PDO-Based Thread-Embedding Therapy for Hair Loss Management : Mechanistic Hypotheses

Traditional thread-embedding (Maeseon) therapy has been applied in soft-tissue regeneration, yet its mechanistic relevance to hair loss remains incompletely defined. This narrative mechanistic review proposes an immuno-regenerative hypothesis in which polydioxanone (PDO) bioabsorbable threads may modulate the scalp microenvironment. Available evidence suggests that PDO-associated tissue responses could promote a shift from M1-dominant inflammation toward M2-mediated repair, accompanied by regulation of oxidative stress, enhancement of IL-10–related signaling, and suppression of NF-κB activity. PDO degradation may further contribute to extracellular matrix remodeling and VEGF-related microvascular adaptation, potentially creating conditions supportive of follicular regeneration. Overall, PDO-based threads may function not only as structural scaffolds but also as bio-responsive modulators of immune balance. However, this review is hypothesis-generating and does not establish clinical efficacy; further experimental and clinical validation is required to determine its relevance for hair loss management.