Male  androgenetic   alopecia   (AGA)  is  the most common  type of hair  loss  in men. It accounts  for more than 90% of all cases of alopecia   in men (1>.    It occurs  when  genetically predisposed   men are exposed  to androgens.  AGA may negatively   affect patient's   quality  of life and can lead to social   and job-related    problems   (21.   AGA can also  cause indirect  physical   harm, such as sunburn  as a result of hair loss and exposure  to ultraviolet    light <3>.  AGA  may also  be associated   with increased   incidence  of hypertension,    hypercholesterolemia,      and myocardial

infarction  <4>.

The only  FDA approved  therapies  for treatment  are limited  to topical   minoxidil   and oral FIN  with limited   efficacy  (40-60%)  <5l,   As multiple  factors  are implicated  in the pathogenesis of AGA and the existing   conventional   therapies  (i.e.  FIN and minoxidil)   fail to target  all of them;  the demand  for new treatment  techniques  for AGA  is  growing  (6l.

Dutasteride  (DST)  is  a dual  Sa-recluctase   inhibitor,    with  some reports  about the use of oral DST in the treatment  of AGA in men (7>,  Hesitancy  about  the widespread  use of oral  DST in the treatment  of male  AGA  results  from its potential   side  effects  on erectile,

ejaculatory  functions   and fertility   (3>.  Mesotherapy   using DST has been used in patients with  AGA with promising   results   (S,  9>.  It is  believed  that systemic  absorption  after

mesotherapy  is  equal to after oral DST because  the scalp is highly   vascular.  So the possibility   of using  DST topically  with scalp MN would  have some advantages  <10>.

Microneedling   (MN)  is  a relatively   new minimally   invasive  procedure  involving superficial   and controlled  puncturing  of the skin  by rolling  with miniature  fine needles  <11>.

The use of MN in combination   with  minoxidil   showed  promising   results  in treatment  of AGA

(G>.  Furthermore;  the addition   of MN to minoxidil   and oral  FIN  improved  AGA  in  patients who were resistant   to minoxidil  and oral FIN <12J.  To the best of our knowledge;   the use of MN in combination   with DST hasn't  been previously   reported.   This  study  was designed  to evaluate  the efficacy  and safety of topical  DST  with  MN in treatment  of male  AGA.