Abstract
BACKGROUND: Alopecia is a prevalent condition that significantly impacts appearance, mental health, and overall quality of life. Current clinical treatments for alopecia include medication, hair transplantation, low-level light therapy, and stem cell therapy, among others. However, the effectiveness of these treatments remains far from ideal. Extracellular vesicles (EVs) have emerged as a promising therapeutic strategy, yet challenges, such as mass production and clinical application persist. This review aims to explore recent advancements in the use of EVs for the treatment of alopecia. METHODS: A comprehensive literature search was conducted in the PubMed database using a range of relevant keywords: extracellular vesicles, alopecia, hair loss, preparation, exosomes, microvesicles, apoptotic bodies, nanoscale particles, preclinical studies, clinical trial, clinical transformation, regenerative medicine, tissue engineering, stem cell, bioactive molecules, and extraction methods. The papers mostly focus on the biological characteristics and preparation of EVs, the basic and clinical research of EVs in the treatment of hair loss, and the challenges of clinical transformation of EVs were retracted. RESULTS: EVs are nanoscale, spherical particles enclosed by a lipid bilayer. They exert their effects by activating signaling pathways through ligand binding or by entering cells via membrane fusion or endocytosis. Compared to traditional medications or stem cell therapies, EVs offer several advantages, including high biological safety, sustained efficacy, low risk of immune rejection, and ease of storage and transportation. These properties make them a highly promising therapeutic option. CONCLUSION: Significant progress has been made in understanding the preparation, mechanisms, and early clinical applications of EVs. However, further research is needed to optimize key factors, such as dosing, cell sources, and administration frequency to develop more effective and safer therapies. With continued innovation in manufacturing technologies and collaborative efforts between academia and industry, EVs hold great potential for advancing clinical treatments for alopecia in the future.