Protocol summary

Study aim
Determining the efficacy and side effects of exosome therapy compared to mesotherapy in patients with pattern hair loss
Design
An open-label, phase 2–3 randomized clinical trial will be conducted on 60 patients. Simple randomization using the block balanced randomization method will be applied, and the randomization list will be generated via the website [randomization.com](http://www.randomization.com).
Settings and conduct
Patients with pattern hair loss who meet the inclusion criteria will be recruited from the dermatology clinic at Bouali Hospital,in Sari, Mazandaran Province, Iran
Participants/Inclusion and exclusion criteria
Age range:18 to 60 years ,type of hair loss: Male and female pattern hair loss based on the Hamilton and Ludwig scales, Lack of satisfactory response to medications, follicular unit transplantation, and hormonal therapies, History of autoimmune diseases ,Diabetes mellitus ,Pregnancy and breastfeeding ,Previous allergic reaction to treatment components, Diagnosis of telogen effluvium or other types of alopecia (e.g., alopecia areata)
Intervention groups
Group A will include patients receiving exosome therapy alone, administered once a month for three months. Group B will include patients receiving a combination of exosome therapy and mesotherapy, administered once a month for three months. Group C will include patients receiving mesotherapy alone، administered once a month for three months All patients will be evaluated one month after the final treatment session to assess their response to therapy.
Main outcome variables
PGAIS(Patient Global Aesthetic Improvement Scale)

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20160427027636N8
Registration date: 2025-08-02, 1404/05/11
Registration timing: prospective

Last update: 2025-08-02, 1404/05/11
Update count: 0
Registration date
2025-08-02, 1404/05/11
Registrant information
Name
Ghasem Rahmatpour Rokni
Name of organization / entity
Mazandaran University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 11 3322 1755
Email address
gh.rahmatpour@mazums.ac.ir
Recruitment status
recruiting
Funding source
Expected recruitment start date
2025-08-23, 1404/06/01
Expected recruitment end date
2026-08-23, 1405/06/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Efficacy and safety of exosome therapy versus mesotherapy on male and female pattern hair loss: Randomized controlled trial
Public title
Efficacy and safety of exosome therapy versus mesotherapy on male and female pattern hair
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
"Man and woman aged 18 to 60 years, healthy and not pregnant" "Male pattern hair loss (MPHL) grade III to IV based on the Norwood-Hamilton scale" "Female pattern hair loss (FPHL) with early localized or diffuse hair loss corresponding to grade I-3 to III based on the Ludwig scale" Patients who are in a stable state of improvement or worsening after one year of treatment with medications such as minoxidil, finasteride, dutasteride, and spironolactone, or who continue to experience hair loss after six months of medication use. Patients who have undergone follicular unit extraction and transplantation and experience hair thinning and shedding in both the transplanted and non-transplanted areas of the scalp one year after surgery. Patients undergoing treatment and monitoring for estrogen, progesterone, testosterone, and other pituitary or thyroid replacement therapies, yet continue to experience hair thinning and shedding. Willingness and ability to provide written informed consent for photography and authorization prior to undergoing any study-related procedures.
Exclusion criteria:
Age
From 18 years old to 60 years old
Gender
Both
Phase
1-2
Groups that have been masked
No information
Sample size
Target sample size: 60
Randomization (investigator's opinion)
Randomized
Randomization description
A patient randomization list will be generated using the balanced block randomization method with the help of an online randomization website. Then, a list will be generated using the original generator section of *randomization.com* with blocks of 6. These will be placed sequentially into sealed envelopes. After preparing the sealed envelopes, the list will be destroyed. Patients will be randomly assigned in a 1:1:1 ratio into one of three groups. Group A will include patients who will receive *exosome therapy alone*, once a month for three months. Group B will include patients who will receive a *combination of exosome therapy and mesotherapy, once a month for three months. Group C will include patients who will receive *mesotherapy alone*, once a month for three months. All patients will be evaluated one month after the final intervention session to assess their response to treatment.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics Committee, Mazandaran University of Medical Sciences
Street address
Mazandaran University of Medical Sciences, Moalem square
City
Sari
Province
Mazandaran
Postal code
4741948178
Approval date
2025-07-12, 1404/04/21
Ethics committee reference number
IR.MAZUMS.REC.1404.145

Health conditions studied

1

Description of health condition studied
Androgenetic alopecia with male and female pattern hair loss
ICD-10 code
L64
ICD-10 code description
Androgenetic alopecia (male and female pattern hair loss)

Primary outcomes

1

Description
Blinded investigator global aesthetic improvement scale
Timepoint
Assessments will be conducted at baseline, monthly after each injection for a total of three months, and once more in the fourth month, which corresponds to one month after the final treatment session.
Method of measurement
Ludwig and Hamilton scale questionnaire

Secondary outcomes

1

Description
patient satisfaction
Timepoint
"At the end of four months from the start of the intervention"
Method of measurement
Questionnaire

2

Description
Patient global aesthetic improvement scale
Timepoint
"At the end of four months from the start of the intervention"
Method of measurement
Questionnaire

3

Description
reported side effects
Timepoint
"At the end of four months from the start of the intervention"
Method of measurement
questionnaire

