Effectiveness of Exosome Treatment in Androgenetic Alopecia: Outcomes of a Prospective Study

Abstract Objective Harnessing the regenerative capabilities of stem cell-derived exosomes holds great promise for developing novel hair growth therapies, offering hope for individuals experiencing hair loss or alopecia. This aimed to elucidate the effect of “foreskin-derived mesenchymal stromal cells derived exosome” injection into the scalp on hair density in patients with androgenetic alopecia and the contribution of this treatment on patient satisfaction. Method This prospective study included 30 male patients, aged between 22 and 65, with hair type III-VI according to the Norwood-Hamilton scale. Characterization of the stem cell exosomes was performed with the nanoparticle tracking analysis (NTA), hair densities were calculated via digital imaging analysis, and patient satisfaction was questioned with a modified survey. Results NTA results showed a characteristic distribution of peaks for exosomes 139.7 ± 2.3 nm in diameter. A statistically significant increase in hair density was observed in the 4th and 12th weeks after treatment ( p < 0.05). Patient-reported satisfaction revealed a statistically significant difference in the answers given in the 12th week compared to the 4th week ( p < 0.05). No side effects or complications were observed after exosome injection. Conclusion Foreskin-derived mesenchymal stromal cells derived exosome injection increased hair density, with sustained patient satisfaction throughout the study. The exosome application resulted in no side effects. 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 www.springer.com/00266 .