Efficacy and Safety of Microneedling Combined With Mesotherapy for Androgenic Alopecia: A Retrospective Study Comparing Four Treatment Protocols

ABSTRACT Background and Aims Androgenic alopecia (AGA) is a prevalent form of hair loss characterized by progressive miniaturization of hair follicles, significantly impacting patients’ self‐confidence and quality of life. Current FDA‐approved treatments demonstrate limited to moderate efficacy. Microneedling combined with mesotherapy techniques has emerged as a promising drug delivery system for enhancing therapeutic outcomes in hair loss disorders. This retrospective interventional study aimed to evaluate the efficacy and safety of four distinct microneedling‐based mesotherapy protocols for the treatment of androgenic alopecia. Methods Sixty‐three patients with clinically confirmed AGA were allocated to four treatment groups. All groups received microneedling therapy combined with different mesotherapy formulations: Group I ( n = 16) received 2 mL hyaluronic acid (HA); Group II ( n = 20) received 1.5 mL HA plus 0.5 mL finasteride; Group III ( n = 15) received 1.5 mL HA plus 0.5 mL latanoprost; and Group IV ( n = 12) received 1 mL HA plus 0.5 mL finasteride and 0.5 mL latanoprost. Patients underwent six treatment sessions at 3–4 week intervals. Standardized digital photographs were obtained at baseline, 3 months, and 6 months. Efficacy was assessed using physician satisfaction scores (treating and blinded evaluators) and patient satisfaction scores. Safety was monitored after each treatment session. Results Thirty‐nine women and 24 men completed the study. Women demonstrated significantly higher improvement rates (48%) compared to men (29%). Female pattern hair loss showed better response (45%) than male pattern AGA (37.5%). Participants under 30 years achieved higher improvement rates (47%) compared to those aged 30–49 years (42.9%). Group IV (combination therapy with finasteride and latanoprost) demonstrated the highest efficacy across both sexes and hair loss patterns. All treatment protocols were well‐tolerated with minimal adverse effects. Conclusions The findings of the current study support the use of combination mesotherapy protocols for enhanced therapeutic outcomes in AGA management.