Introduction

Telogen effluvium (TE) is a diffuse, non‑cicatricial alopecia characterized by premature transition of hair follicles from anagen to telogen phase, often following systemic or psychological stressors. Therapeutic options are limited with no FDA‑approved agents. Adipocyte-derived mesenchymal stem cells-conditioned media (ADSC-CM), containing cytokines and growth factors, has emerged as a potential regenerative modality promoting follicular proliferation.

Aim

To assess the effectiveness of adipocyte-derived mesenchymal stem cells-conditioned media (ADSC-CM) formulation in telogen effluvium patients.

Patient Profile

Patients (aged ~20–70 years) diagnosed with telogen effluvium

Methods

• Retrospective cohort study 
• 50 patients 
• All patients received 5 monthly sessions of ADSC‑CM with a one-month interval between each two consecutive sessions.
• The scalp was gently cleansed before applying 3 mL of ADSC‑CM using an automated microneedling device at a depth of 1.0 mm across the entire scalp, without the need for topical or intralesional anesthesia.

 

Assessment

• Hair parameters were measured before treatment and 1 month after the last session using trichoscopy/trichometry. 
• Key variables included
  1. Positive parameters consisted of those for which an increase indicates favorable response; this included hair density; AHST; % thick hair; cumulative hair thickness & number of follicular units. 
  2. Negative parameters consisted of those for which a decrease indicates favorable response; these include: % thin hair; % medium hair; and derived Sinclair grade.

Results 

• ADSC‑CM produced significant improvement in all major hair growth parameters across scalp regions (frontal, temporal, occipital).
  1. Hair density increased (up to ~29 hairs/cm²)
  2. Cumulative hair thickness increased (up to ~2.67 mm/cm²)
  3. Number of follicular units increased (up to ~19%) (Fig 1)

Figure 1: Effect of ADSC‑CM on Positive Hair Parameters in Different Scalp Regions

Test used: Paired t-test; *Statistically significant result (p<0.05).

Reduction in disease severity

Table 1: Effect of ADSC‑CM on Negative Hair Parameters in Different Scalp Regions

Parameter	Region	Mean Change	p-value
% Thin hair	Frontal	−1.06	0.100
	Temporal	−1.88	0.052
	Occipital	−2.50	<0.001*
% Medium hair	Frontal	−0.22	0.826
	Temporal	−1.14	0.277
	Occipital	−3.32	0.001*
Sinclair scale	Frontal	−0.21	<0.001*
	Temporal	−0.31	<0.001*
	Occipital	−0.36	<0.001*

70%–92% of patients showed positive improvement depending on the parameter and scalp region (Figure 2)

Figure 2: Favourable response rate by parameters and scalp region

• Other hair quality improvements
• Increase in average hair thickness and proportion of thick hairs
• Decrease in thin hair percentage (in some regions) 
• Age did not affect outcomes
• No significant difference between idiopathic vs secondary telogen effluvium (p>0.05)
• Safety
  1. No major adverse effects reported
  2. Good tolerability in all patients

Conclusion

Adipocyte-derived mesenchymal stem cells-conditioned media therapy leads to significant hair regrowth with high response rates and strong improvements in density, thickness, and disease severity in telogen effluvium.

Reference

Stem Cells Cloning: Adv. Appl. 2023:16 77–89