Background: Management of Alopecia Areata (AA) is often challenging as patients may be unresponsive to conventional treatments such as corticosteroids, contact immunotherapy, minoxidil, phototherapy and systemic therapy. Because adipocyte derived stem cell (ADSC) conditioned media contains several growth factors which can activate hair follicles and regenerate hair growth, it can be alternative therapeutic option for chronic refractory AA. Objectives: This study aimed to evaluate the efficacy of adipocyte-derived stem cell conditioned media (SCM2®- Black) for chronic refractory AA. Methods: Nine male patients (26~46 years old, mean age 36.8 years) with chronic, treatment-refractory AA who were treated with adipocyte-derived stem cell conditioned media in conjuction with fractional laser or microneedling from March 2017 were evaluated retrospectively. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy. Results: Hair regrowth over 50% of scalp was observed in 6 patients (67% of the patients), with five complete hair regrowth (56% of the patients). Mean period to achieve more than 50% hair regrowth was 14 weeks. 2 patients showed no more than 25% of response, and 1 patients had no response among them. Conclusion: we suggest that adipocyte-derived stem cells conditioned media in conjuction with fractional laser therapy and microneedling could be one of the efficient treatment option for chronic refractory AA.