new treatments in dermatology. Its applications include, among others (3):
- Scars (from acne, surgery, etc.)
- Hair loss
- Wrinkle reduction
- Damage from the sun (UV)
How Does Microneedling Work?
The published research suggests microneedling promotes hair regrowth in two ways (4):
First, it enhances the absorption of minoxidil or any other topical stimulant. This is why in most skin conditions where microneedling is useful, doctors typically recommend it alongside a topical medication.
One is stimulating the dermis to release growth factors in response to the injury from the needles. It is also possible that the needles break up the fibrosis that builds up between the hair follicles in the balding scalp.
Microneedling Can Treat Androgenetic Alopecia
Androgenetic Alopecia (AGA) is the most common type of hair loss in men and women (5). The two first-line treatments that the FDA has approved are minoxidil (for men and women) and finasteride (for men) (6). However, the market for non-pharmaceutical treatments is growing, and microneedling is arguably the most popular such intervention.
The first study was performed in 2013, recruiting 100 patients with mild-to-moderate AGA (9). The participants were split into two groups. The first group received weekly microneedling treatment with twice daily application of 5% minoxidil, while the second group was given only 5% minoxidil.
Photographs were taken at baseline and then at the end of treatment. There were three parameters that researchers used to track efficacy:
- 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.
You can see the results after 12 weeks in the graph below:
The mean hair count of patients in both groups improved. However, the counts in the combination group increased by nearly four times compared to the minoxidil-only group.
The dermatologists’ assessments of the before and after photos of the patients painted a similar picture:
The dermatologists rated all the men in the microneedling group as showing at least some improvement. This was often the best possible regrowth (+3 on the scale). On the other hand, they found that a substantial proportion of men in the minoxidil-only group showed no regrowth. When men in the minoxidil-only group did respond to treatment, the improvement was only mild (+1).
In the photographs below, you can see the before and after photos of some men in the combination treatment who had an excellent response to treatment.
Microneedling in Treatment-Resistant Patients
In 2015, researchers from Mumbai studied the effects of microneedling on men with AGA who did not respond to conventional treatments like Rogaine and Propecia (10). This study was small – only four patients – but the results were suggestive.
All four patients had been on finasteride and 5% minoxidil for anywhere from two to five years. There was no further loss of hair during this period, but their regrowth had stagnated.
As part of the study, the patients starting receiving microneedling sessions for six months alongside their ongoing treatment.
The results were tracked using a standardized seven-point evaluation scale, along with patient evaluation.
At the end of the six-month period, three of the patients expressed more than 75 percent satisfaction with the results, while the fourth patient expressed more than 50 percent satisfaction. In addition, dermatologists assessed all patients as showing +2 or +3 responses on a seven-point evaluation scale ranging from -3 to +3.
You can see the before and after photos of one study participant in the images below:
Microneedling Without Minoxidil
Most of the published research agrees that adding microneedling to a topical stimulant like minoxidil substantially increases regrowth. Around 3 times as much or even more, up to 4 times.
Until recently, researchers didn’t know if microneedling will work on its own, without minoxidil.
In 2020, a clinical study out of China answered this question (11). The researchers recruited 71 male volunteers, 20-60 years old, stages 3-6 on the Norwood-Hamilton scale.
They randomly split the participants into 3 groups:
- The first got 5% topical minoxidil daily, with no microneedling.
- Another group received microneedling alone, once every 3 weeks, for a total of 8 sessions.
- The last group was the combination treatment: daily minoxidil, plus the microneedling sessions once every 3 weeks. On the day of the microneedling this group skipped the minoxidil.
Treatment lasted 24 weeks. Participants also returned 6 months later for a follow-up evaluation.
The primary outcome measure was the number of new hairs in a one-centimeter squared balding area. Here are the results:
- Group 1, minoxidil alone, had an average of 14 new hairs per centimeter squared.
- Group 2, microneedling alone, had an average of 21 new hairs per centimeter squared.
- And Group 3, microneedling in combination with minoxidil, had an average of 40 new hairs per centimeter squared.
In other words, the combination group had nearly 3 times as many new hairs compared to minoxidil monotherapy.
However, the key new information in this study was from group 2: the men who just did microneedling as a standalone treatment – without any minoxidil.
Remarkably, these men had one and a half times the regrowth of the minoxidil group. So just one microneedling session every 3 weeks easily outperformed daily minoxidil.
