Repigmentation and Hair Growth Using ASCE HRLV-E Therapy in a Patient with Alopecia Totalis: a Case Report
Background: Alopecia totalis (AT), a severe form of alopecia areata, leads to complete scalp hair loss in 1-2% of cases. Conventional therapies such as intralesional steroids (<30% efficacy) and JAK inhibitors (35-40% response at 36 weeks) offer limited durable benefits, high relapse, and safety concerns. This leaves refractory patients with significant psychological burden as it impairs their quality of life.
Case Presentation: A 49-year-old female with minoxidil-refractory AT received 5 biweekly intradermal sessions of ASCE HRLV-E exosomes (1 vial/session) with microneedling. After 5 sessions, increased density of fine depigmented terminal hairs was noted. At 1-year follow-up, and without continuation of treatment, we noted substantial long coarse white terminal hair regrowth with central occipital/parietal repigmentation. No adverse effects were noted and the patient reported a 10/10 satisfaction with the end result.
Discussion: ASCE exosomes promote Wnt/β-catenin activation, HFSC proliferation, angiogenesis, and melanogenesis. It currently outperforms topicals in preclinical/clinical alopecia models. To our knowledge, this is the first reported case of durable regrowth and repigmentation of patient with AT following 1-year without treatment.
Conclusion: ASCE HRLV-E exosome therapy with microneedling induced safe, sustained hair regrowth and repigmentation in a refractory AT patient. The results were durable following 1 year without intervention or adjunct therapies.