Objectives: This presentation explores exosome therapy for scarring alopecia, a condition marked by irreversible follicular destruction due to fibrosis, trauma, or inflammation. A brief review of a 300-subject study on exosome therapy for androgenic alopecia establishes its role in follicular regeneration and scalp homeostasis. We then examine case studies using the same protocol, assessing whether exosome-driven signaling, immunomodulation, and extracellular matrix remodeling can promote follicular neogenesis in cicatricial alopecia, defining the therapeutic limits of exosome-based interventions.