A lot has changed in the world of exosomes since we first reported on them two years ago. Here’s where things stand today, according to top doctors.
Featured Experts
- Saranya Wyles, MD, PhD is a board-certified dermatologist in Rochester, MN
- Marina Peredo, MD is a board-certified dermatologist in New York
What are exosomes?
Bridging the gap between aesthetics and regenerative medicine (similarly to platelet-rich plasma, or PRP), exosomes are lipid bilayer extracellular vesicles that contain growth factors, mRNA and miRNA. “Essentially, they’re just messages—a mixture of signals, or cell talk,” says Rochester, MN dermatologist Saranya Wyles, MD, PhD. “This is how cells communicate with each other, and we found a way to isolate them and bottle them up to share them as different products.” New York dermatologist Marina Peredo, MD explains that exosomes are known to target damaged cells to support skin rejuvenation and hair growth, and potentially reduce signs of aging. “I think exosomes are the new frontier in regenerative medicine.”
Exosomes are a very exciting addition to the regenerative aesthetics portfolio, but what we started learning was that they can be variable.
Dr. Saranya Wyles
What We Know Right Now
01 APPLYING EXOSOMES TOPICALLY CAN BE EFFECTIVE
Though there is ample uncertainty surrounding exosomes, research supports the efficacy of some topical application. “We published a clinical study in the Aesthetic Surgery Journal using a platelet-derived exosome product [Plated Skin Science INTENSE Serum] twice a day on patients 40 to 80 years old,” Dr. Wyles says. “The biggest improvement we saw was in redness, but patients also saw improvement in brown spots and luminosity, and reduced wrinkles.”
Dermatologists and plastic surgeons are also utilizing exosomes in the treatment room. They can be applied before a procedure to prime the skin—improve texture and tone—which can encourage better results. But, the most common way they’re being used is post-procedurally, after lasers and microneedling.
Dr. Peredo applies Exovex by ExoCel Bio, a serum using exosomes derived from placental stem cells, after Clear + Brilliant and Morpheus8 treatments, among others. “This serum has been shown to significantly reduce the discomfort, redness and downtime following these procedures by up to 80 percent, with ongoing benefits observed weeks post-treatment,” says Dr. Peredo. “The growth factors in exosomes have anti-inflammatory properties and continue to promote skin rejuvenation.” Another in-office serum derms favor is ExoCR from Cartessa Aesthetics. The exosomes in this formula are derived from Wharton’s Jelly, a tissue found in the umbilical cord.
And let’s not forget about the potential for exosomes in hair care. Dr. Peredo applies Exovex following the KeraLase laser hair treatment to support healthy hair growth. “We already know that platelets through PRP and PRF [platelet-rich fibrin] have a role in hair stimulation,” she says. “I think there’s a lot of promise in exosomes for hair growth.” Dr. Wyles agrees: “I think this is where platelet technology that is more refined using platelet exosomes can truly be a game changer.”
02 FDA REGULATION IS UNDERWAY
Today, exosomes can only be used to make cosmetic claims, such as, “this serum improves the look of the skin,” versus “reduces eczema.” Or, “this serum makes hair look thicker or fuller,” versus “stimulates hair growth.” Dr. Wyles explains that brands cannot say their exosome products benefit wound healing, eczema, acne scars, etc. because those are medical claims. “These claims need FDA approval, which no company has yet,” she says.
However, pre-clinical studies are showing promise in these areas. “At Mayo Clinic, we’re working on exosome clinical trials for eczema and showing incredible pre-clinical results. We’re also doing trials for patients with radiation wounds and chronic, non-healing wounds. All of these are under FDA surveillance, so I’m excited to get these treatments approved in the future. Then, we will be in a much safer zone to say what is valid or not. There is true potential in what exosomes can do in terms of improving skin health and so many medical conditions.”
03 EXOSOMES CAN’T BE INJECTED—YET
“If someone is injecting exosomes, that is illegal,” says Dr. Wyles. “Currently, there are no exosomes that are FDA-approved for injection. However, there are really good pre-clinical studies underway right now for this use. Companies like Rion, for example, have submitted their studies for FDA approval. Once we get that first approved injectable exosome product, it’s going to defray much of the caution surrounding the exosome space in regards to safety.” But, don’t expect this to happen quickly. Dr. Wyles predicts it could be 2030 before the FDA gives companies the green light.
04 THERE ARE DOWNSIDES
“Exosomes are a very exciting addition to the regenerative aesthetics portfolio, but what we started learning was that they can be variable,” says Dr. Wyles. “Exosomes can come from fat, platelets, bone marrow, umbilical cords, placenta, plants, etc. There is so much variability, and the donor source really matters. Unlike fillers or neurotoxins, or even lasers, every single exosome product can vary because the source varies. This is unlike anything we’ve ever seen in the aesthetics industry. Also, unlike other skin-care ingredients that are standardized and have a chemical structure, exosomes have no chemical structure.”
05 WE NEED MORE RESEARCH ON PLANT EXOSOMES
The jury is still out on the efficacy of plant exosomes. “Humans and plants share about 10 or 20 percent overlap in DNA, but other than that, there are big differences,” says Dr. Wyles. “Plants are great sources for skin care and there is evidence for plant actives, but there is too much variability to say that plant exosomes, or plant-derived exosome-like nanoparticles (PDENs), can be understood by human cells. Think of what an exosome is doing: it’s delivering a message. A message from human sources is like speaking in English, but a message from plants is like speaking in Spanish. Therefore, the skin probably won’t understand the message well, if at all.”
