Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Jul 26, 2025; 17(7): 108519
Published online Jul 26, 2025. doi: 10.4252/wjsc.v17.i7.108519
Therapeutic potential of stem cell-derived exosomes in hair regeneration: A systematic review
Neil Poddar, Adarsh Aratikatla, Ashim Gupta
Neil Poddar, Medical School, Albany Medical College, Albany, NY 12208, United States
Adarsh Aratikatla, Medical School, The Royal College of Surgeons in Ireland, Dublin D02 YN77, Ireland
Ashim Gupta, Department of Orthopaedics and Regenerative Medicine, Future Biologics, Lawrenceville, GA 30043, United States
Author contributions: Poddar N, Aratikatla A, and Gupta A drafted, critically reviewed and edited the manuscript; Gupta A conceptualized and supervised the study; all authors approved the final version of the article for publication.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ashim Gupta, MS, PhD, MBA, DABRM, FABRM, CEO, Professor, Department of Orthopaedics and Regenerative Medicine, Future Biologics, 2505 Newpoint Pkwy, Lawrenceville, GA 30043, United States. ashim6786@gmail.com
Received: April 16, 2025
Revised: May 27, 2025
Accepted: June 16, 2025
Published online: July 26, 2025
Processing time: 99 Days and 15 Hours
Abstract
BACKGROUND

Exosome-based therapies represent a promising approach for hair regeneration. Unlike conventional treatments such as minoxidil and finasteride, exosomes deliver bioactive cargo that can stimulate dermal papilla cells, enhance angiogenesis, and modulate inflammatory pathways. However, variability in exosome sources, isolation techniques, and dosing protocols limits their clinical translation.

AIM

To synthesize findings from in vitro, preclinical and clinical studies, and to evaluate the efficacy, mechanisms, and challenges associated with exosome-based hair restoration therapies.

METHODS

A literature search was conducted using multiple databases (PubMed/Medline, Embase, Scopus, and Web of Science) employing terms for exosomes and hair regeneration for articles published in English to February 2025, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

RESULTS

A total of 27 studies (three in vitro, three pre-clinical, 18 with both in vitro and pre-clinical component and three clinical) met the pre-defined search and inclusion criteria and were included in this review.

CONCLUSION

Exosome-based therapies hold immense promise for hair regeneration by leveraging their ability to modulate key signaling pathways and enhance hair follicle regeneration. While in vitro and preclinical studies demonstrate consistent efficacy across diverse exosome sources, methodological heterogeneity and a limited number of clinical studies warrant further clinical research to realize their full clinical potential for hair regeneration.

Keywords: Alopecia; Hair loss; Hair regeneration; Stem cells; Exosomes; Extracellular vesicles; Secretome; Regenerative medicine

Core Tip: This review synthesizes findings from in vitro, preclinical, and clinical studies to evaluate the efficacy, mechanisms, and challenges associated with exosome-based hair restoration therapies. A total of 27 studies met the pre-defined search and inclusion criteria and were included in this review. Exosome-based therapies hold immense promise for hair regeneration by leveraging their ability to modulate key signaling pathways and enhance hair follicle regeneration. While in vitro and preclinical studies demonstrate consistent efficacy across diverse exosome sources, methodological heterogeneity and limited number of clinical studies warrant further clinical research to realize their full clinical potential for hair regeneration.