Table of ContentsView AllTable of ContentsTypes of Hair Loss It HelpsResultsParts of the Head TreatedUsing a DermarollerSeeing a ProfessionalHow Often to Do It
Table of ContentsView All
View All
Table of Contents
Types of Hair Loss It Helps
Results
Parts of the Head Treated
Using a Dermaroller
Seeing a Professional
How Often to Do It
With proper application, professionally administered scalp microneedling with a medical-grade dermaroller or dermapen can work for many people with certain types of hair loss. That said, scalp microneedling won’t work for everyone, and the risks of at-home microneedling for hair loss with needles longer than 0.25 millimeters (mm) outweigh the potential benefits.
Read on to learn what types of hair loss microneedling can help, parts of the head that can be treated with microneedling, how to use a derma roller for hair regrowth at home, when to see a professional, and how often this procedure should be performed.
Vahit Ozalp / Getty Images
Which Types of Hair Loss Could Microneedling Help?
In medical terms,male-pattern baldnessandfemale-pattern hair lossare called androgenetic alopeciaorAGA. This is the most common type of hair loss. Microneedling, when used with other hair loss treatments, has been shown to help people with hair loss who don’t respond to conventional therapy.Preliminary results suggest microneedling may also help those withtelogen effluvium hair loss.
Results of Microneedling for Hair Loss: Before and After
Microneedling for hair loss is a relatively new treatment. In the early 2020s, limited high-quality human research with large sample sizes was performed to investigate the “before and after” results of microneedling as a stand-alone treatment (monotherapy).
Animal studies in mice with before- and after-treatment photos suggest that microneedle stimulation alone induces enhanced hair growth, but larger, randomized human studies are needed.
Findings suggest scalp microneedling works best with other hair-loss treatments. Forthcoming large, double-anonymized human studies should help to determine the safety, efficacy, and potential benefits of microneedling for hair loss as a monotherapy.
Can People Using Minoxidil or Finasteride Try Microneedling?
It is safe for people using minoxidil or finasteride to also try microneedling. In fact, research suggests that combining 5% minoxidil with microneedling works better than using it alone.
In 2013, a pilot study found that applying a 5% minoxidil lotion with a derma roller once a week for 12 weeks increased hair counts significantly more than using just minoxidil.
A small 2022 study with 18 participants found that microneedling with 5% minoxidil topical solution once a week for six weeks as part of alopecia treatment showed efficacy and safety. Ten weeks after the treatment was completed, 15 study participants (83.3%) said they were “satisfied” with their hair growth results.
Another small 2022 study on the efficacy of platelet-rich plasma injections plus microneedling for the treatment of androgenetic alopecia found that PRP plus microneedling was more effective than PRP alone in men or women with moderate (level 4 on the 1-7 Norwood scale) hair loss.
Are the Benefits of Microneedling Worth It?
Parts of Head Treated With Microneedling
Managing expectations is key if you’re considering trying microneedling for hair loss. Microneedling as a standalone treatment has yet to be shown to regrow enough hair to cover large bald spots if someone has advanced hair loss.
The best candidates for scalp microneedling are in the early stages of alopecia and have moderate hair loss associated with male or female patterns of androgenetic alopecia. The parts of the head treated with microneedling aren’t usually completely bald but rather have lower hair count numbers or thinner strands that have lost some of their volume over time.
How to Use a Dermaroller for Hair Regrowth
Microneedles used for do-it-yourself home treatments are usually between 0.1 millimeters (mm) and 0.2 mm long.Microneedles used on the scalp shouldn’t be pressed hard enough to puncture the skin or cause micro-wounds that bleed. At-home derma rollers used for hair loss are safest and most beneficial when gently applying topical minoxidil without rupturing the skin barrier.
At-Home Microneedling Isn’t Always SafeAggressive at-home microneedling performed with unsterilized needles that are either too long or pushed too hard into the scalp can cause injury and infection. A derma roller with short needles probably won’t have adverse side effects. However, repeated overuse of an at-home microneedling device that creates micro-wounds in the scalp can be harmful.