Intervention groups

1

Description
Intervention group: Group A will include patients who receive exosome therapy alone once a month for three months
Category
Treatment - Drugs

2

Description
Intervention group: Group B will include patients who receive a combination of exosome and mesotherapy once a month for three months.
Category
Treatment - Drugs

3

Description
Intervention group: Group C will include patients who receive mesotherapy alone once a month for three months
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Clinic of Dermatology, Bou-Ali Sina Hospital
Full name of responsible person
Ghasem Rahmatpour Rokni
Street address
Mazandaran Province, Sari, Pasdaran Blvd, H23J+9PJ, 48158 38477, Iran
City
Sari
Province
Mazandaran
Postal code
4815838477
Phone
+98 11 3334 3011
Fax
+98 11 3334 3011
Email
Bou_Ali_hospital@mazums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Mazandaran University of Medical Sciences
Full name of responsible person
Ahmad Ali Enayati
Street address
Mazandaran University Of Medical Sciences, The beginning of the highway Valiasser, Joybar Three-way, Imam (AS) square
City
Sari
Province
Mazandaran
Postal code
4878415466
Phone
+98 11 3434 7021
Email
ethics@mazums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Mazandaran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Mazandaran University of Medical Sciences
Full name of responsible person
Ghasem Rahmatpour Rokni, MD
Position
Assistant Professor of Dermatology
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Bualisina Hospital, Pasdaran Boulevard, Sari
City
Sari
Province
Mazandaran
Postal code
3847748158
Phone
+98 11 3334 2334
Fax
Email
dr.rokni@yahoo.com
Web page address

Person responsible for scientific inquiries

Contact
Name of organization / entity
Mazandaran University of Medical Sciences
Full name of responsible person
Ghasem Rahmatpour Rokni
Position
Assistant Professor of Dermatology
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Bu-Ali Sina hospital
City
Sari
Province
Mazandaran
Postal code
3847748158
Phone
+98 11 3322 1755
Fax
Email
dr.rokni@yahoo.com
Web page address

Person responsible for updating data

Contact
Name of organization / entity
Mazandaran University of Medical Sciences
Full name of responsible person
Ghasem Rahmatpour Rokni
Position
Assistant Professor of Dermatology
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Bu-Ali Sina hospital
City
Sari
Province
Mazandaran
Postal code
3847748158
Phone
+98 11 3322 1755
Fax
Email
dr.rokni@yahoo.com
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
No - There is not a plan to make this available
Statistical Analysis Plan
No - There is not a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
No - There is not a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
Title: Dataset and Documentation for the Clinical Trial on Exosome Therapy vs. Mesotherapy for Hair Loss Details: The dataset includes de-identified individual participant data related to the primary outcome (blinded Investigator Global Aesthetic Improvement Scale, blinded-IGAIS) and secondary outcomes (Patient Global Aesthetic Improvement Scales, PGAIS; patient satisfaction; reported side-effects). Additional documentation includes the study protocol, statistical analysis plan, and case report forms. Only de-identified data will be shared to protect participant privacy. Aggregate data, such as summary statistics and results published in the final report, may also be shared.
When the data will become available and for how long
Data and documentation will be available starting 6 months after the publication of the primary study results and will remain accessible for a period of 5 years.
To whom data/document is available
Access to the data and documentation will be restricted to academic researchers affiliated with recognized universities or research institutions. Requests from industry researchers may be considered on a case-by-case basis, provided they demonstrate a clear scientific purpose aligned with the study’s objectives.
Under which criteria data/document could be used
The data and documentation may be used for non-commercial research purposes, such as secondary analyses, meta-analyses, or validation studies, provided they align with the original study’s objectives. Users must agree to: Not attempt to re-identify participants. Use the data solely for the approved research purpose. Cite the original study and acknowledge Mazandaran University of Medical Sciences in any publications or presentations. Submit a formal request detailing the intended use, including the proposed analysis plan. Sign a data use agreement ensuring compliance with ethical standards and data protection regulations. Requests will be reviewed by the study’s principal investigator and the Mazandaran University of Medical Sciences Research Ethics Committee.
From where data/document is obtainable
Requests for data or documentation should be directed to the principal investigator, Dr. Ghasem Rahmatpour Rokni, via email at dr.rokni@yahoo.com Vice-Chancellor for Research and Technology Mazandaran University of Medical Sciences Moallem Square, Sari, Mazandaran, Iran Phone: 09125443956 Requests can also be submitted through the university’s research portal: [insert website, if applicable]. The principal investigator or a designated member of the research team will respond to inquiries.
What processes are involved for a request to access data/document
Applicants must submit a formal request via email or the university’s research portal, including a detailed proposal outlining the intended use of the data/documents, the research objectives, and the proposed analysis plan. The request will be reviewed by the principal investigator and the Mazandaran University of Medical Sciences Research Ethics Committee within 4 weeks. If approved, the applicant will be required to sign a data use agreement. De-identified data and/or documentation will be provided in a secure format (e.g., encrypted files) within 2 weeks of agreement signing. The entire process, from request submission to data delivery, is expected to take approximately 6–8 weeks, barring unforeseen delays.
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