Microneedling / Derma Rolling for Hair Regrowth

hey guys dr gary here so as you know i'm double board certified and do facial plastic surgery and hair restoration this topic actually comes from some of the comments that you guys have put on my videos and it's about micro needling and derma rolling for hair restoration and i want you to stay tuned till the end because i'm going to actually offer some recommendations for a protocol that you can use for at-home microneedling in general i'm not a huge fan of the diy culture when it comes to doing things you know medically related however there's actually research studies that are done with microneedling being done at home as part of the study it's like an accepted type of process as opposed to some of the other stuff that you guys have seen of mine like the fillers and the botox that people are doing at home much more dangerous it's much harder to kind of really harm yourself doing some of this at home so of course you know be smart about it always consult with the doctor before you get started but there is sort of some general guidelines i'm going to give you at the end of the video so let's jump into it microneedling what is it it's also called percutaneous collagen induction therapy and it's basically multiple fine needles that are used to create these like micro punctures in the skin and the therapy is relatively new it came about in the 1990s and i think it was 1995 that it was first demonstrated to be effective for scars for skin laxity is kind of like how it started out and then these days it's used for many different things microneedling such as flap and graft survival when we do reconstructive surgeries hyperhidrosis so excess sweating there's also a movement for basically delivering drug therapy using microneedling right because creating little punctures allows things to enter in and that's going to become applicable with hair as well things like melasma also of course skin rejuvenation all of that has been shown to be improved with microneedling and also for hair so it's been used for different types of alopecia either as monotherapy or in combination with other things like minoxidil with steroids with vitamins with prp so you can do the micromilling alone or you can combine it with those other modalities and all of that has really solid evidence behind it like randomized clinical control studies to support its use so what are the mechanisms for hair regrowth like why is the hair growing back and there's two general concepts here one is increasing the growth factors in the local vicinity of where you've done the microneedling and if it's combined with prp or platelet-rich plasma then you get the added benefit of the actual platelets that you're putting back into the scalp opening up and spilling their growth factors so there's that but then even without prp it's been shown that the growth factors in that local area increase with microneedling as the body looks to to repair itself and the other mechanism is activation of stem cells in the hair bulge area that's where the stem cells live when it comes to to the actual follicle of the hair that has been shown to increase with microneedling microneedling has been shown to actually produce a new hair follicles and mice and then in humans and when we look at like the actual you know zoomed in pictures of the hair overall thickness of the hair tends to increase and there are fewer miniaturized hairs or what we call villas hairs and they become more terminal hairs or more essentially mature type of hairs with the micro needling it's not common that you increase the actual density of the hairs you increase the actual like diameter of the hair shafts along with of course turning the finer hairs into more mature hair so all that is helpful and then in terms of indications like what types of hair loss uh could you use microneedling for androgenic alopecia which is the big one that's the male pattern hair loss or female pattern hair loss so that has been shown to to be helped with microneedling and alopecia areata which is the condition that i have though i have a more aggressive form called universalis but al pisheriata where you just get like one spot say on the scalp or on the beard microneedling has been shown to help with recovery of those bald spots and also telogen effluvium is another hair condition that can also be helped so then in terms of the delivery of the microneedling right like what is the actual system that's delivering those needles and there are different ways to do it in the crudest way which is actually what we typically do when we do prp is using little tiny needles usually we use like two 30 gauge needles once the prp has been placed into the scalp you go in with these little tiny needles and you basically go around the scalp manually and do that throughout the scalp it's not really something that is easy to do at home it's not really what is used like say on the face for example so the more standard ways of doing it are either with dermal rollers basically it's this device that's passed back and forth multiple directions and it produces these little micro punctures at the skin surface the problem with the dermal roller is that it can actually break the strands of hair so it can kind of cut the hairs they'll ultimately grow back but if you're not looking for a haircut i mean it could be a problem [Music] because you're going to thin out your hair so that's the issue with the dermal roller the alternative is a derma pen which punches vertically with the needles onto the skin and so that is the more recommended type of normal rolling or micro needling the better thing to use is a dermal pen if you can and that is coming in again vertically and creating those stamps and then basically avoiding the breakage of of the hair that covers the delivery mechanisms now in terms of the depth right like how deep how long should these needles be there's really no true consensus in the literature on this right now the studies that have been done on the subject have used lengths of needles from 0.6 millimeters to 2.5 millimeters that's sort of the wide range when people are doing this at home they're usually using under like up to maybe one millimeter of depth because the deeper you go the more painful the process is and there has been some data to show that hair growth actually 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 you go and the more times you roll over the better the results that is kind of what the studies have shown but the problem is if you go too deep then you risk getting scarring scar tissue formation which can actually then hurt your ability to grow hair that's where the the potential harm comes in when people ask me oh can i just make a needle at home like all you know every day that's where you can run into trouble if you go too deep and if you're you're doing this too often you can run into scarring problems so again like any um therapy whether it be like a procedural therapy or a drug therapy there's like a therapeutic window and you can fall just short of that and not see any benefit or you can go overboard and actually cause harm so you got to be careful the other interesting thing to mention is that in alopecia specifically androgenic alopecia as it advances the scalp generally thins out and we're going to put a table up here there's been actual calculations that have been done in normal controls initial stage of hair loss and then advanced hair loss the scalp is getting thinner so you have to adjust for that if you're doing micro needling if they adjust the depth of the needles so the longer ones like generally 1 to 1.5 millimeters can be helpful in the initial stages as the hair loss progresses you're going to want to go for shorter needle lengths like 0.5 to 1 millimeters for example just to adjust for that thinning effect that occurs over time as far as actually applying the micro needling it can be painful so there are different ways to kind of numb up the area at shorter