At-Home Microneedling Isn’t Always Safe
Aggressive at-home microneedling performed with unsterilized needles that are either too long or pushed too hard into the scalp can cause injury and infection. A derma roller with short needles probably won’t have adverse side effects. However, repeated overuse of an at-home microneedling device that creates micro-wounds in the scalp can be harmful.
Deciding to See a Microneedling Professional
In most people, the hair follicle bulge containing specialized stem cells resides 1.00–1.80 mm below the skin’s surface.However, using needles longer than 0.25 mm at home isn’t recommended because it increases the risk of infection, scarring, or permanently damaging your hair follicles.
Because hair follicle stem cells that trigger hair regrowth are relatively deep beneath the skin’s surface, it’s hard to reach them using an at-home microneedling device without the risk of injury or adverse complications. See a professional for best results.
How Often to Do Microneedling for Hair Loss
There isn’t an evidence-based consensus on how often to do microneedling for hair loss. Some studies recommend doing it once a week, while others have found results with monthly sessions. Because longer needles cause deeper micro-wounds that take more time to heal, the frequency between treatments should be spread out to accommodate the healing process.
When it comes to microneedling for hair loss, doing it more often isn’t necessarily better. The scalp needs time between treatments to heal. Doing scalp microneedling too often increases the risk of adverse side effects such as infection or scarring.
Summary
Some research supports the use of microneedling for hair loss. Still, large-scale randomized controlled human studies are needed to see how well it works as a standalone treatment and establish best practices regarding needle depths and treatment frequency.
More evidence-based research is needed to determine how many weeks or months it takes until someone sees results or how long microneedling results last. Available studies suggest microneedling works best when combined with other hair-loss treatments, such as a topical 5% minoxidil solution.
At-home microneedling can be unsafe. It’s important to speak to a healthcare provider, such as adermatologist, about what type of hair loss you’re experiencing and if professional microneedling would be worth it.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zhou Y, Jia L, Zhou D, Chen G, Fu Q, Li N.Advances in microneedles research based on promoting hair regrowth.Journal of Controlled Release. 2023;353:965-974. doi:10.1016/j.jconrel.2022.12.040Zhang Y, Sheng Y, Zeng Y, et al.Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population.J of Cosmetic Dermatology. 2022;21(12):6985-6991. doi:10.1111/jocd.15424Dhurat R, Mathapati S.Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy.Indian J Dermatol. 2015;60(3):260. doi:10.4103/0019-5154.156361Starace M, Alessandrini A, Brandi N, Piraccini BM.Preliminary results of the use of scalp microneedling in different types of alopecia.J of Cosmetic Dermatology. 2020;19(3):646-650. doi:10.1111/jocd.13061Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez R, Gelfuso G.Topical treatment for scarring and non-scarring alopecia: an overview of the current evidence.CCID. 2021;Volume 14:485-499. doi:10.2147/CCID.S284435Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA.Microneedling for hair loss.J of Cosmetic Dermatology. 2022;21(1):108-117. doi:10.1111/jocd.14525Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, Kang H.Repeated microneedle stimulation induces enhanced hair growth in a murine model.Ann Dermatol. 2016;28(5):586. doi:10.5021/ad.2016.28.5.586Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Malhotra K, Herakal KC.Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?Int J Res Med Sci. 2020;8(4):1282. doi:10.18203/2320-6012.ijrms20201310Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P.A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study.Int J Trichol. 