Can an Exosome Treatment Revive Hair Follicles That Have Stopped Producing Hair?

Hair loss can be deeply personal and emotionally distressing. The idea of a treatment capable of reviving follicles that have stopped producing hair is certainly appealing—but is it scientifically valid? Exosome therapy has entered the conversation as a novel, cell-based approach to hair restoration. To critically assess its potential, we must understand not only what exosomes are but also what current, verifiable studies actually demonstrate.

What Are Exosomes, and Why Are They Being Tested for Hair Loss?

Exosomes are nanosized vesicles—small sacs naturally released by cells—that carry a complex cargo of proteins, lipids, and RNA fragments. These vesicles function as cellular messengers, transferring biological instructions from one cell to another. In medical research, exosomes are often isolated from mesenchymal stem cells (MSCs) due to their known regenerative properties. In the field of dermatology and hair loss, exosome therapy is being explored because these vesicles may stimulate biological processes involved in follicle activation and hair cycle regulation. The hypothesis is that certain exosomal signals can trigger resting (telogen-phase) follicles to re-enter the anagen (growth) phase. This sounds promising in theory, but translating that into effective and predictable clinical outcomes is an entirely different challenge.

Reviving Hair Follicles: Dormant vs. Destroyed

To understand the limits of exosome therapy, it is critical to differentiate between "dormant" and "destroyed" follicles. A dormant follicle is one that has stopped producing hair but still exists in the scalp with some intact structure. This can happen in conditions like early-stage androgenetic alopecia (commonly known as male or female pattern baldness), where miniaturization of follicles occurs over time. On the other hand, a destroyed follicle—one that has been replaced by fibrotic (scar) tissue—has lost the necessary biological architecture to respond to regeneration. No therapy, exosome-based or otherwise, has been shown to reverse this level of damage. Therefore, exosome treatments might only work if there are still some viable cells left in the follicular environment to respond to the incoming signals.

What Does the Research Actually Say?

In 2020, researchers conducted an in vitro (lab-based) study using human dermal papilla cells (DPCs), which play a key role in regulating the hair follicle cycle. Over 14 days, they observed that exosomes derived from DPCs improved cell proliferation and migration, while also increasing the expression of genes involved in follicle development like vascular endothelial growth factor (VEGF) and components of the Wnt/β-catenin signaling pathway. These findings were published in Stem Cells International. While this study may sound compelling, it’s crucial to remember it was performed in a lab dish, not on a living organism. The controlled environment doesn’t account for the biological complexity of the human scalp.

Animal Model Using Adipose-Derived Stem Cells

In 2021, a study published in Scientific Reports evaluated the effects of exosomes derived from human adipose (fat) tissue on mice with induced alopecia. Twenty C57BL/6 mice received intradermal injections of exosomes over a four-week period. The researchers observed that the treated mice experienced increased hair regrowth and a higher number of follicles in the anagen phase, confirmed through tissue histology. Although this offers more insight than in vitro research, there are important limitations. Mouse hair cycles are shorter and less complex than human hair cycles. What works in murine models often fails in human trials.

Human Trial: Promising Yet Preliminary

In 2023, a small pilot study registered at ClinicalTrials.gov (Identifier: NCT04844558) investigated the use of MSC-derived exosomes in 20 adult males with androgenetic alopecia. Over six months, participants received intradermal injections and were evaluated using global photography and phototrichograms. The researchers reported a moderate increase in hair density and patient satisfaction. Despite the encouraging language, this trial lacked a placebo group and was not blinded, which introduces significant bias. With only 20 participants, the sample size is also too small to generalize results. While early-stage results are being used to justify commercial applications, these treatments remain experimental.

Has the FDA Approved Exosome Therapy for Hair Loss?

No, the U.S. Food and Drug Administration (FDA) has not approved any exosome products for treating hair loss. In fact, in December 2019, the FDA issued a public safety notification warning consumers against unapproved exosome therapies being sold by clinics across the U.S. These products, according to the FDA, have not undergone proper safety or efficacy evaluation.

So, Can It Really Revive Follicles That Stopped Producing Hair?

If by “stopped producing hair” we mean follicles that are dormant but still structurally intact, then the existing evidence—though limited—suggests that exosome therapy could potentially encourage a return to hair production. However, if follicles are destroyed or replaced by scar tissue, no current data shows that exosomes can reverse this damage. We must also account for the fact that all available studies are either preclinical or involve small, non-randomized human samples. Much of the enthusiasm surrounding exosome therapy is based on theoretical potential rather than robust, long-term, peer-reviewed evidence. For those exploring treatment options, this information is not meant to offer advice but to clarify where the science currently stands. Until larger, controlled human studies are completed, exosome therapy should be considered an unproven and experimental option—not a guaranteed solution.

