Originally developed for wound repair, ACell’s extracellular matrix (ECM) technology is now being used by forward-thinking clinics to support everything from chronic ulcer closure to hair follicle regeneration.
At ForHair, we’ve used ACell in combination with blood-derived treatments to help patients achieve visible, lasting results, especially those seeking non-surgical options or enhanced healing from follicular unit excision (FUE).
This guide explores the science behind ACell, how it works, and what the latest research tells us about its effectiveness in both hair restoration and advanced wound healing. You’ll find real-world outcomes, treatment timelines, and important considerations to help you decide if ACell is right for your needs.
Key Takeaways
- ACell® UBM is a porcine-derived scaffold that signals your body to regenerate rather than scar.
- It’s FDA-cleared for wound healing and surgical repair, and widely used off-label for hair restoration.
- When paired with PRP or CRP, most patients see visible thickening in 3–6 months.
- It’s also helping advance bladder repair, tendon healing, and biologic hernia meshes.
What Is ACell UBM?
Composition & FDA-cleared Indications
ACell’s core material is Urinary Bladder Matrix (UBM), derived from the innermost lining of porcine bladder. This decellularized matrix retains structural proteins like collagen and laminin but removes all cells to avoid rejection. It’s marketed under names like Cytal®, MicroMatrix®, and Gentrix®.
The FDA has cleared ACell’s UBM products for:
- Chronic wounds (including diabetic foot ulcers and pressure sores)
- Surgical soft-tissue repair (hernia reinforcement, graft bolstering)
- Burn management and trauma wounds
Its use in hair restoration, however, is considered off-label.
Mechanism: Scaffold, Angiogenesis, Stem Cell Signaling
Now that we know what UBM is, let’s look at how it works once it enters the body.
Think of ACell as a regenerative scaffold. When applied to damaged tissue, it provides a 3D matrix that guides your body to build new, healthy tissue. Rather than forming scar tissue, your immune cells, stem cells, and fibroblasts migrate into the matrix.
The matrix helps:
- Recruit M2 macrophages (healing phenotype)
- Stimulate angiogenesis (formation of new blood vessels)1
- Encourage stem cell signaling for tissue-specific regeneration
Over time, your body remodels the scaffold into functional tissue—a process known as constructive remodeling.2
Hair-Restoration Applications
ACell + PRP / CRP: 70–80% Visible Thickening @ 3–6 Months
At ForHair, we’ve used ACell alongside PRP and our proprietary CRP (cytokine-rich plasma) to restore thinning hair. In our experience—and backed by data from other leading clinics—the majority of patients see visible improvements by month 3 to 6.
These results include:
- Increased hair thickness and diameter
- Reduced shedding
- Better scalp coverage in miniaturized areas
The ECM seems to amplify PRP’s effects, giving the follicles both a regenerative signal and a structural framework to repair.
FUE Adjunct: Donor-Site Healing & Graft Survival Data
But its role doesn’t stop with non-surgical thickening. We also use ACell during transplant procedures to promote healing and boost graft success. When applied to the donor area, it speeds up wound closure and can even rejuvenate some partially damaged follicles. As a result, we see less visible scarring and a potentially larger usable donor zone over time.
In recipient areas, ACell is combined with PRP to improve:
- Graft survival
- Early growth (as soon as 3–4 months post-op)
- Texture and caliber of transplanted hairs In my practice, I regularly see patients achieve a 99% graft yield by month 4.5, which is earlier than what we typically see without ACell.
Body Hair Yield Following ACell Administration – Case Study
By John P. Cole, MD, 2011
To better understand ACell’s potential in challenging scenarios, I conducted a controlled case study testing its impact on body hair yield in scarred donor areas.
I compared the yield from beard hair transplanted to a donor area strip scar pretreated with ACell to the yield of chest hair transplanted to a donor area strip scar that was not pretreated with ACell.
The objectives of the study were to evaluate the yield of two different sources of hair and to see if ACell offered any potential increase in the survival rate of body hair.
Findings
The use of ACell resulted in a 92% yield for beard hair in the donor area scar at 6 months. The absence of ACell resulted in a 0% yield for chest hair in the donor area scar at 6 months.
