What happens when you put microneedling and minoxidil head to head, each on its own, and then combine them? A randomised trial from China Medical University did exactly that in 60 men with pattern hair loss over 24 weeks. The surprise was in the middle arm: microneedling alone grew slightly more hair than 5% minoxidil alone. And the combination beat both by a wide margin, roughly doubling the gain of minoxidil by itself. If you are choosing hardware, our guide to at-home microneedling devices covers motorised pens and stamps.
Study by Bao, Gong, Guo and colleagues, published in the Journal of Cosmetic and Laser Therapy (2020). Summarised by Malcolm Smith, Founder of Hairgenetix. Medically reviewed by Dr. Esther Bodde, MD, Cosmetic & Plastic Surgeon. Last updated 2 September 2026.
Quick answer
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Three-way randomised trial: 60 Chinese men with male pattern hair loss were assigned to 5% minoxidil alone, electric microneedling alone, or both together, for 24 weeks.
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Microneedling alone numerically beat minoxidil alone: a gain of 23.4 hairs per square centimetre versus 18.8 for minoxidil.
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The combination won clearly: 38.3 additional hairs per square centimetre, about twice the minoxidil-only result, with the overall difference between groups statistically significant (p = 0.002).
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A 2022 follow-up by the same team (71 men) repeated the pattern and showed the combination switches on the Wnt/beta-catenin pathway, one of the body's core hair growth signals.
This article is part of our complete guide to microneedling for hair growth.
Why does this study matter?
Most microneedling trials answer only half the question. The landmark Dhurat 2013 trial compared needling plus minoxidil against minoxidil alone, so it could not tell you what the needling contributes by itself. Bao and colleagues ran the full three-way comparison: minoxidil alone, microneedling alone, and the two combined, all inside one randomised, evaluator-blinded trial.
That design separates the two effects cleanly. It also used an electrodynamic (motorised) microneedle rather than a hand roller, which gives more consistent needle depth on a curved scalp.
What did the researchers do?
The team enrolled 60 Chinese men with Norwood-Hamilton type III to VI androgenetic alopecia and randomised them into three equal groups of 20. Group 1 applied 1 ml of 5% minoxidil solution twice daily. Group 2 received electrodynamic microneedling sessions only. Group 3 received the microneedling sessions plus 5% minoxidil, with 2 ml of the solution delivered into the scalp during each needling session.
The microneedling arms received 12 treatments, one every 2 weeks, across the 24-week study. Blinded evaluators measured the change in total hair density from baseline to week 24.
What did they find?
| Treatment arm |
Hair density gain at 24 weeks |
| 5% minoxidil alone |
+18.8 hairs/cm² |
| Microneedling alone |
+23.4 hairs/cm² |
| Microneedling + 5% minoxidil |
+38.3 hairs/cm² |
The overall difference between the three groups was statistically significant (p = 0.002), and the combination arm was the clear winner: roughly double the gain of minoxidil alone. Safety was reassuring too, with no significant differences in toxicity between the three groups.
The result that raises eyebrows is the middle row. Microneedling by itself, with no drug at all, produced a numerically larger density gain than the best-known topical treatment for hair loss. The abstract does not report a pairwise statistical test between those two arms, so treat it as a strong signal rather than a proven superiority claim. The likely reason it showed up at all is intensity: 12 sessions at 2-week intervals with a motorised device is a far heavier needling dose than the sparse protocols that have failed to show a standalone effect.
What about the mechanism? The 2022 follow-up
In 2022 the same research group published a larger companion trial in the Journal of Dermatological Treatment. Seventy-one men completed the same three-arm design (23 minoxidil only, 23 microneedling only, 25 combination), and the combination again showed superior clinical results. This time the team also took scalp tissue samples and found that combination treatment further upregulated FZD3, beta-catenin and LEF-1, key molecules in the Wnt/beta-catenin signalling pathway, at both the gene and protein level.
Wnt/beta-catenin is one of the central switches that pushes resting hair follicles back into their growth phase. It is also the pathway at the heart of the copper peptide story: GHK-Cu and AHK-Cu are studied for supporting the same follicle growth signalling, which is why they pair naturally with microneedling. Our GHK-Cu vs AHK-Cu comparison covers that evidence in detail.
