Resumo

Objectives: To evaluate the frequency of lymphocytic inflammatory infiltrates in female androgenetic alopecia (FAGA) and assess the clinical outcomes of a combined anti-inflammatory and regenerative treatment protocol. Introduction: Female androgenetic alopecia is a progressive, non-scarring hair disorder marked by follicular miniaturization. Growing histopathological evidence suggest that perifollicular inflammation, particularly lymphocytic infiltrate, may significantly contribute to disease progression and therapeutic resistance. Materials / method: Scalp biopsies from 50 female patients diagnosed with FAGA were retrospectively analyzed. Among them, 42 (84%) exhibited perifollicular lymphocytic infiltrates. These patients were treated with a combination of topical corticosteroids, oral minoxidil and exossomes derived from plant-based stem cells. Clinical evolution was monitored through standardized photography and trichoscopy. Results: The combined use of topical corticosteroids, oral minoxidil and plant-derived exossomes contributed to the reactivation of miniaturized follicles and the reduction of clinical signs of inflammation, including pruritus, erythema and scalp sensitivity. Patients also showed improvement in hair density and shaft thickness, with early evidence of follicular neogenesis. Conclusion: The high prevalence of perifollicular lymphocytic infiltrate in FAGA highlights the importance of addressing inflammation as a central therapeutic target. A combined approach using anti-inflammatory and regenerative agents proved effective in enhancing follicular recovery, suggesting a promising direction for personalized treatment strategies in female androgenetic alopecia.