Methods:
I selected a patient with four distinct strip scars on the donor area. Two of these were used for comparison. One midline scar (0.5 cm x 7 cm), located in Boxes 1 and 5 (per Donor Area Mapping4,5), was treated with 50 beard hair grafts. Another scar (0.4 cm x 3.5 cm) in Box 6 received 6 chest hair grafts.
Recipient sites were created using a 1.3 mm solid core needle mounted on a Counting Incision Device (Cole Instruments). I harvested 50 anagen beard grafts—25 from each side of the neck—using a 0.9 mm punch set to 2.3 mm depth. Chest hair grafts (n=6) were extracted using the same punch, set to 2.4 mm.
Prior to implantation, I injected 2 cc of ACell solution (1 mg/cc) into the full thickness of the scar designated for beard hair grafts. The chest hair recipient site received no ACell treatment.
Results:
Six months post-transplant, I evaluated graft survival in both treated scars. Using a Gentian Violet marker affixed to a Counting Incision Device (CID), I marked and recorded each growing hair at the base of the graft site for accurate tracking.
In the ACell-treated scar, 46 out of 50 beard hair grafts showed visible growth, indicating a 92% yield. In contrast, none of the 6 chest hair grafts in the untreated scar exhibited growth, resulting in a 0% yield.
Key Insights
1. Beard Hair Outperforms Chest Hair in Yield and Coverage
- Beard hair demonstrated a 92% survival rate when pre-treated with ACell, significantly outperforming chest hair (0% yield without ACell).
- Beard hair also has structural advantages: thicker diameter and natural wave, which provide better visual density and volume compared to other body hair types.
2. ACell May Enhance Graft Survival
- The application of ACell appeared to improve beard hair graft yield beyond previously observed rates (typically ~60%).
- While chest hair without ACell showed no survival, anecdotal and prior informal observations suggest ACell might improve even lower-yielding body hair types.
- More controlled studies are needed to isolate ACell’s true impact across various body hair sources.
3. Scar Tissue Is a Reliable Testing Site
- Strip scars are hairless and biologically stable, making them ideal for measuring transplant yields.
- Unlike bald scalp zones, scars avoid confounding variables like dormant or exogen hairs that can affect yield accuracy.
4. Hair Growth Rate Supports Early Anagen Onset
- Many transplanted beard hairs were 6 cm long at 6 months, suggesting early return to anagen or enhanced growth rates.
- Growth rates are consistent with or exceed typical beard/scalp hair averages, but it’s unclear whether ACell influenced growth speed or just survival.
5. Precision Tools Improved Accuracy
- The use of the Counting Incision Device (CID) with Gentian Violet markers enabled highly accurate hair growth tracking, addressing a major limitation in most yield studies.
6. Density Impacts Body Hair Survival
- Lower density placement improves body hair graft survival. This study controlled for density to isolate other variables like ACell use and hair source.
7. Cosmetic Considerations Matter
- Despite strong survival, beard hair’s texture and curl may contrast with native scalp hair in some patients, affecting aesthetic outcomes.
- Beard hair is generally preferred when volume is a priority, especially in patients with limited scalp donor reserves.
Off-Label Considerations & Informed Consent
Of course, it’s important to be transparent about how ACell is used in practice, especially when it goes beyond FDA-cleared indications.
While ACell is FDA-cleared for wound healing, its use in hair restoration is technically off-label. We make that clear in our consultations. Patients receive informed consent outlining the experimental nature of the treatment, its safety record, and what to expect.
In expert hands, off-label use is common and ethically sound, but as always, transparency matters.
Other Applications
Outside of hair restoration, ACell continues to show impressive healing potential in clinical wound care and surgical repair.
Chronic Ulcers Case Series – Complete Closure ≤ 13 Weeks
A landmark case series in the Journal of the American College of Certified Wound Specialists (2010) treated 3 patients with severe, non-healing wounds (including diabetic foot ulcers) using MatriStem UBM.
Result: All wounds achieved full closure with complete epithelialization and minimal scarring by 13 weeks after initial treatment.
Notably, these ulcers had previously failed months of standard therapy. After repeated UBM applications, robust granulation tissue formed, and the wounds closed in roughly 9–13 weeks, which is remarkably fast given the chronicity.
This early report suggested UBM could “reset” the healing process in chronic ulcers, even resulting in tissue quality closer to normal skin (with less scar) when healed.
