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The findings cannot be directly extrapolated to female pattern hair loss without dedicated meta-analyses No standardised outcome measures: Different studies used different methods to count hairs (phototrichogram, TrichoScan, clinical photography), making direct comparison imprecise Publication bias risk: Studies showing positive results are more likely to be published than negative ones, which could inflate the apparent effect size Need for larger RCTs: The authors themselves call for larger randomised controlled trials with standardised protocols to establish optimal treatment parameters What This Means for Your Hair This meta-analysis provides the strongest evidence to date that microneedling should be considered a primary treatment for androgenetic alopecia not just an add-on to existing therapies

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