depths sometimes you don't need any numbing but it's sometimes nice to use a topical anesthetic like what i use in the practice sometimes for that would be blt or beta cane lidocaine tetracaine it's a mix you need a prescription for that because there's some toxicity risk of using too much of it or leaving it on the scalp for too long so you have to be careful there's also injected anesthesia that can be used to numb up an entire area before that type of therapy and then again sometimes people don't use any anesthesia for again shorter lengths of needles but for for deeper needling you need some kind of anesthesia if you're going to want to disinfect or your doctor needs to disinfect the area before you get started that could be done with something like a betadine solution or there are different aseptic sprays out there as well you have to select the proper depth and it's also about how many applications so how many times do you go over the same area the average out there is usually three but again it's more about looking for the desired endpoint rather than how many times you're rolling over the desired endpoint is pinpoint bleeding and mild to moderate erythema which is redness once you reach that end point you should stop you shouldn't just keep going it's you typically safe to wash the hair at least six hours after after treatment some people will just wait until the next day to wash their their hair when it comes to frequency like how often should you be doing microneedling on the scalp for hair restoration well the data is is kind of mixed right so some studies recommend weekly treatments and have done weekly treatments and shown improvements some studies have gone all the way out to eight weeks that's the range that i saw in the literature one week to eight weeks that's the frequency that that you can micro needle again whether you're going to to the doctors or choosing to do some of this at home and then there are these other combinations right like adding something to just microneedling alone and that could be minoxidil which is also called rogaine usually you don't want to do it on the same day so you don't want to like microneedle and just apply the minoxidil because it can burn because of the alcohol content that exists in minoxidil and then there have been studies that have shown that there are greater hairs actually produced from microneedling with minoxidil compared to just using minoxidil alone so there is data to support that combination and then also prp platelet-rich plasma we talk about it in some other videos but there was a study from 2019 that actually showed that prp with microneedling is better in comparison to prp alone or minoxidil alone with patients with androgenic alopecia so good data to support the use of prp with microneedling because again what i said earlier where you get that kind of double impact in terms of additional growth factor release because you get the release from just microneedling and then you get the release because of the platelets that you're introducing so that that's helpful and then also steroids can be combined with microneedling and that's used for conditions like alopecia areata that's more confined to a specific site in terms of side effects you can expect some itching sometimes the redness the erythema can last for a long period of time hair shedding is possible especially in the early kind of period when you first start this for a few months infection is always a risk because you know you're making all these little tiny pokes in the scalp some people can have a reaction to the local anesthesia that's being used so again that's not something you'd be doing at home that's obviously under proper medical guidance but even then there are different potential toxicities of anesthetic so that has to be done carefully and then there is a risk of scarring that we already discussed so we still need as a community in in terms of our literature to determine the ideal needle length the the best frequency of treatment and the best combinations and and how to best administer them and then as far as at home regimens and again there have been research studies that have been designed in this way and that's why i feel comfortable bringing some of this up with you guys one way to to to optimize the application as we talked about previously is with the dermapen so that's that stamping the vertical stamping so that would be a better thing to use than than just rolling it you have to make sure you clean the scalp well and we we talked about ways of doing that in terms of depth selection i would start with the the lowest depth the the most shallow depth and that typically is like 0.5 millimeters you want to be effective in your delivery else what's the point of doing it but you don't want it to be harmful and potentially cause unnecessary pain and potential for scarring so i would start with a 0.5 millimeter depth it's tolerable type of depth for most people and it can still yield results i would start with one application just to begin until you're you know more comfortable and can move on to something closer to two or three applications and that's again how many times you're going over the same general area and i would start with monthly application as opposed to you know doing it definitely don't do it every day and then from a monthly application you can slowly increase it to maybe every three weeks and every two weeks and maybe doing it weekly if again you can tolerate it and i would definitely be kind of you know checking in with your doctor making sure you're not developing any signs of scarring and that you're continuing to to have good results right or else don't do it if you're not seeing any results but with most types of hair treatments i advise that people give it about six months before giving up on the treatment unless of course there are complications or reasons you should stop and again in general best to talk to you know a hair doctor about these regimens before you get going on it that's pretty much my spiel to you guys on microneedling and derma rolling for hair restoration i think that it's a very viable medical therapy and it has good data to support it it's very much in line with data that exists on prp therapy and on low level laser light therapy so they're you know kind of uh comparable it's definitely a good solution and even more powerful with those kind of combinations that we discussed so hopefully you guys found that useful i'm still working on my video on medical therapies for men and women mainly for androgenic alopecia just trying to be very comprehensive about it stay tuned for that i know you guys have been asking me for that video and it's coming hopefully this was helpful check out all my other videos on hair restoration hair transplant surgery you know drop me a comment tell me what you think was this helpful i know a few of you had asked me to to make this video so i hope it's helpful i really want to make sure that these videos are rooted in science and are not just like you know just my opinion and most of my channel is that i try to kind of reduce it down to the essentials and try to eliminate a lot of the technical terminology but you guys are smart and able to figure all the stuff out so hopefully this is helpful please like the video and subscribe to the channel so you can you know be updated anytime we post something new take care guys see

Channel: Doctor Gary Linkov

Views: 4,295,646

Keywords: Microneedling, what is microneedling, microneedling before and after, microneedling at home, derma roller, how to derma roll, derma roller for beard, derma roller beard, derma roller how to use, derma roller hair regrowth, hair regrowth, hair regrowth for men, hair loss, hair growth, hair regrowth techniques, hair loss treatment, prp hair regrowth, dermarolling, derma-rolling, dermarolling before and after hair, dermarolling before and after beard, alopecia treatment

Id: thQ1taoKoo4

Length: 15min 15sec (915 seconds)

Published: Mon Aug 09 2021