Topical minoxidil is not working

What if I try to enhance the enzyme activity in the scalp with Tretinoin and 1.5mm microneedling.  If it still doesn’t respond after combining min tret and microneedling, then maybe I its time to think about oral.

I’m afraid I have to disagree with your logic. If your scalp doesn’t contain Sulfotransferases, then adding Tretinoin may increase some systemic absorption, but 1.5mm microneedling will not make the drug active in the scalp skin. Microneedling may help independently; however, as the liver contains the appropriate enzymes, minoxidil should be effective when taken orally.