This is one of the best posts I have seen, and a very good example of healthy and well argumented criticism (I'm looking at you,
@roberta)
This is exactly my take on this whole microneedling thing. At first, I was very exited to try this thing coz the scientific evidence firm the published study was promising. If science is properly done, results MUST be able to be reproduced if the same methodology is followed. Most people here actually followed the same methodologies as the first Indian and Chinese studies, and the outcome was FAR from the same.
Now, some people will argue that "everyone is different" to justify the fact that there are a lot non-responders here, but they fail to realize that this argument is a bad one, because given the results of the study, we SHOULD NOT expect this amount of non-responder. Following the numbers of the studies, we should expect a very small amount of non-responders, because according to those two, every single subject responded to the treatment at least to a degree.
What we should be discussing is WHY are we seeing this kind of non-reproducibility? I can think of some reasons:
1) a degree of dishonesty by the researchers, such as conveniently selecting good responders and ignoring the bad ones to skew their conclusion AFTER conducting the trials, which might make sense if there are competing interests. Rachita Dhurat, for example, allegedly has a dermarolling business. However, I cannot say the same for the Chinese authors of the second study.
2) non-random racial sampling: this has been discussed before. Every single needling study published so far (as far as I know) has been made by Asian researchers. As such, all the subjects are either Indian or Chinese individuals. Where are the damn western studies? Are there some genetic factors exclusive to Asian groups that make them more prone to respond to needling than predominantly European groups? That is something we cannot rule out yet.
3) small deviations from the original methodologies:
We are trying our best to imitate their methodology, however, what we cannot properly reproduce is the way the researchers have measured progress. That is, hair count by square cm and hair thickness. We simply lack the equipment to measure these variables, so we are left with no other options than to rely on the subjective self assessment. The thing is, the studies have also employed self assessments and even so, the outcome between them and this trial has been largely different. In the Dhurat and Chinese studies, the self-assessment reports are mostly positive, with close to zero unsatisfied subjects. There is no question that this is NOT the case here.
However there is an important detail we should take into account, as pointed out by another user the other day. In the Dhurat study, every subject had their head shaved. Here, a lot of us are doing this with our non-shaved hair. Shaving a subject's hair may make it easier to note progress because you can notice new follicles and increasing density in the absence of dense hair obstructing our view.
It should be noted though, that the new micrineedling study (another Chinese one, LOL) published this year produced results that are more in line with what we are seeing here, but I would also dare to say that even then, response rates are somewhat higher in that study than in this trial.
What else do you think that might be happening to explain the discrepancy between the published studies and our reality? I think this is something worth discussing.
well done