Acquired Trichorrhexis Nodosa Caused by Scalp Massage After Topical Minoxidil: A Case Report and Literature Review

June 2025 in “ Journal of Cosmetic Dermatology ”

Xi Chen, Xinzhou Liu, J. Liu, Zhenbo Hu, Guoyan Liu

trichorrhexis nodosa topical minoxidil androgenetic alopecia mesenchymal stem cell exosome scalp massage Rogaine MSC exosome

Studysummary This case study reports that reducing scalp massage following minoxidil application and using mesenchymal stem cell exosomes led to significant improvement in hair condition for a patient with trichorrhexis nodosa.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This case report describes a 47-year-old male with acquired trichorrhexis nodosa (TN) caused by excessive scalp massage following the application of topical minoxidil for androgenetic alopecia. The patient experienced hair breakage and alopecia patches, which improved significantly after reducing massage time and receiving mesenchymal stem cell (MSC) exosome injections. The study highlights that excessive mechanical manipulation, such as scalp massage, can lead to TN, and suggests that MSC exosomes can be an effective adjuvant treatment. The report emphasizes the importance of avoiding physical and chemical damage to the hair and removing causative factors to manage TN effectively.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Research cited in this study

3 / 3 results

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

November 2024 in “Journal of Cosmetic Dermatology”

In this case series, mesenchymal stem cell exosomes were reported to improve hair length, density, pigmentation, and cuticle layer recovery in three patients with acquired trichorrhexis nodosa, suggesting potential as a therapeutic approach for this hair condition.

research Adipose Mesenchymal Stromal Cell-Derived Exosomes Carrying MiR-122-5p Antagonize the Inhibitory Effect of Dihydrotestosterone on Hair Follicles by Targeting the TGF-β1/SMAD3 Signaling Pathway

March 2023 in “International Journal of Molecular Sciences”

This study found that exosomes from adipose mesenchymal stromal cells, particularly those carrying miR-122-5p, may enhance hair follicle regeneration in androgenic alopecia by targeting the TGF-β/SMAD3 axis.

research Trichorrhexis Nodosa After Hair Transplantation: Dermoscopic, Pathologic and Electron Microscopy Analyses

9 citations , November 2013 in “Dermatologic Surgery”

Hair transplant complications were likely due to deep graft placement and rough handling.