These findings were supported by later research, such as Alvarez’s paper from 2017.
The results showed that patients treated with UBM in addition to a total contact cast (TCC) had significantly faster wound healing (mean of 62.4 days vs. 92.8 days in the control group) and a higher incidence of healing at 12 and 16 weeks. Furthermore, the UBM group experienced a lower rate of ulcer recurrence at one year (10% vs. 50% in the control group).
Partial-Thickness Burns – Re-Epithelialisation in 5–7 Days
Burns are another area where fast, scar-minimizing healing makes all the difference—and ACell performs well here, too.
One study using MatriStem® on partial-thickness burns showed new skin formation began in 5 days. By day 29, the burns had fully healed, without skin grafting or hypertrophic scarring.8
Diabetic Foot & Pressure-Ulcer Reimbursement Status (LCD L36690)
Medicare recognizes ACell under LCD L36690, meaning it’s reimbursed for:
- Diabetic foot ulcers
- Venous leg ulcers
Coverage typically kicks in when the wound hasn’t improved after 4 weeks of standard care. UBM can then be applied weekly or biweekly, with up to 8 covered applications per wound.
Emerging Regenerative Indications (2023–25)
Bladder-Tissue Engineering Breakthroughs (Front. Bioeng. Biotech 2025)
UBM’s use is circling back to its source: the bladder. A 2025 review in Frontiers in Bioengineering described how UBM scaffolds seeded with exosomes or stem cells support bladder wall regeneration. In animal studies, this led to improved capacity and muscle integration, potentially paving the way for organ-level repair in urology.9
Tendon/Orthopaedic Repairs & Hernia Meshes
Orthopaedic surgeons are now using ACell as a biologic patch for rotator cuff and Achilles tendon repairs.10
In hernia surgery, the surgeon might apply UBM during the procedure. After closing as much of the fascia as possible, a Gentrix® UBM mesh is laid over the defect as an onlay or underlay to reinforce the repair. This is a one-time implant that will integrate over months.
Combination Strategies: ECM + Nanomedicine/Drug Delivery
Researchers are also experimenting with hybrid ECM strategies:
- UBM + silver nanoparticles to fight infection: Preclinical research supports that combining silver nanoparticles (AgNPs) with biomaterials—like scaffolds and wound matrices—can significantly reduce infection risk and inhibit biofilm formation by pathogens.11
- UBM + gene therapy vectors to stimulate growth factor production: Such delivery systems are being investigated in animal models to stimulate targeted healing by boosting growth factor production at the injury or repair site.
- UBM + stem-cell exosomes to enhance regenerative signaling: Animal models indicate that exosome-seeded matrices accelerate tissue repair, modulate inflammation, and improve integration of the graft, especially in musculoskeletal and urological tissues.12
These next-gen applications are still in preclinical stages but hint at a future of programmable, targeted healing.
ACell vs Other Regenerative Adjuncts
In regenerative dermatology and wound care, ACell isn’t the only game in town. Here’s how it compares:
Candidate Selection, Protocol & Expected Timeline
Best Hair Candidates:
- Early to moderate thinning (miniaturized follicles still present)
- Men and women with AGA who want non-surgical improvement
Wound Candidates:
- Chronic ulcers resistant to 4+ weeks of standard care
- Post-surgical wounds with delayed healing
ForHair Protocol (Hair):
- Extract blood; prepare CRP (high-cytokine plasma)
- Mix with powdered ACell (typically MicroMatrix®)
- Inject into the scalp under local anesthesia
Timeline:
- Month 1: Reduced shedding, early healing
- Month 3: Visible thickening in thinning areas
- Month 6: Maximal density and texture improvement
- Month 12+: Optional booster if needed
Risks, Limitations & Regulatory Status
ACell is considered safe and well-tolerated. However, like any medical treatment, it’s not risk-free.
Known Side Effects:
- Temporary swelling or soreness at injection sites
- Rare allergic reactions (porcine-derived)
- Rare granulomas or calcification (usually in large-volume surgical use)
- Regulatory Status:
FDA-cleared for wounds and surgical reinforcement - Off-label for hair restoration
Experienced clinics should walk patients through this distinction and provide clear, written consent.
FAQs
Is ACell safe for hair loss?
How long does it take to see results from ACell + PRP?
Can ACell regrow completely bald areas?
