Last updated: 2026-08-20
What comes first when the scalp is red and itchy?
If your scalp becomes oily and itchy soon after washing, or if the skin around the hair follicles looks red, scalp inflammation (scalp dermatitis) needs to be treated first. When thick scale has built up or there are scratch marks and oozing, medication and scalp care are used first to reduce redness and itching. If sebum and scale have simply accumulated without signs of irritation such as wounds or oozing, a deep-cleansing head spa may be added to the plan.
Once wounds heal and redness and itching settle, hair thickness and the width of the part line are checked again. This includes comparing whether hair loss caused by the inflammation has decreased and whether short new hairs are regrowing in the same spots. If redness has improved but the part line keeps widening and thinner hairs increasingly appear among thicker ones, hair loss treatment is added alongside inflammation care.
Following this order makes it possible to distinguish what changed from treating the inflammation and adjusting the scalp environment alone versus what changed after adding exosome injections. Starting several treatments at once while inflammation is still present makes it hard to tell what caused changes in redness or shedding.
What do exosomes contain?
At Thewells, exosome injections are used together with other treatments for patients whose part line keeps widening and whose hair keeps thinning even after scalp inflammation has been treated. This involves medication suited to the type of hair loss and scalp care, along with injecting cell-derived signaling substances around the hair follicles.
Exosomes are small membrane-bound particles released by cells, containing proteins, lipids, and nucleic acids. Unlike methods that inject living cells, exosome treatments use substances that cells have produced, then separated and purified.
PRP (platelet-rich plasma) is prepared by drawing a patient's blood and isolating the platelet-rich layer. Mesotherapy involves injecting selected substances, such as PDRN, into multiple points on the scalp. Exosome treatment uses a product obtained through cell culture and then purified. Because blood draws, the substances used, and storage and preparation methods all differ between these approaches, one cannot rank them simply by name. The choice of what to inject depends on the scalp's redness, hair thickness, and treatments already underway.
In which conditions are exosome injections added?
Exosome injections may be added when scalp inflammation has resolved but hair follicles remain while hair continues to thin. This is especially considered when hair thickness decreases at the part line and crown, and when photos taken from the same angle show a widening area that looks sparse.
Exosome injections are not a substitute for hair loss medication. If a patient taking prescribed medication for male- or female-pattern hair loss develops uncomfortable symptoms, the clinician asks which medication was taken, at what dose, and when the symptoms began. Rather than stopping medication on one's own, the ingredient, dosage, method of use, and timing of discontinuation should be adjusted through a prescribing visit. Exosome injections can be added on top of this medication and scalp care.
If hair loss suddenly occurs all over the scalp, recent illnesses, weight changes, and medications are reviewed, and thyroid function and iron deficiency are tested. In particular, if acute diffuse hair loss begins after childbirth, injections are not decided on right away. The timing of delivery, whether breastfeeding, whether there was significant blood loss, iron deficiency, and sleep and diet are all checked. The natural course is also monitored, since hair that shifted into the resting phase after childbirth typically sheds heavily before the shedding gradually decreases. Only if hair continues to thin after the underlying cause has been treated and the amount of shedding has been confirmed is adding exosome injections considered.
How many sessions are needed, and what is compared?
At the first visit, photos are taken under the same lighting and at the same part-line position. The number of hairs growing from a single follicle and the proportion of thin hairs mixed among thicker ones are also recorded in the scalp chart. After injections, follow-up photos are taken under the same conditions and location to compare part-line width and hair thickness.
The decision to continue with another injection is not based solely on a feeling of tightness or lightness in the scalp right after a single session. The number of hairs collected in the drain while shampooing can vary depending on how many days have passed since the last wash and how the hair was brushed. Instead, changes in hair thickness and the size of sparse-looking areas are checked together using photos and scalp records taken under matching conditions.
These results guide the next step in treatment. If hair thickness and part-line width continue to improve, injections continue; once the condition stabilizes, the expected interval is reviewed and visits may be spaced out further. If redness, itching, or scale return, the number of injections is not increased—inflammation treatment is resumed instead. If shedding continues to increase, the cause of hair loss and medication history are reviewed again.
Even products labeled "exosome" can differ in the source cells and separation/purification methods used. Before treatment, it helps to confirm the product name, source cells, storage conditions, preparation method after opening, and expected treatment interval. Records are checked at each visit to confirm whether the same product was used as before. Manufacturing, isolation, purification, and standardization have been reported as important factors for clinical application.[^1]
Research on aging and age-related conditions should not be read as evidence proving effectiveness for hair loss treatment specifically.[^2]
Patients should also report any itching or oozing and whether scalp inflammation is currently being treated. The clinician checks any hair loss medications being taken, medications that affect blood clotting, and pregnancy/breastfeeding status, and records the product name and date of any previous PRP or mesotherapy treatments. If swelling or redness lasts longer than expected after a procedure, or if warmth and pain worsen, the next injection is postponed. The scalp is re-examined for inflammation before the treatment plan and interval are adjusted.
Frequently Asked Questions
Q. What is contained in exosome injections?
They contain a product made by separating and purifying substances released by cells. The product includes cell-derived materials such as proteins, lipids, and nucleic acids. This is not a treatment that directly injects living stem cells.
Q. In what condition is scalp exosome injection added to treatment?
It may be added once scalp inflammation has resolved but hair continues to thin even though follicles remain. This is done alongside medication suited to the type of hair loss and scalp care, while measuring hair thickness and comparing part-line width. It does not automatically replace prescribed hair loss medication.
Q. Can I get the injection right away if my scalp is red and itchy?
If there is redness, itching, thick scale, or wounds, scalp inflammation is treated first. If sebum and scale have built up, the clinician checks whether the scalp needs to avoid irritation and decides whether to add a deep-cleansing head spa. Only after wounds heal and inflammation decreases are hair thickness and part-line width reassessed and an injection date scheduled.
References
[^1]: Lee KWA, Chan LKW, Hung LC. Clinical Applications of Exosomes: A Critical Review. 2024. PMID: 39063033. [^2]: Li H, Bai L. Advances in mesenchymal stem cell and exosome-based therapies for aging and age-related conditions. 2025. PMID: 40713733.
This content is provided for medical information purposes only. Actual diagnosis and treatment may vary depending on individual scalp condition.