Background: Male adrogenetic alopecia (AGA) suffers from the problem of limited therapeutic options, inadequacy of results with medical therapy, and patients’ reluctance for hair transplantation. Polydioxanone (PDO) threads have emerged as a popular procedure for non-surgical face lift. Based upon the similarity in the mechanism of action of PDO threads and microneedling, which has been trial-proven as a hair growth stimulator, we performed PDO thread treatment in 5 male AGA patients.
Methods: Five male patients of AGA with unsatisfactory response to 18-months of medical therapy, were included after counseling and consent. Under topical anaesthesia, multiple monofilament PDO threads were inserted in the scalp using needles, with 1-cm spacing. Post-procedure care included oral antibiotics. Follow-up was done at week 2, 6 weeks and 12. Efficacy evaluation was done by Global Photographic Improvement (GPI), comparison of the trichoscopy hair follicular count (HFU) in a fixed target area, and patient satisfaction on Visual Analogue Score (VAS) ranging from 1-10.
Results: At 12 weeks, all patients had appreciable improvement, with a GPI of 40-75%. While the trichoscopic HFU count increment ranged from 48 HFU/cm2 to 93 HFU/cm2, patient satisfaction was also good with VAS ranging from 4-8. No significant adverse effects were encountered.
Conclusion: The results of this pilot study suggest scalp threading as a novel, effective and safe option for hair restoration. Owing to the limitations of this study, including small sample size, limited follow-up period, and lack of histological analysis, these results warrant further validation in controlled trials with larger sample size.
Androgenetic alopecia, thread lift, polydioxanone, hair restoration, microneedling, PDO