Mesenchymal Stem Cell Exosomes Therapy for Acquired Trichorrhexis Nodosa: A Case Series

ABSTRACT Background Recent preclinical studies have demonstrated the potential efficacy of stem cell exosomes in the treatment of hair loss. However, there is a paucity of clinical studies investigating the application of exosomes for this purpose. This case series presents three patients treated with exosomes for acquired trichorrhexis nodosa (ATN), a condition characterized by hair shaft abnormalities and breakage. Objectives This study aims to evaluate the effectiveness and safety of utilizing mesenchymal stem cell (MSC) exosomes as a novel therapeutic approach for the management of ATN. Methods A standardized process was employed to prepare 0.1 mL of exosomes, which were subsequently injected into bilateral regions of the patients' scalps at 0.5–1 cm intervals on a monthly basis. Each injection comprised a total volume of 5 mL, and all three patients underwent a minimum of four treatment sessions. The comparative efficacy of the treatment was evaluated using clinical photographs, dermatoscopy, and scanning electron microscopy (SEM) for all three patients post‐intervention. Results The hair condition of the three patients demonstrated significant improvement, characterized by increased length and density, enhanced pigmentation with a reduced presence of dusty white dots, and the disappearance of dermoscopic black dots and broken hairs. SEM analysis revealed a remarkable recovery in the hair cuticle layers. At the 1‐year follow‐up, hair growth essentially remained normal. Conclusion Exosomes derived from mesenchymal stem cells demonstrate efficacy in treating ATN, presenting a novel therapeutic approach for this condition.