Is ACell covered by insurance?
How often do I need ACell treatments?
What is ACell made from?
What makes CRP different from regular PRP?
CRP is a ForHair-enhanced version of PRP with higher concentrations of healing cytokines.
Next Steps
ACell is helping patients restore confidence and quality of life. When paired with regenerative plasma or used in surgical settings, it gives your body the tools it needs to heal in a more natural, tissue-specific way.
If ACell sounds like a good fit, we’d love to help you explore your options further.
Bibliography
- Tallapaneni V, Kalaivani C, Pamu D, Mude L, Singh SK, Karri VVSR. Acellular Scaffolds as Innovative Biomaterial Platforms for the Management of Diabetic Wounds. Tissue Eng Regen Med. 2021 Oct;18(5):713-734. doi: 10.1007/s13770-021-00344-1. Epub 2021 May 28. PMID: 34048000; PMCID: PMC8440725.
- Dziki, J., Badylak, S., Yabroudi, M. et al. An acellular biologic scaffold treatment for volumetric muscle loss: results of a 13-patient cohort study. npj Regen Med 1, 16008 (2016). https://doi.org/10.1038/npjregenmed.2016.8
- “CRP + Acell Treatments | Platelet-Rich Plasma (PRP) | Forhair.” ForHair Hair Transplant Clinic, 12 June 2025, www.forhair.com/crp-acell-treatments/.
- Cole, J. Donor Area Mapping, ISHRS meeting Amsterdam, Holland, 2009.
- Devroye, Cole’s FUE safe area, Hair Transplantation, W.P. Unger, R.M. Shapiro, R. Unger, M. Unger, S. Zarl, eds. Informa Healthcare: London, 2010; 258.
- Kimmel H, Rahn M, Gilbert TW. The clinical effectiveness in wound healing with extracellular matrix derived from porcine urinary bladder matrix: a case series on severe chronic wounds. J Am Col Certif Wound Spec. 2010 Nov 30;2(3):55-9. doi: 10.1016/j.jcws.2010.11.002. PMID: 24527148; PMCID: PMC3601863.
- Alvarez, O.M., Smith, T., Gilbert, T.W., Onumah, N., Wendelken, M.E., Parker, R., & Markowitz, L. (2017). Diabetic Foot Ulcers Treated With Porcine Urinary Bladder Extracellular Matrix and Total Contact Cast: Interim Analysis of a Randomized, Controlled Trial. Wounds : a compendium of clinical research and practice, 29 5, 140-146 .
- Kim JS, Kaminsky AJ, Summitt JB, Thayer WP. New Innovations for Deep Partial-Thickness Burn Treatment with ACell MatriStem Matrix. Adv Wound Care (New Rochelle). 2016 Dec 1;5(12):546-552. doi: 10.1089/wound.2015.0681. PMID: 28078188; PMCID: PMC5165666.
- Zhang, Yi, et al. “Recent Advances in Innovative Biomaterials for Promoting Bladder Regeneration: Processing and Functionalization.” Frontiers in Bioengineering and Biotechnology, vol. 12, 6 Jan. 2025, pmc.ncbi.nlm.nih.gov/articles/PMC11743525/, https://doi.org/10.3389/fbioe.2024.1528658. Accessed 17 July 2025.
- Wen, Huawei, and Yushun Fang. “Acellular Porcine Achilles Tendon Patch Encapsulating Tendon-Derived Stem Cells for Rotator Cuff Repair in a Rabbit Model.” Scientific Reports, vol. 14, no. 1, 27 Mar. 2024, p. 7257, www.nature.com/articles/s41598-024-57495-z, https://doi.org/10.1038/s41598-024-57495-z. Accessed 17 July 2025.
- Nam, Geewoo, et al. “The Application of Bactericidal Silver Nanoparticles in Wound Treatment.” Nanomaterials and Nanotechnology, vol. 5, Jan. 2015, p. 23, https://doi.org/10.5772/60918.
- Qindeel M, Barani M, Rahdar A, Arshad R, Cucchiarini M. Nanomaterials for the Diagnosis and Treatment of Urinary Tract Infections. Nanomaterials (Basel). 2021 Feb 22;11(2):546. doi: 10.3390/nano11020546. PMID: 33671511; PMCID: PMC7926703.