How Permanent Are Results?
After 6 months, the study participants returned for the follow-up assessment.
90% of the men treated with minoxidil alone lost all their new hair. The men in the two microneedling groups had better retention: 10% of these men lost all their newly formed, hair, 70% had mild to moderate hair loss, and 20% retained their hair.
This suggests that the regrowth from microneedling tends to last longer than standard pharmaceutical treatments.
Different Types of Microneedling Devices – Which Is Best?
There is no one-size-fits-all answer to this question. Each type of device has its own strengths and weaknesses. Let’s see each one in turn.
The dermaroller is perhaps the most well-known microneedling tool. When you think of microneedling, a dermaroller is what will probably come to mind.
It consists of a handle attached to a rotating barrel. On the surface of the barrel are a few hundred microneedles.
As you roll the dermaroller over your scalp, the needles on the rotating barrel penetrate the skin. The penetration is deep enough to cause the skin and follicles to rejuvenate, but not to the point of causing permanent damage and scarring.
The advantage of the dermaroller is that it’s quick. Because you just roll it across the skin, you can cover large areas of the scalp in a short time.
On the other hand, it has two main disadvantages.
Firstly, you can’t adjust the length of the needles. Since the needles on the barrel are fixed, you will have to purchase multiple derma rollers if you want to experiment with the needle size.
The second disadvantage has to do with the direction of application. Ideally, you want the needles to insert vertically into the skin, straight down.
This is how the other two microneedling devices (dermastamp and dermapen) works. But the dermaroller doesn’t do this. Each needle inserts the skin at an angle, and completes a sweeping motion before exiting. This might cause slightly more damage than necessary.
After some use, the dermaroller needles will get dull and require replacing. Depending on how often you use it and how well you maintain it, you should be able to get a few months out of each unit.
The dermastamp is another option. It is a rectangular block on the end of a handle, and the block contains needles. Just as with the dermaroller, you can use the stamp on the scalp as well as the face.
Aside from the obvious structural differences, the dermastamp has a few benefits over the roller.
In particular, the stamp is much easier to manipulate when using it yourself. This is especially true for hard-to-reach areas, such as the sides and back of the head.
There is also less risk of damaging the surrounding hair follicles and removing healthy hair strands, which can occur if hair gets stuck in the roller.
You can purchase adjustable dermastamps (whereas such rollers do not exist). This means you can decrease and increase the needle length as necessary for the best results.
This is similar to the dermastamp, but battery operated. The dermapen takes the tip of a disposable microneedle in the form of a cartridge. The cartridge pulsates up and down at a certain frequency.
Because the needles are mechanically stamped into your skin at high speeds, you don’t need as many needles. There are typically only 5 to 9 needles on the cartridge.
The frequency is fully adjustable by the user. Faster speeds mean more punctures, for a more intense experience. The user can adjust both the intensity of the treatment, as well as the size and number of the needles (since there are cartridges with different needle configurations). This makes the dermapen a fully customizable experience.
The disadvantage of the dermapen is that it’s obviously a more complicated device, so more likely to break down. It also costs more. There are various quality devices. Cheap ones from China cost 20 or 30 dollars. This goes all the way up to several hundred dollars for branded, quality devices.
How To Use The Dermaroller
If you want to start microneedling, you have two options:
- You can have it at a professional clinic by a licensed dermatologist or other qualified professional, or
- You can do it yourself at home.
A visit to the clinic will give better results, especially if you have no experience in microneedling yourself. On the other hand, the cost of the visits will add up over time, making this a non-viable option for many men.
A good idea would be to get your first couple of treatments at the clinic. Then, with the benefit of these experiences, you can start microneedling at home.
Before anything else, you want to make sure your dermaroller is sterilized prior to use. Also, your scalp should be clean and dry (we will return to hygiene shortly).
To begin, place the dermaroller at the area you want to treat. You need to roll across all directions: 2-3 times horizontally, 2-3 times vertically, diagonally, and so on. Do this for each area you want to treat.
Depending on the area you treat, the session should last between 15-20 minutes.
A common question is how hard you should apply, and if bleeding is OK. In our experience, pinpoint bleeding is not necessary to see results. You can apply just enough pressure to feel mild discomfort.
Having said that, many of the published studies describe applying pressure to the point of causing bleeding. Bleeding will work for hair regrowth, but you also increase your chances of infection, especially if you are doing it at home.
What Size Needles?