2013;5(1):6. doi:10.4103/0974-7753.114700Jia L, Xiong J, Guo R, Li Y, Jiang H.Effects of microneedling with 5% minoxidil topical solution combination therapy in treatment of androgenetic alopecia.J of Cosmetic Dermatology. 2022;21(11):5665-5671. doi:10.1111/jocd.15263Muhammad A, Iftikhar N, Mashhood A, et al. (October 18, 2022)Comparison of Efficacy of Platelet-Rich Plasma (PRP) With PRP Microneedling in Androgenetic Alopecia.Cureus14(10): e30418. doi:10.7759/cureus.30418Mistriotis P, Andreadis ST.Hair follicle: a novel source of multipotent stem cells for tissue engineering and regenerative medicine.Tissue Engineering Part B: Reviews. 2013;19(4):265-278. doi:10.1089/ten.teb.2012.0422English RS, Ruiz S, DoAmaral P.Microneedling and its use in hair loss disorders: a systematic review.Dermatol Ther (Heidelb). 2022;12(1):41-60. doi:10.1007/s13555-021-00653-2Singh A, Yadav S.Microneedling: Advances and widening horizons.Indian Dermatol Online J. 2016;7(4):244. doi:10.4103/2229-5178.185468.Additional ReadingBasilio FMA, Brenner FM, Werner B.Microneedling for female pattern hair loss: case report and histopathological changes.S&CD. 2022;14. doi:10.5935/scd1984-8773.2022140074Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F.Microneedling in androgenetic alopecia; comparing two different depths of microneedles.J of Cosmetic Dermatology. 2021;20(4):1241-1247. doi:10.1111/jocd.13714Fertig RM, Gamret AC, Cervantes J, Tosti A.Microneedling for the treatment of hair loss?Acad Dermatol Venereol. 2018;32(4):564-569. doi:10.1111/jdv.14722Liang X, Chang Y, Wu H, et al.Efficacy and safety of 5% minoxidil alone, minoxidil plus oral spironolactone, and minoxidil plus microneedling on female pattern hair loss: a prospective, single-center, parallel-group, evaluator blinded, randomized trial.Front Med. 2022;9:905140. doi:10.3389/fmed.2022.905140
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zhou Y, Jia L, Zhou D, Chen G, Fu Q, Li N.Advances in microneedles research based on promoting hair regrowth.Journal of Controlled Release. 2023;353:965-974. doi:10.1016/j.jconrel.2022.12.040Zhang Y, Sheng Y, Zeng Y, et al.Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population.J of Cosmetic Dermatology. 2022;21(12):6985-6991. doi:10.1111/jocd.15424Dhurat R, Mathapati S.Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy.Indian J Dermatol. 2015;60(3):260. doi:10.4103/0019-5154.156361Starace M, Alessandrini A, Brandi N, Piraccini BM.Preliminary results of the use of scalp microneedling in different types of alopecia.J of Cosmetic Dermatology. 2020;19(3):646-650. doi:10.1111/jocd.13061Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez R, Gelfuso G.Topical treatment for scarring and non-scarring alopecia: an overview of the current evidence.CCID. 2021;Volume 14:485-499. doi:10.2147/CCID.S284435Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA.Microneedling for hair loss.J of Cosmetic Dermatology. 2022;21(1):108-117. doi:10.1111/jocd.14525Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, Kang H.Repeated microneedle stimulation induces enhanced hair growth in a murine model.Ann Dermatol. 2016;28(5):586. doi:10.5021/ad.2016.28.5.586Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Malhotra K, Herakal KC.Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?Int J Res Med Sci. 2020;8(4):1282. doi:10.18203/2320-6012.ijrms20201310Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P.A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study.Int J Trichol. 2013;5(1):6. doi:10.4103/0974-7753.114700Jia L, Xiong J, Guo R, Li Y, Jiang H.Effects of microneedling with 5% minoxidil topical solution combination therapy in treatment of androgenetic alopecia.J of Cosmetic Dermatology. 2022;21(11):5665-5671. doi:10.1111/jocd.15263Muhammad A, Iftikhar N, Mashhood A, et al. (October 18, 2022)Comparison of Efficacy of Platelet-Rich Plasma (PRP) With PRP Microneedling in Androgenetic Alopecia.Cureus14(10): e30418. doi:10.7759/cureus.30418Mistriotis P, Andreadis ST.Hair follicle: a novel source of multipotent stem cells for tissue engineering and regenerative medicine.Tissue Engineering Part B: Reviews. 