Objective To explore the effect of nanocrystal microneedle introduction of 5% minoxidil tincture combined with compound glycyrrhizin tablets on hair growth in patients with alopecia areata. Methods A total of 62 patients with alopecia areata diagnosed and treated in the Department of Dermatology, the Fourth Afffliated Hospital of Nanjing Medical University from June 2022 to June 2025 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 31 patients in each group. The control group was treated with topical 5% minoxidil tincture combined with compound glycyrrhizin tablets, and the study group was treated with nanocrystal microneedle introduction of 5% minoxidil tincture combined with compound glycyrrhizin tablets. The treatment effect, hair growth, hair-related indicators and adverse reaction rate were compared between the two groups. Results The total effective rate of the study group (96.77%) was higher than that of the control group (77.42%) (P<0.05). The scores of various hair growth indicators in the study group at 1 month after treatment were lower than those in the control group (P<0.05). The levels of hair density and hair follicle density in the study group after treatment were higher than those in the control group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The treatment regimen of nanocrystal microneedle introduction of 5% minoxidil tincture combined with compound glycyrrhizin tablets can effectively promote hair growth in patients with alopecia areata, especially in improving hair density and hair follicle density, with high safety.