Does adding microneedling to minoxidil actually grow more hair, or is the famous Dhurat result a one-off? A 2018 randomised controlled trial from India put the question to a second, independent test in 68 men with pattern hair loss. The combination won again: men who added a derma roller to their 5% minoxidil gained over six times more hair in the measured area than men on minoxidil alone. Just as valuable is the authors' honesty: the gains, while statistically clear, were not yet cosmetically dramatic at 12 weeks.
Study by Kumar, Inamadar and Palit, published in the Journal of Cutaneous and Aesthetic Surgery (2018). 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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Microneedling plus 5% minoxidil beat minoxidil alone in this randomised, observer-blinded trial of 68 men: a mean gain of 12.52 hairs per square inch versus 1.89 over 12 weeks (P < 0.0001).
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Patients noticed the difference too: 4 men in the combination group rated their improvement at 50%, versus none in the minoxidil-only group.
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The honest caveat: the authors state the response was not cosmetically significant at 12 weeks. A statistical win is not yet a mirror-visible one.
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Why the effect was smaller than Dhurat 2013: most likely fewer needling sessions. This trial tapered to fortnightly; the landmark trial needled weekly throughout.
This article is part of our complete guide to microneedling for hair growth.
Why does this study matter?
One trial is a finding; two independent trials are a pattern. The Dhurat 2013 trial was the first to show that microneedling multiplies the effect of minoxidil, and for five years it stood largely alone. Kumar and colleagues ran the replication: a different clinic, a different patient group, the same design of 5% minoxidil with or without needling.
The result confirmed the direction of the Dhurat finding, with a design feature that deserves credit: the outcome assessor was blinded to group allocation, which protects the hair counts from wishful measurement. The trial also used a lighter needling schedule than Dhurat and found a smaller effect, a pattern with a practical lesson about how often to needle.
What did the researchers do?
The team recruited 68 men aged 18 to 40 with Norwood-Hamilton grade III or IV androgenetic alopecia at a dermatology department in Vijayapur, India, randomising 34 to each group. Both groups applied 5% minoxidil twice daily for 12 weeks.
The combination group additionally received in-clinic microneedling with a 1.5 mm derma roller: weekly for the first four sessions, then fortnightly for four more, eight sessions in total. Hair counts were taken from a fixed one square inch target area using video dermoscopy at baseline and week 12, and patients rated their own improvement at the end. Sixty of the 68 men completed the trial (31 combination, 29 minoxidil alone), and the analysis covered those completers.
What did they find?
| Outcome at week 12 |
Microneedling plus minoxidil |
Minoxidil alone |
| Mean hair count gain (per square inch) |
+12.52 |
+1.89 |
| Patients rating their improvement at 50% |
4 of 31 |
0 of 29 |
| Completed the 12 weeks |
31 of 34 |
29 of 34 |
The hair count difference was significant at P < 0.0001, meaning a gap this large is extremely unlikely to be chance. In the combination group the average count rose from 82.35 to 94.87 hairs; the minoxidil-only group barely moved. Self-assessment pointed the same way: every man who rated his improvement at 50% was in the microneedling group.
Then comes the caveat, written plainly by the authors themselves: the response achieved was not cosmetically significant. Twelve extra hairs in a square inch is real, measurable growth, but at 12 weeks it is not yet the kind of change a stranger notices across a room. Anyone selling microneedling as a fast transformation is contradicted by this paper, and we would rather you know that.
Why was the effect smaller than in Dhurat 2013?
Dhurat's participants needled weekly for all 12 weeks; Kumar's protocol delivered eight sessions instead of twelve. The two trials also counted hairs over different areas (per square centimetre versus per square inch), so their raw numbers are not directly comparable, but Kumar's own discussion acknowledges that their change in hair count was much smaller than Dhurat's.
Read together with the Kakizaki 2023 trial, where four monthly sessions with no topical produced no density gain at all, a consistent dose picture emerges: session frequency appears to matter. Weekly needling paired with a topical shows the strongest results; stretch the interval and the effect shrinks.
