Groundbreaking mRNA treatment offers hair loss recovery for millions worldwide

For decades, treatments for thinning hair have been stuck in a narrow lane. You either rub on minoxidil, a lotion that boosts blood flow to the scalp, or take finasteride, a pill that blocks hormones that shrink hair follicles. Both can help, but neither offers a permanent fix. The moment you stop, the results usually fade.

That’s why scientists around the world have been searching for a better, more lasting solution—and a team from North Carolina State University may have just found a promising new direction.

At the center of their research is a molecule so small you can’t see it without advanced tools. It’s called miR-218-5p, and it’s part of a family of microRNAs—tiny fragments of genetic material that help regulate how genes are turned on or off. What makes this one special is its powerful role in waking up hair follicles that have gone dormant.

Every hair on your head starts its journey in a follicle. At the bottom of each follicle sits a cluster of cells known as dermal papilla, or DP cells. These cells act as managers, telling the follicle when to rest and when to grow. In your body, DP cells perform this job well. But when scientists take them out and grow them in a flat dish, they quickly lose much of their ability to trigger new hair growth.

The NC State team, led by biomedical scientist Ke Cheng, took a different approach. Instead of growing the cells in a flat, two-dimensional layer, they let them cluster together in three-dimensional groups called spheroids. These tiny balls of cells behave much more like they do in real hair follicles. In fact, when researchers placed them on a keratin scaffold—a supportive protein structure—the DP spheroids regained a remarkable ability to spark hair regrowth.

“The 3D cells in a keratin scaffold performed best,” Cheng explained. “The spheroid mimics the hair microenvironment, and the keratin scaffold acts as an anchor, keeping the cells where they’re needed.”

The big question was why the 3D spheroids worked so much better. To find out, the team studied what the cells released into their surroundings. DP cells don’t just communicate directly—they also send out exosomes, tiny bubble-like packets filled with proteins, genetic material, and other signaling molecules.

Inside those exosomes, the researchers found something striking. Compared to cells grown flat in a dish, the 3D spheroids produced exosomes with about 25 times more miR-218-5p. This surge suggested that the microRNA might be a key player in moving follicles from their resting state, known as telogen, into the growth phase, called anagen.

To test the idea, scientists turned to mice, a standard model in hair research. The animals had their fur shaved so regrowth could be easily tracked. Some were treated with standard minoxidil, others with 2D DP cells, and another group with exosomes from the 3D spheroids.

The results were dramatic. Mice treated with spheroid-derived exosomes quickly regrew almost all their fur, outperforming both minoxidil and the 2D cell treatment. In some cases, nearly full coverage was achieved within 15 to 20 days.

Further tests showed why. The miR-218-5p molecule boosted activity in the Wnt/β-catenin signaling pathway, which plays a central role in pushing follicles into growth mode. At the same time, it lowered levels of SFRP2, a natural blocker in that pathway. In other words, the microRNA tilted the balance heavily toward hair regrowth.

When researchers injected synthetic versions of miR-218-5p, the same growth-boosting effect was seen. Blocking the molecule reversed the results, slowing or halting regrowth. The strongest results, however, came when the full exosomes were used, suggesting other molecules inside them also played supporting roles.

The idea of injecting live DP cells into the scalp has been explored before, but it’s complicated. Growing, expanding, and keeping those cells alive long enough to work is not easy. There are also concerns about how long they last after being injected.

Exosomes, on the other hand, sidestep many of these challenges. They are cell-free, easier to handle, and could even be turned into topical treatments like creams, sprays, or patches. That would make them far more user-friendly than surgery, injections, or daily pills.

“Cell therapy with the 3D cells could be an effective treatment for baldness,” Cheng said. “But you have to grow, expand, preserve and inject those cells into the area. MiRNAs, on the other hand, can be utilized in small molecule-based drugs. So potentially you could create a cream or lotion that has a similar effect with many fewer problems.”

Hair loss isn’t just a cosmetic concern—it can take a deep emotional toll. It affects millions of men and women worldwide, leading to feelings of insecurity, anxiety, and lowered self-esteem. Current treatments can slow loss or spark limited regrowth, but none guarantee lasting results. Surgery, while effective for some, carries risks like scarring and high costs.

That’s why this research feels like a breakthrough. For the first time, scientists are uncovering a clear molecular signal that could be harnessed into a safe, simple therapy. If developed into a cream or gel, a treatment based on miR-218-5p or exosome technology could change the way hair loss is managed.

Of course, moving from lab mice to people is a big leap. The study used healthy mice, not models of hormone-driven hair loss or age-related thinning. Human hair loss is complex, often involving genetics, hormones, and other factors. Scientists will need to test whether miR-218-5p works in these more realistic conditions.

There are also questions about which cells in the follicle actually respond to the exosomes. Pinpointing the exact targets will help researchers fine-tune the treatment. Delivery is another hurdle. The current experiments used injections with chemical helpers, but for everyday use, patches or lotions will be far more practical.

The findings, published in Science Advances, highlight what could be a turning point in the field. The study was supported by the National Institutes of Health, the American Heart Association, and equipment funded by the National Science Foundation. Cheng served as the corresponding author, with postdoctoral researcher Shiqi Hu as first author.

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