2013;19(4):265-278. doi:10.1089/ten.teb.2012.0422English RS, Ruiz S, DoAmaral P.Microneedling and its use in hair loss disorders: a systematic review.Dermatol Ther (Heidelb). 2022;12(1):41-60. doi:10.1007/s13555-021-00653-2Singh A, Yadav S.Microneedling: Advances and widening horizons.Indian Dermatol Online J. 2016;7(4):244. doi:10.4103/2229-5178.185468.Additional ReadingBasilio FMA, Brenner FM, Werner B.Microneedling for female pattern hair loss: case report and histopathological changes.S&CD. 2022;14. doi:10.5935/scd1984-8773.2022140074Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F.Microneedling in androgenetic alopecia; comparing two different depths of microneedles.J of Cosmetic Dermatology. 2021;20(4):1241-1247. doi:10.1111/jocd.13714Fertig RM, Gamret AC, Cervantes J, Tosti A.Microneedling for the treatment of hair loss?Acad Dermatol Venereol. 2018;32(4):564-569. doi:10.1111/jdv.14722Liang X, Chang Y, Wu H, et al.Efficacy and safety of 5% minoxidil alone, minoxidil plus oral spironolactone, and minoxidil plus microneedling on female pattern hair loss: a prospective, single-center, parallel-group, evaluator blinded, randomized trial.Front Med. 2022;9:905140. doi:10.3389/fmed.2022.905140
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zhou Y, Jia L, Zhou D, Chen G, Fu Q, Li N.Advances in microneedles research based on promoting hair regrowth.Journal of Controlled Release. 2023;353:965-974. doi:10.1016/j.jconrel.2022.12.040Zhang Y, Sheng Y, Zeng Y, et al.Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population.J of Cosmetic Dermatology. 2022;21(12):6985-6991. doi:10.1111/jocd.15424Dhurat R, Mathapati S.Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy.Indian J Dermatol. 2015;60(3):260. doi:10.4103/0019-5154.156361Starace M, Alessandrini A, Brandi N, Piraccini BM.Preliminary results of the use of scalp microneedling in different types of alopecia.J of Cosmetic Dermatology. 2020;19(3):646-650. doi:10.1111/jocd.13061Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez R, Gelfuso G.Topical treatment for scarring and non-scarring alopecia: an overview of the current evidence.CCID. 2021;Volume 14:485-499. doi:10.2147/CCID.S284435Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA.Microneedling for hair loss.J of Cosmetic Dermatology. 2022;21(1):108-117. doi:10.1111/jocd.14525Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, Kang H.Repeated microneedle stimulation induces enhanced hair growth in a murine model.Ann Dermatol. 2016;28(5):586. doi:10.5021/ad.2016.28.5.586Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Malhotra K, Herakal KC.Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?Int J Res Med Sci. 2020;8(4):1282. doi:10.18203/2320-6012.ijrms20201310Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P.A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study.Int J Trichol. 2013;5(1):6. doi:10.4103/0974-7753.114700Jia L, Xiong J, Guo R, Li Y, Jiang H.Effects of microneedling with 5% minoxidil topical solution combination therapy in treatment of androgenetic alopecia.J of Cosmetic Dermatology. 2022;21(11):5665-5671. doi:10.1111/jocd.15263Muhammad A, Iftikhar N, Mashhood A, et al. (October 18, 2022)Comparison of Efficacy of Platelet-Rich Plasma (PRP) With PRP Microneedling in Androgenetic Alopecia.Cureus14(10): e30418. doi:10.7759/cureus.30418Mistriotis P, Andreadis ST.Hair follicle: a novel source of multipotent stem cells for tissue engineering and regenerative medicine.Tissue Engineering Part B: Reviews. 2013;19(4):265-278. doi:10.1089/ten.teb.2012.0422English RS, Ruiz S, DoAmaral P.Microneedling and its use in hair loss disorders: a systematic review.Dermatol Ther (Heidelb). 2022;12(1):41-60. doi:10.1007/s13555-021-00653-2Singh A, Yadav S.Microneedling: Advances and widening horizons.Indian Dermatol Online J. 2016;7(4):244. doi:10.4103/2229-5178.185468.
