A Prospective Study of Exosome Therapy for Androgenetic Alopecia.

BACKGROUND: Androgenetic alopecia (AGA) is a prevalent condition that significantly impacts patients' psychological well-being and quality of life. Traditional treatments, such as minoxidil and finasteride, have limited efficacy and undesirable side effects. Exosome therapy, which uses extracellular vesicles to promote tissue regeneration, offers a promising alternative. This study evaluates the effectiveness of exosome therapy combined with microneedling (MTS) for treating AGA. OBJECTIVE: To assess the efficacy of exosome therapy in promoting hair regrowth in patients with AGA following microneedling treatment. METHODS: This prospective, open-label study included 16 male patients aged 36-45 years with mild to moderate AGA. Microneedling was performed on the scalp followed by the application of exosome topical therapy (ZISHEL XOMAGE, Zishel Bio Inc., Seoul, Republic of Korea). Hair density and patient satisfaction were evaluated through clinical assessments and photographic documentation at 1, 3, 6, and 12 months after treatment. Side effects were also monitored. RESULTS: At the 12-month follow-up, the average increase in hair density was 35 hairs/cm2, with a standard deviation of 6.5 hairs/cm2. Baseline hair densities ranged from 75 hairs/cm2 to 95 hairs/cm2, with improvements observed in all patients. Patient satisfaction was high, with 80% of participants reporting noticeable improvements in hair regrowth and 87% indicating satisfaction or high satisfaction with the results. Mild side effects, including scalp tenderness and slight irritation, were reported but resolved within 48 hours. CONCLUSION: Exosome therapy, in combination with microneedling, offers a promising non-surgical treatment for AGA, demonstrating significant improvements in hair regrowth and patient satisfaction. Further studies with larger samples and longer follow-up periods are needed to confirm the long-term efficacy of this approach. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .