Exosome-Based Therapies for Alopecia Areata: A Systematic Review of Clinical and Experimental Evidence

This systematic review evaluates the potential of exosome-based therapies for treating alopecia areata (AA), an autoimmune condition with limited treatment options. The review included 40 studies, comprising clinical, preclinical, in vivo, and in vitro research. Clinical studies reported increases in hair density and improvements in hair count, length, and thickness, while experimental studies showed significant hair regrowth and follicular regeneration. The activation of the Wnt/β-catenin pathway and enhanced dermal papilla and hair follicle stem cell function were noted, alongside anti-inflammatory effects. The safety profile was favorable, with only mild, transient local reactions reported. Despite promising results, the review highlights the need for robust randomized controlled trials and standardization of exosome sources, doses, and delivery methods before clinical application.