Plant-Derived Extracellular Vesicles Delivered by Microinfusion Microneedling for Androgenetic Alopecia: A Retrospective Case Series.

INTRODUCTION: Extracellular vesicles (EVs), often referred to in the literature as "exosomes," have emerged as candidate biologic mediators for hair restoration, but clinical evidence remains limited. Microinfusion of drugs into the skin (MMP®) is a tattoo device-based technique that combines microneedling with controlled intradermal delivery and may offer a reproducible way to administer scalp treatments. METHODS: We performed a retrospective case series of adults with androgenetic alopecia (AGA) treated with a plant-derived EV formulation delivered through MMP®. Patients underwent 6 monthly sessions. Treatment tolerance, patient-reported outcomes, and blinded investigator assessments from standardized clinical photographs and site-matched trichoscopy were reviewed. RESULTS: Twenty patients were included. Tolerance was favorable: 85% reported no adverse effects and 15% reported mild procedural pain. Subjectively, 95% of patients perceived improvement after six sessions, including 55% who reported marked improvement. Blinded evaluation also suggested benefit, more clearly at the clinical level than at the trichoscopic level. Mean clinical ratings indicated mild-to-marked improvement in 70% of cases, whereas mean trichoscopic ratings indicated mild-to-marked improvement in 50% and stabilization-to-mild improvement in 45%. CONCLUSION: In this retrospective series, plant-derived EVs delivered by MMP® were feasible, well tolerated, and associated with favorable subjective and blinded efficacy signals in patients with AGA.