Abstract
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Background: Androgenetic alopecia (AGA) is the most common form of hair loss in men, characterized by progressive follicular miniaturization driven by androgen sensitivity and genetic predisposition. Although topical minoxidil and oral 5α-reductase inhibitors may slow progression, responses are variable and long-term adherence can be challenging. Regenerative medicine has therefore gained interest, particularly mesenchymal stromal cell–based approaches that may support follicular repair through paracrine signaling. We report a male AGA case treated with intradermal umbilical cord–derived mesenchymal stromal cell (UC-MSC) injection prepared under GMP conditions.
Observation: The patient is a 35-year-old male with progressive patterned scalp hair loss consistent with AGA predominantly involving the frontal hairline and vertex (Hamilton–Norwood stage IVA). He had no prior treatment history for AGA and sought intervention due to ongoing thinning. UC-MSCs were obtained from full-term umbilical cord tissue with written parental consent and donor screening, and processed in a GMP-certified facility in accordance with local regulatory standards. The patient received a single intradermal scalp injection of 1.5 mL cell suspension containing 1.1×10? cells in normal saline using a 31-G needle, distributed across the affected scalp areas. As adjunctive therapy, topical 5% minoxidil spray (2–3 sprays per application, twice daily) was administered to promote scalp vasodilation and enhance follicular blood supply, potentially supporting anagen maintenance. A secretome-based hair growth serum was applied three times weekly to provide bioactive factors associated with MSC paracrine activity, which may support follicular signaling and tissue repair. Ketoconazole 2% shampoo, used once weekly, was included for its antifungal and anti-inflammatory properties and its potential role in reducing scalp inflammation, although its direct anti-alopecia effect remains incompletely defined. At one-month follow-up, the patient reported reduced hair shedding with early visible improvement in hair thickness and coverage (Hamilton–Norwood stage III). No immediate adverse events were observed.
Key message: This case illustrates the feasibility of GMP-prepared UC-MSC scalp injection as a regenerative approach for male AGA, with early clinical improvement after a single session. The observed response is biologically plausible given MSC-mediated paracrine effects that may modulate perifollicular inflammation, enhance angiogenesis, support dermal papilla signaling, and prolong anagen. Adjunctive therapies were employed to support the scalp microenvironment but should be considered complementary rather than primary drivers of the observed response. Prospective controlled studies are required to clarify the independent contribution of UC-MSC therapy, optimize dosing and treatment intervals, and establish long-term safety and durability.
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