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The mechanism by which toxicity results is complex, but is believed to involve reaction between unconjugated NAPQI and critical proteins as well as increased susceptibility to oxidative stress caused by the depletion of glutathione

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The microneedling-for-hair evidence base is built on other compounds a randomized pilot of microneedling plus minoxidil (PMID 23960389) and a 2025 study of copper-peptide microneedling for androgenetic alopecia (PMID 40225275) neither of which establishes a safety profile for AHK-Cu delivered this way

Science 342:971976