Favorable effects of microneedling on long-standing androgenetic alopecia in an elderly man: A case report.

BACKGROUND: Androgenetic alopecia (AGA) is the most common type of alopecia. Currently, various methods have been tried to treat male AGA, but the outcomes are often unsatisfactory, especially for elderly persons. AIMS: We report a case of an elderly man with a severe long-standing AGA, which was successfully managed with microneedling and minoxidil. PATIENTS/METHODS: The patient was a 70-year-old Japanese man with family history of AGA, showed no abnormality in physical and laboratory examinations, and had received no treatment. We did monotherapy with 5% minoxidil twice daily to the right half of the scalp, while on the left half topical minoxidil was combined with weekly microneedling using an automated microneedling pen. RESULTS: After 14 weeks of treatment, negligible hair growth was observed on the monotherapy side. On the combined-therapy side, however, hair growth was obvious and the density of hairs determined under trichoscope was significantly increased compared with the monotherapy side (P < .001). Only transient pain, erythema, and pinpoint bleeding were observed as adverse effects. CONCLUSION: Although we need further clinical trials to assess the efficacy and safety and to standardize the method, microneedling combined with topical minoxidil could be a treatment option for severe AGA in elderly patients.