摘要

Objectives: This study compares the therapeutic outcomes of combining a 1540 nm erbium:glass fractional laser with microneedling versus microneedling alone for moderate androgenetic alopecia. The primary aim is to determine whether fractional photothermal stimulation augments hair density, follicle diameter, and overall scalp coverage beyond what microneedling alone can achieve, while maintaining an acceptable safety profile in both male and female participants. Introduction: Androgenetic alopecia is a prevalent, progressive condition affecting men and women, characterized by hormonal sensitivity and gradual follicular miniaturization. Recent evidence highlights the regenerative potential of controlled dermal injury, via microneedling or non-ablative laser, in stimulating hair follicle stem cells. However, data remain scarce regarding the synergistic effect of combining these techniques to maximize hair regrowth and improve scalp coverage in moderate disease severity. Materials / method: A randomized, parallel-group trial enrolled 26 adults with moderate androgenetic alopecia, divided equally into two arms. Group A received three monthly sessions of a 1540 nm erbium:glass fractional laser applied to the scalp immediately followed by microneedling; Group B underwent identical microneedling but without laser. Digital trichoscopy assessed hair density (hairs/cm²) and shaft thickness at baseline and two months post-final session. Safety outcomes were recorded at each visit. Results: Compared to baseline, Group A showed a significantly greater rise in hair density (mean +18.2%±3.4) than Group B (mean +9.4%±2.8; p<0.01). Follicle diameter likewise increased more in Group A (+16.1%±2.7) versus Group B (+8.5%±2.3; p<0.05). Photographic and trichoscopic evaluations revealed notably improved scalp coverage in the combination group. Mild erythema was observed in both cohorts, resolving within 24–48 hours, with no serious adverse events reported. Conclusion: Adding a 1540 nm erbium:glass fractional laser to microneedling confers superior hair regrowth outcomes compared to microneedling alone in moderate androgenetic alopecia. Enhanced follicular stimulation appears to result from synergistic dermal remodeling and localized growth factor release. This minimally invasive combination was well tolerated, suggesting its promise as a next-level approach. Further research with larger cohorts and extended follow-up is warranted to validate and optimize these findings.