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
    TLDR Excessive scalp massage after using minoxidil can cause hair damage, but reducing massage and using MSC exosomes can help.
    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.
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