Follow-up visits were done at 2 weeks, 6 weeks and 12 weeks after the procedure.At 12 weeks, all patients (n = 5) had appreciable degree of increase in hair counts, confirmed with investigator-evaluated improvement in GPI (40%-75%; average of 57%) ( Fig. 2), trichoscopic hair count increment (48-93 HFU/cm 2 ; average of 67 HFU/cm 2 ) and patient satisfaction evaluated with VAS ranging from 4 to 8 with a mean of 6 ( Table 1).Except for mild pain experienced during thread insertion (n = 5), and mild transient swelling (n = 2), the procedure was very well tolerated by all. There was no case of significant bleeding, ecchymosis, persistent pain, headache or postprocedure infection.Polydioxanone (PDO) filament, a synthetic absorbable suture prepared from polyester, poly (p-dioxanone) has high flexibility and high retention strength, is non-allergenic and has a slow absorption rate (6-8 months). The risk of bacterial colonization or infection is minimal. As a non-surgical face lift modality, threads stimulate neocollagenesis within 2-3 weeks with clinical results expected to last for 2-3 years. 1 We preferred monofilament threads, instead of barbed/screwed.Although the exact mechanism of action of hair growth stimulation by PDO threads remains speculative, it is likely to be similar to that of microneedling, involving enhanced expression of hair-related genes, release of growth factors like PDGF and direct activation of stem cells in the hair bulge area. 3,5 A randomized trial by Dhurat et al. 4 had indeed displayed the superiority of the combination of microneedling with minoxidil over minoxidil alone in MPHL.Although this pilot study seems to offer scalp threading as a novel efficacious and safe non-surgical approach to hair regrowth, the limitations of this study including small number of cases, limited follow-up period and lack of scalp histological analysis warrant further research with controlled trials with a larger cohort. Further, the persistence of the hair growth-stimulating effect of the threads, and theoretical possibility of foreign body granuloma formation in the long term remain to be explored.Disclaimer "We confirm that the manuscript has been read and approved by all the authors, that the requirements for authorship as stated earlier in this document have been met, and that each author believes that the manuscript represents honest work".