Zhou Y, Jia L, Zhou D, Chen G, Fu Q, Li N.Advances in microneedles research based on promoting hair regrowth.Journal of Controlled Release. 2023;353:965-974. doi:10.1016/j.jconrel.2022.12.040
Zhang Y, Sheng Y, Zeng Y, et al.Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population.J of Cosmetic Dermatology. 2022;21(12):6985-6991. doi:10.1111/jocd.15424
Dhurat R, Mathapati S.Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy.Indian J Dermatol. 2015;60(3):260. doi:10.4103/0019-5154.156361
Starace M, Alessandrini A, Brandi N, Piraccini BM.Preliminary results of the use of scalp microneedling in different types of alopecia.J of Cosmetic Dermatology. 2020;19(3):646-650. doi:10.1111/jocd.13061
Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez R, Gelfuso G.Topical treatment for scarring and non-scarring alopecia: an overview of the current evidence.CCID. 2021;Volume 14:485-499. doi:10.2147/CCID.S284435
Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA.Microneedling for hair loss.J of Cosmetic Dermatology. 2022;21(1):108-117. doi:10.1111/jocd.14525
Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, Kang H.Repeated microneedle stimulation induces enhanced hair growth in a murine model.Ann Dermatol. 2016;28(5):586. doi:10.5021/ad.2016.28.5.586
Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001
Malhotra K, Herakal KC.Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?Int J Res Med Sci. 2020;8(4):1282. doi:10.18203/2320-6012.ijrms20201310
Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P.A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study.Int J Trichol. 2013;5(1):6. doi:10.4103/0974-7753.114700
Jia L, Xiong J, Guo R, Li Y, Jiang H.Effects of microneedling with 5% minoxidil topical solution combination therapy in treatment of androgenetic alopecia.J of Cosmetic Dermatology. 2022;21(11):5665-5671. doi:10.1111/jocd.15263
Muhammad A, Iftikhar N, Mashhood A, et al. (October 18, 2022)Comparison of Efficacy of Platelet-Rich Plasma (PRP) With PRP Microneedling in Androgenetic Alopecia.Cureus14(10): e30418. doi:10.7759/cureus.30418
Mistriotis P, Andreadis ST.Hair follicle: a novel source of multipotent stem cells for tissue engineering and regenerative medicine.Tissue Engineering Part B: Reviews. 2013;19(4):265-278. doi:10.1089/ten.teb.2012.0422
English RS, Ruiz S, DoAmaral P.Microneedling and its use in hair loss disorders: a systematic review.Dermatol Ther (Heidelb). 2022;12(1):41-60. doi:10.1007/s13555-021-00653-2
Singh A, Yadav S.Microneedling: Advances and widening horizons.Indian Dermatol Online J. 2016;7(4):244. doi:10.4103/2229-5178.185468.
Basilio FMA, Brenner FM, Werner B.Microneedling for female pattern hair loss: case report and histopathological changes.S&CD. 2022;14. doi:10.5935/scd1984-8773.2022140074Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F.Microneedling in androgenetic alopecia; comparing two different depths of microneedles.J of Cosmetic Dermatology. 2021;20(4):1241-1247. doi:10.1111/jocd.13714Fertig RM, Gamret AC, Cervantes J, Tosti A.Microneedling for the treatment of hair loss?Acad Dermatol Venereol. 2018;32(4):564-569. doi:10.1111/jdv.14722Liang X, Chang Y, Wu H, et al.Efficacy and safety of 5% minoxidil alone, minoxidil plus oral spironolactone, and minoxidil plus microneedling on female pattern hair loss: a prospective, single-center, parallel-group, evaluator blinded, randomized trial.Front Med. 2022;9:905140. doi:10.3389/fmed.2022.905140
Basilio FMA, Brenner FM, Werner B.Microneedling for female pattern hair loss: case report and histopathological changes.S&CD. 2022;14. doi:10.5935/scd1984-8773.2022140074
Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F.Microneedling in androgenetic alopecia; comparing two different depths of microneedles.J of Cosmetic Dermatology. 2021;20(4):1241-1247. doi:10.1111/jocd.13714
Fertig RM, Gamret AC, Cervantes J, Tosti A.Microneedling for the treatment of hair loss?Acad Dermatol Venereol. 2018;32(4):564-569. doi:10.1111/jdv.14722
Liang X, Chang Y, Wu H, et al.Efficacy and safety of 5% minoxidil alone, minoxidil plus oral spironolactone, and minoxidil plus microneedling on female pattern hair loss: a prospective, single-center, parallel-group, evaluator blinded, randomized trial.Front Med. 2022;9:905140. doi:10.3389/fmed.2022.905140
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