Role of scalp threads as a therapeutic armamentarium in the management of androgenetic alopecia

Objectives

Androgenetic alopecia (AGA) is the most frequently encountered entity in clinical practice. However, its treatment options like topical minoxidil often reach a response plateau, and few of them are non-responders, complicating management. Oral antiandrogens are limited by their potential side effects. As a result, there is an increasing demand for supplementary therapies to enhance hair density. One such approach is the thread embedding technique (TET), which is gaining relevance in managing pattern hair loss due to its ability to promote connective tissue remodeling. Material and Methods: This prospective cohort study evaluated 17 patients (13 males and 4 females, aged 25–40 years) diagnosed with AGA. Patients with Norwood–Hamilton grades 2–5 and Ludwig grades 2–3 were enrolled. Baseline trichoscopic analysis was conducted before TET, measuring hair density, thickness, and anagen-to-telogen ratio. The treatment area was mapped in a grid pattern, and the number of threads was planned accordingly. Under topical anesthesia, Mint Mono ™ threads (29 G, 30 mm or 30 G, 25 mm) were inserted into the dermis. Global photographs were taken before treatment and at 3 months. 10 dermatologists assessed these images using a 7-point scale (from −3 = greatly decreased to +3 = greatly increased).