Systematic Review of Exosome Treatment in Hair Restoration: Preliminary Evidence, Safety, and Future Directions

This systematic review evaluated 16 studies (15 preclinical and 1 clinical) on the use of exosomes, small extracellular vesicles, for hair restoration. The studies showed promising results, with exosomes derived from adipose-derived stem cells (ADSCs) and dermal papilla cells (DPCs) modulating the hair growth cycle. A clinical trial involving 39 androgenetic alopecia patients showed significant increases in hair density and thickness after topical ADSC-Exo treatment, with no significant adverse reactions reported. However, the U.S. Food and Drug Administration (FDA) has not approved exosomes for treating hair disorders, and there are concerns about the potential risk of tumor development. Further studies are needed to define the mechanism of action, optimize delivery and efficacy, and address safety concerns.