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Thread Therapy May Improve Efficacy of Minoxidil for Women


While many recent clinical trials appear to be investigating new treatments for Male Pattern Baldness – such as topical finasteride – a new study has explored a new solution for Female Pattern Hair Loss.

Researchers from the Department of Dermatology, Venereology and Andrology, Faculty of Medicine at Zagazig University, Zagazig in Egypt looked into combining Poly‐l‐lactic acid microthread therapy (PLLA) with the only currently MHRA-licensed and FDA-approved female hair loss treatment, high strength minoxidil.

Their aim was to establish the potential efficacy and safety of this combination approach for women with genetic hair thinning, following an initial pilot study in October 2019.

Thread therapy cotton sewing

What is monofilament thread therapy?

Most commonly seen in Korean beauty treatments promoted as ‘anti-ageing’, Poly‐l‐lactic acid microthread therapy (PLLA) – also known as monofilament thread therapy, ‘thread therapy’ or by brand names such as Silhouette Soft thread therapy – is generally used to lift the skin and decrease wrinkles.

It initially caught the attention of the media when Real Housewives stars on both sides of the pond – Sonja Morgan from the Real Housewives of New York and Lauren Simon from the Real Housewives of Cheshire – tried ‘soft thread facelifts’.

The Apprentice 2013 winner, Dr. Leah Totton, who practices the procedure at her aesthetic clinic, explains on her website, “The threads used in this treatment are made of PLA (polylactic acid), a biodegrable polymer that is also used for sutures, orthopaedic pins, and bone fracture treatments. Thread cones are inserted into the face to lift sagging skin, creating a firmer, younger look. After the treatment, the threads will gradually anchor themselves to your tissue and stimulate the body’s collagen production, creating a smooth, shapely appearance that’s completely natural.”

Performed under local anaesthetic, she estimates the procedure – when carried out on the face or neck – can take between 30 minutes and one hour, with 48 hours of sensitivity afterwards and a two week full recovery period.

She outlines potential adverse events associated with thread therapy as “Bruising, soreness, allergic reactions,” and estimates the results should last for up to 18 months.

Over 90 per cent improvement seen

The details of the latest small-scale Egyptian trial were published in the Journal of Cosmetic Dermatology in December 2019.

A total of 27 women took part in the randomized, half‐split study whereby each side of their heads were treated differently, based on a left‐head to the right‐head pattern.

Each participant had PLAA thread therapy treatment performed once on one side of their scalp; they then applied minoxidil to their whole scalp for a 6 month period.

Whilst the frequency of the minoxidil applications was not disclosed in the abstract, it is likely to have been either once or twice per day, as is the normal routine for using this popular hair loss solution. Although minoxidil comes in a number of different formulations, information as to the consistency and strength of the medication was also not provided.

Photo records and dermoscopy assessments were taken at baseline and then every two months throughout the trial. The photographic evidence was blind-reviewed by three independent dermatologists.

The final assessment showed significant increased hair density in hair counts and photo assessments in candidates where the combination approach of thread therapy and high strength minoxidil.

Their mean hair density was seen to increase from 114 ± 27 to 143 ± 25/cm2 (P < .001) in the combined thread therapy plus minoxidil group, whilst the mean density registered 113 ± 24 to 123 ± 19/cm2 in the minoxidil only group (P < .001).

The photographic evidence was overwhelmingly in support of the combination poly‐l‐lactic acid microthread therapy with minoxidil approach with a 93% (25/27 patients) improvement rate. This was compared to 52% (14/27) of patients in the minoxidil-only group.

Therefore, the researchers concluded this type of thread therapy “may improve hair density, hair thickness, and hair appearance better than minoxidil alone”.

Whilst this novel and minimally-invasive approach to Female Pattern Hair Loss Treatment is undoubtedly exciting, this was a particularly small-scale trial and far more longer-term and wider-reaching large clinical studies are needed until its true potential is uncovered.

Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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