Limitations to keep in mind
This was a 12-week trial, which is short for hair. Minoxidil alone often needs four to six months to show its full effect, so both groups may have been judged before their results fully arrived. Eight of 68 men were lost to follow-up and excluded from the analysis. The study enrolled only men aged 18 to 40 with moderate loss, so it does not tell us about women, older men or advanced baldness. And the needling was done in clinic by professionals with a 1.5 mm roller, a clinic-only depth rather than a starting point for home use.
What does this mean for your routine?
Three lessons carry over. First, combine: needling plus a topical outperformed the topical alone. Second, be consistent: the taper to fortnightly sessions here, and the weaker result that came with it, is a quiet argument for a regular schedule rather than needling when you remember. Third, be patient: even the winning protocol looked modest at 12 weeks, so judge your own routine in months, not weeks.
If you want the combination approach in one box, our Copper Peptide Derma Stamp Set pairs a depth-controlled stamp with a copper peptide serum. For choosing between rollers, stamps and pens at home, see our at-home device buyer's guide; the complete guide covers depth, frequency and aftercare.
Frequently asked questions
Did microneedling plus minoxidil beat minoxidil alone in this trial?
Yes. Men using both gained a mean of 12.52 hairs per square inch over 12 weeks, versus 1.89 for minoxidil alone (P < 0.0001).
Were the results visible in the mirror?
Mostly not yet. The authors report that the response was not cosmetically significant at 12 weeks, although 4 of 31 men in the combination group rated their improvement at 50%. Hair change on this timescale is measurable before it is obvious.
How often was microneedling done in the study?
Eight in-clinic sessions with a 1.5 mm derma roller over 12 weeks: weekly for the first four sessions, then once every two weeks for four more.
Why were the gains smaller than in the Dhurat 2013 study?
Most likely session frequency: Dhurat's participants needled weekly for the full 12 weeks, while this trial tapered to fortnightly. The two studies also counted hairs over different areas, so their numbers are not directly comparable.
Who was studied, and does it apply to me?
Men aged 18 to 40 with moderate (Norwood grade III to IV) pattern hair loss. The findings do not directly cover women, older men or advanced loss, though the combination principle holds across the wider research record.
References
1. Kumar MK, Inamadar AC, Palit A. "A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil plus Microneedling versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia." Journal of Cutaneous and Aesthetic Surgery, 2018. PubMed 30886475.
2. 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.
3. Kakizaki P, Contin LA, Barletta M, et al. "Efficacy and Safety of Scalp Microneedling in Male Pattern Hair Loss." Skin Appendage Disorders, 2023. PubMed 36636456.
4. Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA. "Microneedling for hair loss." Journal of Cosmetic Dermatology, 2022. PubMed 34714971.
Minoxidil Plus Microneedling vs Minoxidil Alone: the Kumar 2018 Randomised Trial
Does adding microneedling to minoxidil actually grow more hair, or is the famous Dhurat result a one-off? A 2018 randomised controlled trial from India put the question to a second, independent test in 68 men with pattern hair loss. The combination won again: men who added a derma roller to their 5% minoxidil gained over six times more hair in the measured area than men on minoxidil alone. Just as valuable is the authors' honesty: the gains, while statistically clear, were not yet cosmetically dramatic at 12 weeks.
Study by Kumar, Inamadar and Palit, published in the Journal of Cutaneous and Aesthetic Surgery (2018). 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?
One trial is a finding; two independent trials are a pattern. The Dhurat 2013 trial was the first to show that microneedling multiplies the effect of minoxidil, and for five years it stood largely alone. Kumar and colleagues ran the replication: a different clinic, a different patient group, the same design of 5% minoxidil with or without needling.
The result confirmed the direction of the Dhurat finding, with a design feature that deserves credit: the outcome assessor was blinded to group allocation, which protects the hair counts from wishful measurement. The trial also used a lighter needling schedule than Dhurat and found a smaller effect, a pattern with a practical lesson about how often to needle.
What did the researchers do?
The team recruited 68 men aged 18 to 40 with Norwood-Hamilton grade III or IV androgenetic alopecia at a dermatology department in Vijayapur, India, randomising 34 to each group. Both groups applied 5% minoxidil twice daily for 12 weeks.