Limitations to keep in mind
This was a single-centre trial of 60 men, all Chinese males with type III to VI pattern loss, so the numbers may not transfer exactly to women, other ethnic groups or milder hair loss. The abstract reports the overall three-group comparison (p = 0.002) but not pairwise tests, so the microneedling-versus-minoxidil gap should be read cautiously. The in-clinic protocol, professional devices and every-2-week sessions, is also heavier than most at-home routines, and 24 weeks is a snapshot of a process that plays out over years.
What does this mean for your routine?
The practical takeaway matches the wider evidence: needling provides the stimulus, a topical active provides the signal, and together they outperform either alone. Bao's combination arm delivered the topical directly into freshly created micro-channels during each session, which is exactly the logic behind our Copper Peptide Derma Stamp Set: the stamp opens the channels and the serum supplies actives targeting the same growth signalling the 2022 follow-up measured. If you use minoxidil, the trial supports pairing it with regular needling rather than choosing between them. The complete guide covers depth, frequency and aftercare.
Frequently asked questions
Did microneedling really beat minoxidil in this trial?
Numerically, yes: 23.4 hairs per square centimetre gained versus 18.8 for 5% minoxidil over 24 weeks. Without a reported pairwise test, the honest reading is that standalone microneedling performed at least on par with minoxidil here.
How much better was the combination?
The combination arm gained 38.3 hairs per square centimetre, roughly double the minoxidil-only result and about 60% more than microneedling alone.
How often was microneedling done in the study?
Every 2 weeks, for 12 sessions in total across 24 weeks, using a motorised electrodynamic microneedle. In the combination group, 2 ml of 5% minoxidil was delivered into the scalp during each session.
Was the treatment safe?
The researchers found no significant differences in toxicity between the three groups over the 24 weeks.
Why does the Wnt/beta-catenin pathway matter?
It is one of the body's main signals for pushing hair follicles into their growth phase. The team's 2022 follow-up found the combination treatment raised three key molecules in this pathway (FZD3, beta-catenin and LEF-1) in treated scalp, a biological explanation for the extra growth and the same signalling that copper peptides are studied for supporting.
References
1. Bao L, Gong L, Guo M, et al. "Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia." Journal of Cosmetic and Laser Therapy, 2020;22(1):1-7. PubMed 29028377.
2. Bao L, Zong H, Fang S, Zheng L, Li Y. "Randomized trial of electrodynamic microneedling combined with 5% minoxidil topical solution for treating androgenetic alopecia in Chinese males and molecular mechanistic study of the involvement of the Wnt/beta-catenin signaling pathway." Journal of Dermatological Treatment, 2022;33(1):483-493. PubMed 32412314.
3. Dhurat R, Sukesh M, Avhad G, et al. "A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia." International Journal of Trichology, 2013. PubMed 23960389.
Electrodynamic Microneedling for Hair Growth: the Bao Randomised Trial
What happens when you put microneedling and minoxidil head to head, each on its own, and then combine them? A randomised trial from China Medical University did exactly that in 60 men with pattern hair loss over 24 weeks. The surprise was in the middle arm: microneedling alone grew slightly more hair than 5% minoxidil alone. And the combination beat both by a wide margin, roughly doubling the gain of minoxidil by itself. If you are choosing hardware, our guide to at-home microneedling devices covers motorised pens and stamps.
Study by Bao, Gong, Guo and colleagues, published in the Journal of Cosmetic and Laser Therapy (2020). Summarised by Malcolm Smith, Founder of Hairgenetix. Medically reviewed by Dr. Esther Bodde, MD, Cosmetic & Plastic Surgeon. Last updated 2 September 2026.
This article is part of our complete guide to microneedling for hair growth.
Why does this study matter?
Most microneedling trials answer only half the question. The landmark Dhurat 2013 trial compared needling plus minoxidil against minoxidil alone, so it could not tell you what the needling contributes by itself. Bao and colleagues ran the full three-way comparison: minoxidil alone, microneedling alone, and the two combined, all inside one randomised, evaluator-blinded trial.
That design separates the two effects cleanly. It also used an electrodynamic (motorised) microneedle rather than a hand roller, which gives more consistent needle depth on a curved scalp.
What did the researchers do?
The team enrolled 60 Chinese men with Norwood-Hamilton type III to VI androgenetic alopecia and randomised them into three equal groups of 20. Group 1 applied 1 ml of 5% minoxidil solution twice daily. Group 2 received electrodynamic microneedling sessions only. Group 3 received the microneedling sessions plus 5% minoxidil, with 2 ml of the solution delivered into the scalp during each needling session.
