A quick search on google scholar resulted in multiple papers linking fibrosis to male pattern baldness... here's a paper from 2008.
https://link.springer.com/article/10.1007/s00403-007-0826-x
Dermal fibrosis in male pattern hair loss: a suggestive implication of mast cells
"It was found that collagen bundles were significantly increased in balding vertexes than in non-balding occiput scalp skin. A near 4-fold increase in elastic fibers was observed in both vertex and occiput scalp skins with MPHL versus controls"
It says balding regions have up to 4x as much fibrotic collagen than non-balding regions. That's a lot. Collagen bundles = fibrosis -> blood flow reduction. It is also well known by Dermatologists that microneedling breaks up excessive clusters of collagen so that the body can get rid of them and replace it with healthier tissue. This is the primary method by which microneedling is used to get rid of scar tissue. However I think it should be said that the scalp is a lot thicker than the face, and even with the face you have to go pretty deep to break up collagen. So with the scalp, even greater of a depth is necessary to really get it broken up.
The fibrosis thing is not simply a theory like people think. The correlation between fibrosis and male pattern baldness has been repeatedly proven. The thing that isn't clear is the biochemical mechanism by which DHT causes this fibrosis to build up. If I had to speculate, DHT is a response to inflammation, seeing as it acts as a vasoconstrictor (anti-inflammatory action). It's likely part of this involves the creation of new collagen, perhaps the bodies effort to target/treat the inflammation somehow.
The hairs which grow back as a result of finasteride is a direct result of DHT's vasoconstricting hair inhibiting effect being lessened. The reason finasteride alone doesn't grow back
all hair, and the reason minoxidil hairs fall out in balding regions when usage is stopped, is because that built up fibrotic tissue in balded areas is still there restricting growth.
So, while the link between male pattern baldness and fibrosis has been well studied and established, I don't think it has become fully accepted by the mainstream yet in the same way that DHT has. New discoveries tend to take 20+ years before they become accepted in the mainstream.
I don't think that noise is from breaking up fibrosis. Some has speculated it's just fluid being popped, like how people "crack" their knuckles. Scar tissue is fibrosis, or excessive collagen - have you ever heard popping from massaging a scar? Of course not. However it is proven that massaging collagen does indeed break it up overtime, and can help stimulate it's repair. People have significantly lessened facial wrinkles and scars by massages. However, a massage isn't going to come close to competing with a microneedling treatment.
