Microneedling For Hair Loss: 5 Strategies to Reduce Pain

Article Summary

Microneedling is an experimental therapy for androgenic alopecia and other hair loss disorders. One of its downsides is that it is painful to administer. However, there are simple and effective strategies to reduce pain levels while microneedling across the scalp:(1) opting for devices that ensure needles enter the scalp at 90 degree angles, (2) applying lidocaine 30-60 minutes prior to a session, (3) avoiding the contraction of scalp perimeter muscles during a session, (4) doing microneedling sessions in the morning to improve healing speeds, and (5) benchmarking session endpoints to evoke erythema rather than excessive pinpoint bleeding. See the scientific details below.

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What is Microneedling?

Microneedling – also known as percutaneous wound induction – is the act of deliberately wounding skin tissues for therapeutic benefit. This is generally done with hundreds of tiny, medical-grade needles ranging in lengths from 0.1mm to 5.0mm.

There are a variety of microneedling devices – from hand-held rollers to automated pens to stamps. But the ones people are most familiar with (in the hair loss world) are dermarollers (pictured below). When rolled against the skin, they puncture its top layers to evoke acute inflammation. Yes, it hurts. And yes, a microneedler looks like a small medieval torture device.

How To Make Microneedling Less Painful

There are a number of ways to reduce the amount of pain experienced in a microneedling session. These are our suggestions:

1. Pick a microneedling device with consistent needle angulation entrypoints
2. Use lidocaine or numbing cream
3. Don’t contract any scalp muscles, so that the skin across the top of your scalp stays relaxed
4. Bonus: Microneedle in the morning to improve wound-healing speed
5. Bonus: Don’t overstimulate your scalp to improve wound-healing speed

We’ll explain each of these below.

1. Pick a Microneedling Device with Consistent Needle Angulation Entrypoints

There are three common types of microneedling devices used for hair growth:

1. Mironeedle roller / dermaroller. This is exactly what it sounds like – a handheld needled roller which we run across the top layers of our skin. These devices require manual pressure applied to the skin, and when the devices are rolled, the needles generate wounds.
2. Microneedle stamp. This is a handheld device designed as a stamp rather than a roller. Compared to rollers, the needle angulation entry of stamps are different. Whereas dermaroller needles undergo continuous angle changes as they’re rolled across the skin, stamp needles enter the skin at a ~90 degree angle every time.
3. Automated pen. Electric automated pens punch into the skin at high speeds, thereby allowing people to drag the needles across the skin with relative ease (and less hair snagging). Like stamps, these needles also enter at ~90 degrees against the scalp skin.

Which Microneedling Device is Least Painful?

In general, microneedling stamps and automated pens are considered less painful than microneedling rollers / dermarollers. Again, this all boils down to needle angulation entrypoints:

Whereas dermaroller needles change needle angulation as the devices are rolled across the skin, dermastamps and automated pens keep their 90 degree angles – thereby creating more precise wounds that tend to confer with slightly less pain.

Moreover, so far, there’s no evidence that stamps and/or automated pains are any less effective than microneedling rollers. So, this reduction in pain does not likely come alongside a reduction in hair regrowth.^[1]https://link.springer.com/article/10.1007/s13555-021-00653-2

2. Use a Numbing Cream (Like Lidocaine)

Many investigation groups studying microneedling for hair growth apply numbing creams to participants’ scalps minutes prior to performing a microneedling session. While this is often a best-practice for in-clinic microneedling sessions, it’s also something available for at-home use, too.

Products such as 5% lidocaine are available on both Amazon and in most drug stores like CVS and Walgreens. All you need to do is apply the cream to your scalp 30-60 minutes prior to performing a microneedling session. This should give the medication enough time to diminish nerve sensitivity throughout the scalp, and in doing so, significantly reduce the pain associated with your microneedling sessions.

This is perhaps the biggest change someone can make to reducing pain from microneedling. While there are no comparative metrics for hair regrowth between participants of studies using / not using numbing creams prior to microneedling, we do not suspect lidocaine to hinder microneedling efficacy. After all, across clinical studies subjecting participants to microneedling sessions with and without lidocaine, hair count improvements tend to remain within the same ballpark.^[2]https://link.springer.com/article/10.1007/s13555-021-00653-2

3. While Microneedling, Don’t Contract Your Scalp Perimeter Muscles

Most people microneedle while looking into a mirror. This isn’t problematic by itself, but sometimes, people looking into the mirror will:

• arch their neck (to get closer to the mirror as lean over the sink)
• stick out their chin (as they look up to focus on their hair)
• raise their eyebrows (as they wince in pain from microneedling)

All of these tendencies / habits create considerable tension across the tops of our scalps, because they engage the scalp perimeter muscles – particularly the occipitalis, temporalis, and frontalis muscles. This skin tension compresses the depth of the skin and pulls it taut like a drum.

The contraction of these muscles can increase skin tension and, in doing so, make microneedling much more painful.

So, while microneedling, make an active effort to avoid these habits. Better yet, some of our members prefer to microneedling while bent over at a 90-degree angle – thus using gravity to their advantage, taking the pressure off the top part of the scalp, and making it significantly harder to contract any of these muscles.

The end-result is a little less pain.

Bonuses: Microneedle in the Mornings; Be Mindful of Session Frequency

Recent research suggests that wounds may heal 60% faster if they’re incurred during daylight hours.^[3]https://www.science.org/doi/10.1126/scitranslmed.aal2774

In that regard, we may want to schedule our microneedling sessions in the mornings. In doing so, we may greatly reduce the amount of time it takes for our scalps to heal.

Moreover, research from our 2021 systematic review on microneedling for the use of hair loss disorders suggests that a microneedling frequency of once every 7-14 days appears to produce the best hair regrowth outcomes.^[4]https://link.springer.com/article/10.1007/s13555-021-00653-2 While this finding is preliminary, it doesn’t hurt to use it as a guiding signal that – at least so far – we cannot quantify (or justify) more frequent microneedling sessions.

Obviously, session frequency also depends on the needle length – and just how hard you wound. For more information on our own microneedling recommendations – and how these change depending on each person, their hair loss disorder, and the device they’re using – please see our ultimate guides (or speak with our research team directly) inside our membership community.

Finally, research within our systemic review also suggested that regrowth outcomes from microneedling occurred through a number of microneedling session endpoints, ranging from light pinkness to pinpoint bleeding and beyond. In other words, you don’t need to completely destroy your scalp skin with wounds to reap the benefits of microneedling. Keep this in mind the next time you see someone post gruesome microneedling “after” photos of their scalp on popular hair loss forums.

Summary

When using microneedling devices across the scalp, we can diminish the pain of each session by (1) opting for devices that ensure needles enter the scalp at 90 degree angles – such as automated pens and/or stamps, (2) applying lidocaine 30-60 minutes prior to a microneedling session, (3) taking care not to contract the scalp perimeter muscles during a microneedling session, (4) wounding in the morning to improve healing speeds, and (5) benchmarking your session endpoints to evoke erythema, redness, and a bit of pinpoint bleeding – rather than lots of blood and a scalp filled with wounds that will take weeks to fully heal.