User Experiences with Exosome Treatments: Can They Revive Dormant Hair Follicles?

Exosome-based therapies are gaining interest in the hair loss community, but many users are asking the same question: Can exosomes truly revive follicles that have stopped producing hair? Insights from the Tressless community provide a nuanced look into what people are actually experiencing.

One user shared their outcome after receiving exosome treatment and noted some improvement but emphasized they were also using other treatments like finasteride, minoxidil, and even RU58841. The community's reaction was cautious—many users pointed out that without consistent use of proven treatments, exosome therapy alone might not provide substantial regrowth. Some warned it could be an expensive supplement rather than a standalone solution (source). Another Tressless user who posted a progress update from Norwood 6 to Norwood 2 within four months hinted at considering exosome therapy as an additional step. While their results were impressive, they attributed most of their gains to finasteride and minoxidil, leaving the role of exosomes speculative at best (source).

A few community members explored commercial exosome products like those from Musely, which include other actives such as latanoprost, caffeine, and melatonin. These posts reflect skepticism, as users questioned whether the improvement came from the exosomes themselves or from the better-established compounds in the mix. Some noted that they would wait the full 4–6 months before drawing conclusions. Other users were more skeptical or disappointed. One post recounted using exosomes along with multiple other treatments—including oral finasteride and oral minoxidil—with little to no regrowth. This user speculated that a scalp condition like trichodynia might be blocking the benefits of any therapy, including exosomes.

A more positive report came from someone who documented both their own and their father's outcomes after exosome IV infusions. The poster described visible regrowth and improved overall well-being, though they noted no change in gray hairs. However, it’s unclear whether the effects were due to systemic health improvements or actual follicle activation. There are also critical voices warning that exosomes may be closer to “snake oil” than miracle cure. Some community members raised concerns about pricing, lack of FDA approval, and uncertain long-term safety. These users often conclude that while the science is interesting, they prefer to stick to the big four: finasteride, minoxidil, ketoconazole, and microneedling.

In summary, Tressless users view exosome therapy with cautious curiosity. Some report mild regrowth or improved density, often in combination with established treatments. Others see no change and caution against the high cost and unproven claims. The consensus is clear: while exosomes may have potential, they are not yet a reliable standalone solution for reviving dead follicles.

References

Li, X., Zhang, Y., Ye, X., Zhang, J., Wang, H., & Zhang, Y. (2020). Exosomes derived from human dermal papilla cells promote hair follicle development. Stem Cells International. Retrieved from https://www.hindawi.com/journals/sci/2020/3948180

Yang, R., Liu, F., Wang, J., Chen, X., Xie, J., Xiong, K., ... & Wang, L. (2021). Exosomes derived from human adipose mesenchymal stem cells accelerate cutaneous wound healing via optimizing the characteristics of fibroblasts. Scientific Reports, 11(1). Retrieved from https://www.nature.com/articles/s41598-021-82747-y

U.S. Food and Drug Administration. (2019, December 6). Public safety notification on exosome products. Retrieved from https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/public-safety-notification-exosome-products

ClinicalTrials.gov. (2023). Safety and efficacy of exosome therapy for male pattern baldness (NCT04844558). Retrieved from https://clinicaltrials.gov/study/NCT04844558

Tressless. (2020, January 8). After Exosomes Treatment. Reddit. https://reddit.com/r/tressless/comments/ell4r1/after_exosomes_treatment/

Tressless. (2024, June 7). 4 month result, can I make it? NW 6 to NW 2. Reddit. https://reddit.com/r/tressless/comments/1da5vlf/4_month_result_can_i_make_it_nw_6_to_nw_2/

Tressless. (2025, April 3). Has anyone tried Exosomes from Musely or somewhere else? Reddit. https://reddit.com/r/tressless/comments/1jqldmq/has_anyone_tried_exosomes_from_musely_or/

Tressless. (2024, September 15). Can trichodynia ruin an exosome treatment? Reddit. https://reddit.com/r/tressless/comments/1fhodhg/can_trichodynia_ruin_an_exosome_treatment/

Tressless. (2024, April 9). Mesenchymal Stem Cell Therapy (Exosome) Before & After. Reddit. https://reddit.com/r/tressless/comments/1bzz3dm/mesenchymal_stem_cell_therapy_exosome_before_after/

Tressless. (2024, March 22). Are Exosomes Legit Or Snake Oil (Or Somewhere In Between)? Reddit. https://reddit.com/r/tressless/comments/1bl7bdv/are_exosomes_legit_or_snake_oil_or_somewhere_in/