Abstract

Objectives: A phenomenon which affects darker skin types and those with textured hair, cicatricial alopecia in its many shapes and forms is complex, with limited scientific solutions. How can updates in regenerative medicine deliver new successes - a synergy of skin-needling and human-sequence compatible exosome therapies. Introduction: Cicatricial alopecia describes a sub-category of hair loss disorders, where inflamed, damaged follicles are replaced by fibrotic tissue. Whilst underlying inflammation can often be triggered by auto-immune diseases, fungal infections or even radiation therapy, cicatricial alopecia may be also be considered a chronic response to long term trauma, instigated from acute tractional alopecia, where persistent hair friction, tension and pulling lead to follicular abnormalities and permanent hair loss. Materials / method: Whilst topical or oral medications may deliver anti-inflammatory benefits to reduce associated erythema and pruritis, automated skin-needling synergies promote a regenerative cascade that is deemed mechanical, electrical and autologous-chemical in action. With thousands of micro-channels facilitated per-second, the delivery potential of homogenous exosome therapy, serves as a non-donor dependant, multi-dimensional, chemical regeneration. This synergy can work harmoniously with drug combination therapies, particularly for primary Lichen Planopilaris and Frontal Fibrosing Alopecia. Results: As part of a patient daily homecare regimen and expert hair styling, secondary cicatricial alopecia may also be addressed due to cultural, social and functional coiffures as well as trauma initiated from fashion, religious, artistic and work-related headwear. Such secondary forms of scarring hair loss to consider include braiding, cornrows, hair extensions, ‘ballerina baldness’, styling clips, baseball caps and protective helmets. Conclusion: Treatments are best performed every two-weeks, with intra-dermal needle depth. A programme of at least 6-8 procedures is necessary to ensure long lasting results, as is once-daily commitment to topical exosome therapy. Patients of all hair types and morphology may be deemed eligible for treatment, so long as there is some level of follicular activity.