The needles in dermarollers range in size from 0.25 to 1.5mm. Most studies use needles between 1.0-1.5mm.
(If you want a dermaroller designed specifically for hair loss, check out this link)
It is not necessary to microneedle more than once a week. You are not likely to see better results, and only increase the risk of side effects. Researchers have found that even one microneedling session every 3 weeks is sufficient to stimulate regrowth.
It is very important to maintain good hygiene when you dermaroll.
Firstly, ensure your scalp and hair are clean prior to application. Ideally, shampoo thoroughly prior to the dermarolling session, and let your head dry in the air, without rubbing it with a towel. Even more importantly, the dermaroller should be properly sterilized before each treatment.
When it comes to sterilizing your dermaroller, there are two basic ways. You can soak it in alcohol or boil it. Whichever way you choose, remember to allow the dermaroller to air dry.
Never share a dermaroller.
Tips For Optimal Regrowth
1. Cut Your Hair Short
As we saw, dermarolling has been taking dermatology by storm over the past few years.
Dermatologists and other licensed professionals are using it for everything from reducing wrinkles, to treating pigmentation disorders, acne, scars, and more.
In all these applications, the dermaroller is used on bare skin. In line with this, we recommend you keep your hair short for the duration of the treatment.
This will have multiple benefits. Firstly, it will be easier to roll the device, and prevent your catching and pulling out many hairs while rolling. It will also allow you to penetrate the skin, rather than just rolling over hairs.
Short hair will allow you to see results the moment they are produced. You will be able to see the new hairs as soon they pop out of the scalp.
Since this is a lengthy treatment, there can be nothing better than this kind of encouragement. This will increase the likelihood of you adhering to the treatment.
2. Add Scalp Massage to Your Haircare Routine
Dermarolling is one of the two major mechanical methods you can use to stimulate your hair growth. The other is scalp massage.
(Check out our complete scalp massage guide here).
Either of these methods on its own can give excellent regrowth. Combining the two could, in principle, lead to even better regrowth.
3. Combine With an Oral Supplement
Since dermarolling is a topical, mechanical treatment, it makes sense to combine it with something systemic.
If you are dermarolling, you have already committed to the time and effort of weekly sessions. It is practically no extra hassle to add a systemic treatment in the form of a capsule that you take once a day.
You can try saw palmetto, or check out the Hairguard Hairbiotic. It is made with all-natural ingredients and packs all the probiotic strains shown to induce hair growth, including L. Reuteri.
4. Focus on the Balding Areas, and Use Proper Technique
Time is money, so you don’t have to dermaroll all over the scalp. Focus on the balding areas, to begin with, and treat the rest only if you have time.
Also, make sure to roll in all directions: that means up and down, sideways, and diagonally.
Also, we see online horror stories of scalps being covered in blood by users applying excessive pressure. Don’t go too hard. You do not need to bleed. The microneedling will work fine with lighter pressure.
5. Get Your First Session at a Licensed Practitioner
One of the major advantages of dermarolling is that you can do it home for free. Yet you might want to consider getting your first session at a specialist.
This will allow you to see if it’s right for you, and show you the correct technique to use. So pay once, and then do it on your own, for free, for the rest of your life.
Some of the most common mistakes microneedling users make are:
- Excessive frequency of dermarolling. As we mentioned above, microneedling more than once every week is unlikely to improve results. Remember that every time you microneedle you are essentially damaging your scalp. You need to give it sufficient time to heal between sessions.
- Poor hygiene. This is very important, as poor hygiene can lead to infections. These will slow down your progress, as you will have to suspend microneedling sessions until your scalp heals.
- Improper technique. This relates to both the pressure and direction of application (discussed above).
- Not giving the treatment enough time. Allow 3 months at a minimum before you decide if microneedling is right for you. Like all other hair loss treatments, microneedling takes time to show results. If you expect to see a difference overnight, you will not only be disappointed but also potentially missing out on a treatment that could benefit you.
Microneedling is a promising treatment that could potentially help you improve the overall health of your hair. In recent years it has emerged as one of the most popular treatments in the hair loss community.
Its major advantages are that it is highly effective, safe, cheap, and relatively quick to perform. A once-weekly microneedling session should take up no more than 30-60 minutes of your time.
While you can get results from microneedling on its own, these will be far better if you combine it with a topical stimulant like minoxidil. For even better results, you can try minoxidil fortified with finasteride.