The microneedling arms received 12 treatments, one every 2 weeks, across the 24-week study. Blinded evaluators measured the change in total hair density from baseline to week 24.
What did they find?
The overall difference between the three groups was statistically significant (p = 0.002), and the combination arm was the clear winner: roughly double the gain of minoxidil alone. Safety was reassuring too, with no significant differences in toxicity between the three groups.
The result that raises eyebrows is the middle row. Microneedling by itself, with no drug at all, produced a numerically larger density gain than the best-known topical treatment for hair loss. The abstract does not report a pairwise statistical test between those two arms, so treat it as a strong signal rather than a proven superiority claim. The likely reason it showed up at all is intensity: 12 sessions at 2-week intervals with a motorised device is a far heavier needling dose than the sparse protocols that have failed to show a standalone effect.
What about the mechanism? The 2022 follow-up
In 2022 the same research group published a larger companion trial in the Journal of Dermatological Treatment. Seventy-one men completed the same three-arm design (23 minoxidil only, 23 microneedling only, 25 combination), and the combination again showed superior clinical results. This time the team also took scalp tissue samples and found that combination treatment further upregulated FZD3, beta-catenin and LEF-1, key molecules in the Wnt/beta-catenin signalling pathway, at both the gene and protein level.
Wnt/beta-catenin is one of the central switches that pushes resting hair follicles back into their growth phase. It is also the pathway at the heart of the copper peptide story: GHK-Cu and AHK-Cu are studied for supporting the same follicle growth signalling, which is why they pair naturally with microneedling. Our GHK-Cu vs AHK-Cu comparison covers that evidence in detail.
Limitations to keep in mind
This was a single-centre trial of 60 men, all Chinese males with type III to VI pattern loss, so the numbers may not transfer exactly to women, other ethnic groups or milder hair loss. The abstract reports the overall three-group comparison (p = 0.002) but not pairwise tests, so the microneedling-versus-minoxidil gap should be read cautiously. The in-clinic protocol, professional devices and every-2-week sessions, is also heavier than most at-home routines, and 24 weeks is a snapshot of a process that plays out over years.
What does this mean for your routine?
The practical takeaway matches the wider evidence: needling provides the stimulus, a topical active provides the signal, and together they outperform either alone. Bao's combination arm delivered the topical directly into freshly created micro-channels during each session, which is exactly the logic behind our Copper Peptide Derma Stamp Set: the stamp opens the channels and the serum supplies actives targeting the same growth signalling the 2022 follow-up measured. If you use minoxidil, the trial supports pairing it with regular needling rather than choosing between them. The complete guide covers depth, frequency and aftercare.
Frequently asked questions
Did microneedling really beat minoxidil in this trial?
Numerically, yes: 23.4 hairs per square centimetre gained versus 18.8 for 5% minoxidil over 24 weeks. Without a reported pairwise test, the honest reading is that standalone microneedling performed at least on par with minoxidil here.
How much better was the combination?
The combination arm gained 38.3 hairs per square centimetre, roughly double the minoxidil-only result and about 60% more than microneedling alone.
How often was microneedling done in the study?
Every 2 weeks, for 12 sessions in total across 24 weeks, using a motorised electrodynamic microneedle. In the combination group, 2 ml of 5% minoxidil was delivered into the scalp during each session.
Was the treatment safe?
The researchers found no significant differences in toxicity between the three groups over the 24 weeks.
Why does the Wnt/beta-catenin pathway matter?
It is one of the body's main signals for pushing hair follicles into their growth phase. The team's 2022 follow-up found the combination treatment raised three key molecules in this pathway (FZD3, beta-catenin and LEF-1) in treated scalp, a biological explanation for the extra growth and the same signalling that copper peptides are studied for supporting.
References
1. Bao L, Gong L, Guo M, et al. "Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia." Journal of Cosmetic and Laser Therapy, 2020;22(1):1-7. PubMed 29028377.
2. Bao L, Zong H, Fang S, Zheng L, Li Y. "Randomized trial of electrodynamic microneedling combined with 5% minoxidil topical solution for treating androgenetic alopecia in Chinese males and molecular mechanistic study of the involvement of the Wnt/beta-catenin signaling pathway." Journal of Dermatological Treatment, 2022;33(1):483-493. PubMed 32412314.
3. Dhurat R, Sukesh M, Avhad G, et al. "A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia." International Journal of Trichology, 2013. PubMed 23960389.