It may look like a medieval torture device, but many people – including celebrities – are fans of the derma roller. Commonly used to improve the appearance of skin, this device shows promise as a hair loss treatment too. In fact, a 2013 study showed excellent hair regrowth in those treated. So does it work? Read on to find out whether using a derma roller for hair loss is a good idea or whether it’s just a painful fad.
What is a derma roller?
A derma roller is a handheld device with many small surgical needles. These needles are attached to a wheel which, when rolled over the skin, cause microscopic wounds.
These wounds activate the body’s healing response (hemostasis-inflammation-proliferation-tissue remodeling). The idea is that the various growth factors involved in this process mean the newly healed skin is better than before.
Practitioners take advantage of this wound healing response, using derma rollers to treat stretch marks, wrinkles, scars, and similar conditions. Apparently, Kim Kardashian is a fan.
Derma rollers come in various shapes and sizes. Needles range from 0.25mm – 3mm in length, with different size needles recommended for different skin conditions:
In general, though, it seems the more damage you do, the better the results – up to a point. It is reported that improper use of needles greater than 1.5mm can result in collagen breakdown.
But as well as treating skin conditions, new research suggests that derma rolling could reverse hair loss too.
Derma roller for hair loss study
As mentioned, derma rolling activates the body’s wound healing response. The theory goes that this response could be utilised to reverse androgenetic alopecia (male pattern hair loss).
A 2013 medical study, A Randomized Evaluator Blinded Study of Effect of Microneedling in Androgenetic Alopecia: A Pilot Study, put this theory to the test. 100 participants were randomly divided into two test groups: one group received 1ml of 5% minoxidil solution twice daily, the other group received the same minoxidil dosage plus a weekly microneedling (derma roller) procedure.
A derma roller with 1.5mm length needles was used in this study. Both groups had their hair shaved so changes in hair style could not influence the results.
After 12 weeks, three methods were used to determine how effective of each treatment was:
- Change in baseline hair count (the tested area was tattooed to ensure consistent measurement)
- Patient self-assessment of hair growth
- Blinded investigator assessment
The study found:
“Hair counts – The mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively). […] Dermaroller along with Minoxidil treated group was statistically superior to Minoxidil treated group in promoting hair growth in men with AGA for all 3 primary efficacy measures of hair growth.”
In short, the microneedling procedure led to significantly greater hair regrowth than minoxidil alone. This was confirmed through all three methods of assessment.
For comparison, representative results from the minoxidil only group can be seen here.
So how does it work?
Three mechanisms of action through which microneedling leads to improved hair growth are proposed in the study:
Release of platelet derived growth factor, epidermal growth factors are increased through platelet activation and skin wound regeneration mechanism
Activation of stem cells in the hair bulge area under wound healing conditions which is caused by a dermaroller
Overexpression of hair growth related genes vascular endothelial growth factor, B catenin, Wnt3a, and Wnt10 b.
Hair loss is caused by a broad range of molecular signals. Dihydrotestosterone (DHT) – the main hormone believed to be responsible for androgenetic alopecia – is believed to interfere with these signals, causing hair to miniaturise and eventually fall out.
DHT is believed to inhibit many growth-stimulating pathways in the hair follicle. The writers of the study suggest that these pathways are activated in response to microneedling. Growth factor activation and stem cell stimulation are also proposed to play a role in improved hair growth by the writers.
DIY derma rolling for hair loss
With such promising results, you may be tempted to order a derma roller for yourself.
And various members of hair loss forums, encouraged by this study, have done exactly that. Their attempts to replicate the results of this trial can be found here.
If you do decide to try out derma rolling for yourself, here are the basic steps to replicate the study above:
- Use the derma roller once per week – do not use again until the treated area has fully healed
- Use a derma roller with 1.5mm needles
- Properly disinfect the derma roller after each use
- Focus on one section of the scalp at a time, rolling horizontally, vertically, and diagonally 3-4 times
- Replace your derma roller after 20 uses to avoid blunt needles
- Apply 1ml of 5% minoxidil to the scalp twice daily
Derma roller side effects
The results of the derma rolling hair loss trial described above are indeed impressive.
But that doesn’t mean using a derma roller for hair loss is without its drawbacks.
If you plan on using a derma roller in conjunction with minoxidil like the study above, be careful! Applying minoxidil straight after using a derma roller can cause systemic minoxidil absorption. From my own experience, this is not a good thing! On at least two occasions it caused me to wake up in the middle of the night with tachycardia (increased heart rate) – not fun!
In fact, my advice would be to do without the minoxidil altogether.
Derma rolling without minoxidil will still have the desired effects – increased growth factors, stem cell activation, etc. – but with much less risk. And if you’re looking to add a topical solution into the mix, consider rosemary oil – a recent study found it to be just as effective as 2% minoxidil.
One final word of warning: if you’re significantly bald (Norwood 3+, for example), you’re likely to have a visibly red scalp the day after treatment. Perhaps consider investing in a decent hat?!
Is microneedling worth it?
Drawbacks aside, derma rolling is one of the most promising solutions around for actually regrowing lost hair. We know that prescription treatments like finasteride can be effective at maintaining existing hair. However, they’re much less successful at causing regrowth.
But recent findings lend strong support to the regenerative effects of microneedling.
For example, the wound healing response to hair plucking was found to regenerate dormant surrounding hair follicles in mice.
And researchers from the University of Pennsylvania (the same team working on Setipiprant and PGD2-based hair loss treatments) found that wound healing opened an “embryonic window of opportunity” within which dormant molecular pathways were awakened:
We showed that wound healing triggered an embryonic state in the skin which made it receptive to receiving instructions from wnt proteins… Increased wnt signaling doubled the number of new hair follicles.
Best of all, though, derma rolling increases levels of the same growth factors said to make platelet-rich plasma an effective hair loss treatment – but at a fraction of the cost!
I admit, derma rolling isn’t the most enjoyable of experiences. However, it does appear to be an effective tool for hair regrowth. And though the science behind microneedling is not fully understood yet, it is compelling.
So, if you’re looking to regrow your hair, it looks like the old saying is true: pain is beauty!