摘要

Objectives: To evaluate the efficacy and safety of a novel 4-session monthly protocol combining robotic microneedling radiofrequency (MNRF) with sequential topical pharmacologic delivery for the treatment of androgenetic alopecia (AGA). Introduction: Hair loss represents a common clinical concern with multifactorial etiology and significant psychosocial impact. Recent therapeutic strategies have focused on minimally invasive approaches that enhance follicular activity and optimize the scalp microenvironment. The combination of mechanical microchannels, low-energy dermal heating, and sequential application of targeted agents with distinct mechanisms of action has shown potential to act synergistically, promoting follicular stimulation, improving vascularization, and supporting scalp health. Materials / method: This prospective study enrolled 10 patients, 6 male and 4 female, average age 48.8 years old, with clinically diagnosed AGA who underwent four monthly MNRF sessions. The protocol consisted of: Session 1 - topical application of botanical hair exosomes; Session 2 - dutasteride 0,1% solution; Sessions 3 and 4 - minoxidil 0,5% solution. Each session employed 2 passes with a robotic MNRF device: 1st pass at 1.5 mm depth, 80 ms, RF off, with the active agent applied before and after microneedling (“sandwich” technique); 2nd pass at the same depth and duration, but with RF turned on at 4 W (low). Results: A significant improvement was observed in hair shaft thickness, density, and overall hair volume, accompanied by visible enhancement in texture, shine, and scalp coverage. Standardized global macro-photography was evaluated using the Savin scale (for females) or the Norwood/Hamilton scale (for males), while trichoscopic analysis focused on changes in hair density and mean hair shaft diameter. No major adverse effects were reported, and all participants completed the treatment protocol. Conclusion: This minimally invasive, well-tolerated MNRF protocol with sequential pharmacologic delivery including hair exossomes achieved substantial clinical improvement in AGA within six months. The approach represents a promising, reproducible, and multimodal therapeutic option for AGA hair restoration.