The combination group additionally received in-clinic microneedling with a 1.5 mm derma roller: weekly for the first four sessions, then fortnightly for four more, eight sessions in total. Hair counts were taken from a fixed one square inch target area using video dermoscopy at baseline and week 12, and patients rated their own improvement at the end. Sixty of the 68 men completed the trial (31 combination, 29 minoxidil alone), and the analysis covered those completers.
What did they find?
The hair count difference was significant at P < 0.0001, meaning a gap this large is extremely unlikely to be chance. In the combination group the average count rose from 82.35 to 94.87 hairs; the minoxidil-only group barely moved. Self-assessment pointed the same way: every man who rated his improvement at 50% was in the microneedling group.
Then comes the caveat, written plainly by the authors themselves: the response achieved was not cosmetically significant. Twelve extra hairs in a square inch is real, measurable growth, but at 12 weeks it is not yet the kind of change a stranger notices across a room. Anyone selling microneedling as a fast transformation is contradicted by this paper, and we would rather you know that.
Why was the effect smaller than in Dhurat 2013?
Dhurat's participants needled weekly for all 12 weeks; Kumar's protocol delivered eight sessions instead of twelve. The two trials also counted hairs over different areas (per square centimetre versus per square inch), so their raw numbers are not directly comparable, but Kumar's own discussion acknowledges that their change in hair count was much smaller than Dhurat's.
Read together with the Kakizaki 2023 trial, where four monthly sessions with no topical produced no density gain at all, a consistent dose picture emerges: session frequency appears to matter. Weekly needling paired with a topical shows the strongest results; stretch the interval and the effect shrinks.
Limitations to keep in mind
This was a 12-week trial, which is short for hair. Minoxidil alone often needs four to six months to show its full effect, so both groups may have been judged before their results fully arrived. Eight of 68 men were lost to follow-up and excluded from the analysis. The study enrolled only men aged 18 to 40 with moderate loss, so it does not tell us about women, older men or advanced baldness. And the needling was done in clinic by professionals with a 1.5 mm roller, a clinic-only depth rather than a starting point for home use.
What does this mean for your routine?
Three lessons carry over. First, combine: needling plus a topical outperformed the topical alone. Second, be consistent: the taper to fortnightly sessions here, and the weaker result that came with it, is a quiet argument for a regular schedule rather than needling when you remember. Third, be patient: even the winning protocol looked modest at 12 weeks, so judge your own routine in months, not weeks.
If you want the combination approach in one box, our Copper Peptide Derma Stamp Set pairs a depth-controlled stamp with a copper peptide serum. For choosing between rollers, stamps and pens at home, see our at-home device buyer's guide; the complete guide covers depth, frequency and aftercare.
Frequently asked questions
Did microneedling plus minoxidil beat minoxidil alone in this trial?
Yes. Men using both gained a mean of 12.52 hairs per square inch over 12 weeks, versus 1.89 for minoxidil alone (P < 0.0001).
Were the results visible in the mirror?
Mostly not yet. The authors report that the response was not cosmetically significant at 12 weeks, although 4 of 31 men in the combination group rated their improvement at 50%. Hair change on this timescale is measurable before it is obvious.
How often was microneedling done in the study?
Eight in-clinic sessions with a 1.5 mm derma roller over 12 weeks: weekly for the first four sessions, then once every two weeks for four more.
Why were the gains smaller than in the Dhurat 2013 study?
Most likely session frequency: Dhurat's participants needled weekly for the full 12 weeks, while this trial tapered to fortnightly. The two studies also counted hairs over different areas, so their numbers are not directly comparable.
Who was studied, and does it apply to me?
Men aged 18 to 40 with moderate (Norwood grade III to IV) pattern hair loss. The findings do not directly cover women, older men or advanced loss, though the combination principle holds across the wider research record.
References
1. Kumar MK, Inamadar AC, Palit A. "A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil plus Microneedling versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia." Journal of Cutaneous and Aesthetic Surgery, 2018. PubMed 30886475.
2. 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.
3. Kakizaki P, Contin LA, Barletta M, et al. "Efficacy and Safety of Scalp Microneedling in Male Pattern Hair Loss." Skin Appendage Disorders, 2023. PubMed 36636456.
4. Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA. "Microneedling for hair loss." Journal of Cosmetic Dermatology, 2022. PubMed 34714971.