Hair Repigmentation Outcomes in Patients With Graying Hair Treated With Exosome Therapy: A Cross‐Sectional Observational Study

ABSTRACT Background Hair graying is an age‐associated condition primarily caused by the depletion and dysfunction of melanocyte stem cells within hair follicles. Emerging regenerative strategies, including exosome‐based therapies, offer the potential to restore pigmentation by targeting underlying cellular mechanisms. Objective To investigate the clinical outcomes and correlates of hair repigmentation following exosome‐based therapy in individuals with gray hair. Methods This cross‐sectional observational study enrolled 10 patients with visible gray or white hair who were treated with rose stem cell‐derived exosomes (RSCEs) using various procedures. Gray hair repigmentation outcomes were assessed using a standardized scale. Statistical correlations between clinical variables and treatment responses were analyzed. Results A mean of 4.6 ± 1.3 treatment sessions was performed. Repigmentation was observed after an average of 2.4 ± 0.7 sessions and was maintained for 4.7 ± 1.9 months. The various treatment modalities also demonstrated efficacy in both hair regrowth and hair repigmentation. The mean outcome score was 2.8 ± 0.78, with 60% achieving a higher‐grade response (≥ 50% improvement). Shorter duration of graying ( p = 0.0363), presence of androgenetic alopecia (AGA) ( p = 0.0332), and moderate baseline severity (Stage 2) ( p = 0.0133) were significantly associated with better outcomes. No adverse events were reported. Conclusion Exosome‐based therapy appears to be a safe and promising approach for inducing hair repigmentation in individuals with gray hair using various treatment modalities. Factors such as the presence of AGA, shorter duration of graying, and moderate baseline severity may predict a better response. Larger, controlled studies are warranted to validate these findings and help standardize treatment protocols.