This patient first came to see me in March 2019. She had experienced two years of hairline and eyebrow thinning by that point, which was associated with other symptoms: itching, the skin on her forehead was very smooth, and there was evidence of peripilar casts. A scalp biopsy confirmed my suspicions with a diagnosis of Frontal Fibrosing Alopecia (FFA). From March of 2019 to June 2020, she followed a protocol consisting of several rounds of treatments and medications to tackle FFA. Still, she continued to lose density in her frontal hairline.
In June 2020, I began using bone marrow mesenchymal stem cell exosomes to treat alopecia. Although I could not find any literature describing its use in FFA, I offered this treatment to my patient because of the exosomes' potent anti-inflammatory properties, and her treatment was done in June 2020.
As you can see from March 2019 to June 2020, she continued to lose density in her frontal hairline. Her exosome treatment was in June 2020, and as you can see picture to picture, by the end of August 2020, the small raised peripilar casts at the base of many follicles (present since March 2019) have disappeared. Also, comparing each photo taken after her exosome treatment, it appears by the end of August 2020, her density has also increased.This will be a continuing story as we battle FFA, but at present, she seems to be responding better to the exosomes than the previous treatments.