الفهرس 
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Abstract
Alopecia is one of the most common dermatological diseases among the adults, it markedly affects patient’s psychological condition and can be ended by a social stigma especially in females so may cause social withdrawal of the patient. It is crucial to treat the problem of hair loss in young age when it is at initial stage. Early treatment can stop hair loss or turn the process around. Many treatments are available nowadays for treatment of alopecia such as herbal, topical (minxidil 2%, 5%), oral medication (finastride), hair transplantation, laser and mesotherapy by minoxidil, dutastride or PRP. Till now no definite treatment is available for treatment of alopecia but sequential treatment is needed to obtain good results.
The aim of this study is to compare 3 treatment modalities which are; microneedling, mesotherapy and combined microneedling and mesotherapy. This study included 30 patients; 22 females and 8 males. All patients showed hair loss with different degrees of severity. They were classified randomly into 3 equal groups according to the treatment modalties, all received 12 sessions with 2 weeks interval. We based on three parameters for evaluation (photographs, trichogram and scalp biopsy before treatment and after the last session).
The overall clinical assessment, when comparing the three study groups, was in favor of the combined group where all patients showed various degrees of improvement with a higher percentage of improvement. The other 2 groups (I& II) showed improvement in 90 % of cases with variable degrees from mild to good and 10% of patients showed no improvement.
Our study showed no statistical significance between the 3 studied groups indicating the coherence of the 3 groups and hence, the fair comparison thereafter. Owing to the forementioned clinical assesment, trichogram and histopathological examination, our study showed that the combined therapy with microneedling and mesotherapy gave a higher range of improvement when compared with mesotherapy or microneedling alone. For cases of AGA, combined therapy is recommended, meanwhile cases with TE would respond to mesotherapy alone or combined therapy in the same way.
Finally, we recommend further studies on a larger groups of patients with various diffuse hair loss disorders to confirm our results regarding treatment of microneedling, whether enriched with other treatment modalities or alone to give more options to the dermatologist with better patient compliance.