Abstract: This case report describes a 63-year-old female patient who developed localized cicatricial alopecia after a rhytidoplasty. The combined treatment of LED and exosome therapy resulted in significant hair recovery, highlighting the efficacy of regenerative therapies in the management of post-surgical scarring alopecia.

Introduction

Cicatricial alopecia is a rare but well-known complication after rhytidoplasty surgeries. Excessive tension and surgical manipulation of the scalp are contributing factors to this condition. Intercellular communication, especially via exosomes, is an emerging field of study with diagnostic and therapeutic potential. Exosomes, small extracellular vesicles, have been associated with the modulation of biological responses and tissue regeneration, standing out as promising therapeutic agents in regenerative and aesthetic medicine, including scar prevention and hair growth.

Discovered in the 1940s, exosomes began to be studied more deeply only in the 2000s. These vesicles, released by several cells, carry proteins, lipids, nucleic acids, and other substances, modulating processes such as cell proliferation, differentiation, and death. Recent studies indicate that exosomes can reverse alopecia processes, promoting hair regeneration by stimulating cell proliferation and migration, especially in dermal papilla cells.

Patient Information

Patient E.S., female, born on August 17, 1957, 63 years old, underwent a rhytidoplasty. Subsequently, he developed cicatricial alopecia in the right parietal region, approximately 6 cm in diameter.

Clinical Findings

Apart from alopecia, the patient had no history of relevant diseases or past interventions that could contribute to the condition. Physical examination confirmed hair loss in the scar area.

Cronogram

- April 12, 2024: Initiation of combination therapy of LED and weekly intradermal therapy with growth factors and vitamin complex.

- April 26, 2024: Introduction of the protocol with exosomes (2.5 ml), administered in interval sessions.

- June 2024: Completion of treatment with positive results observed.

Diagnostic evaluation

The diagnosis of cicatricial alopecia was confirmed by physical examination and review of the surgical history. The therapeutic approach focused on hair regeneration, based on evidence of the efficacy of LED and exosome therapy.

Therapeutic Intervention

LED therapy was used to promote angiogenesis and stimulate hair growth factors, while the application of exosomes focused on modulating the inflammatory response and activating follicular stem cells. Exosomes show great potential in hair regeneration by modulating cellular responses and stimulating proliferation pathways.

Follow-up and Results

The patient was monitored throughout the treatment, with regular sessions of LED therapy and exosome administration. There was significant recovery of the affected area, with no adverse effects reported. The patient completely adhered to the treatment and expressed great satisfaction with the results.

Discussion

This case highlights the efficacy of the combined use of LED therapy and exosomes in the treatment of scarring alopecia after rhytidoplasty. The literature supports the use of regenerative therapies, especially exosomes, that modulate the inflammatory response, stimulate stem cells, and promote cell proliferation. Recent studies have shown that exosomes derived from dermal papilla cell cultures increase cell viability and proliferation, prolonging the anagen phase of the hair cycle. These results, corroborated by the clinical improvement observed in the patient, suggest that exosomes are a promising alternative for the treatment of cicatricial alopecia, a condition with limited and often unsatisfactory therapeutic options.

Despite the promising results, more studies are needed to confirm the efficacy and fully understand the mechanisms of action of exosomes in a larger sample.

Patient's Perspective

The patient reported a positive experience with the treatment, highlighting the significant aesthetic improvement and the absence of complications during the therapeutic process.

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