Is exosome therapy poised to be the skin rejuvenation treatment of the future?

If you hope to achieve a fortified barrier and hydrated skin minus pigmentation, unevenness, wrinkles and inflammation, exosome therapy might be the new-age solution with negligible downtime

If grappling with the ever-expanding glossary of skincare and hair care ingredients wasn’t a wearying task already, the scope of in-office treatments has also proliferated substantially in the recent past. From basic hydration-boosting and glow-enhancing facials—or medi-facials (medical-grade facials)—to elaborate and potent treatments such as Platelet-rich plasma (PRP), microneedling, laser peels and more, your dermatologist’s clinic is home to a slew of skin-refining treatments for every concern. 

In-office medi-facials and treatments are particularly great for those who follow a fundamental skincare routine that thrives on the maintenance principle as these treatments address such concerns from time to time. If you are looking for something that accelerates skin rejuvenation, there’s a new prospect that deserves your attention. Enter: exosome therapy. After enjoying a major moment in Korea, where invasives are a prominent part of the beauty industry, exosome therapy made a big move to the global market last year. We speak to three expert skin doctors and chalk out a primer on exosome therapy. 

What are exosomes?

New Delhi-based dermatologist and author of Skin Sense, Dr Kiran Sethi says exosomes are active participants in various physiological and pathological processes in the human body. “Exosomes are small extracellular vesicles (a sac around cellular membranes containing fluids) that are released by cells. They play a role in cell-to-cell communication by transferring various molecules, such as proteins, nucleic acids, and lipids, between cells.” Dr Batul Patel, dermatologist and founder, The Bombay Skin Clinic, shares that exosomes are spherical, lipid bilayer-enclosed particles that range from about 30 to 150 nanometres in diameter.

It goes without saying that exosomes are naturally occurring substances in the body. “When injected, applied topically or incorporated into skincare products, exosomes can potentially deliver their cargo of bioactive molecules directly to the skin cells, providing targeted benefits, especially anti-ageing,” says Dr Harshna Bijlani, a Mumbai-based celebrity skin expert. Exosomes are therefore utilised for a therapeutic purpose, the foundational principle of which is similar to that of PRP — using one’s own bodily substance to improve the look and feel of the skin and relieve it from common skin concerns. “Exosomes can be stored, freeze-dried, or formulated into skincare products, making them more practical for widespread use,” informs Bijlani.

What is exosome therapy all about? 

Exosome therapy is also known as exosome-based therapy or exosome regenerative medicine; it is a type of treatment that utilises exosomes for therapeutic purposes, shares Sethi. “It is based on the idea that the beneficial effects of stem cells in regenerative medicine are largely due to their secretions and, particularly, to the exosomes they produce,” says Patel. “The therapy involves isolating exosomes from donor cells (usually stem cells) and injecting them into the recipient, where they can exert therapeutic effects,” she furthers.

It’s interesting to note that exosome therapy is often combined with other injectable or resurfacing treatments as the finishing topper to equip your skin to deal with the post-treatment irritation in a better fashion. However, whether combined with another treatment or not, successfully executing exosome therapy requires surpassing the topmost layers of skin (read: injecting exosomes). “You need to undergo another cosmetic procedure that creates microscopic channels in your skin, like microneedling or laser treatments. These channels allow the exosomes to be absorbed and reach the deeper skin layers for enhanced rejuvenation,” New York-based Eunice Park, MD: dual board-certified facial plastic and reconstructive surgeon toldAllure.

When exosome therapy is conducted through topical application, a deep exfoliative treatment is a must as a precursor. However, exosomes can also be injected into the skin as a by-product of treatments like PRP. “There are natural autologous exosomes available. Guess where? In PRP. The growth factors that you use to stimulate your scalp or your face are packed with exosomes so when you get PRP done, you’re naturally getting exosomes already,” apprises Sethi.

“A technology that unlocks the potential of accessing almost pure autologous (which means from your blood) exosomes is a treatment called Liquid Gold. While PRP offers approximately 20 to 30 per cent of exosomes, Liquid Gold has 96 per cent of them,” says Sethi, pointing at the efficaciousness of the treatment, the price for which starts at about 23,500 rupees per session. “It is US FDA-approved, unlike other exosomal technologies that are not autologous,” adds Sethi. 

The potential benefits 

Exosome therapy is currently being researched for a wide range of benefits, including anti-ageing treatments, hair regrowth and skin rejuvenation, says Patel. “Exosome therapy aims to rejuvenate the skin by stimulating collagen, enhancing skin elasticity, and reducing the appearance of wrinkles and fine lines. Exosomes improve skin hydration and strengthen the skin’s natural barrier function, leading to enhanced moisture retention and protection against environmental factors,” states Bijlani.

According to the skin expert, this therapy also shows potential in wound healing and tissue regeneration, as exosomes can stimulate cell proliferation and facilitate the repair of damaged tissues. “They can help modulate the immune response and reduce inflammation in the skin, potentially improving conditions like acne, eczema, rosacea, or other inflammatory skin disorders,” she explains. “Furthermore, exosomes may have anti-inflammatory properties and the ability to regulate melanin production, making them valuable in managing pigmentation concerns and promoting a more even skin tone.” 

While exosome skin therapy is a relatively new area of research, its exciting potential offers promising prospects for advanced skincare treatments. ​​Bijlani is of the opinion that exosome therapy offers advantages in terms of scalability and safety compared to other treatments. Exosomes can be derived from various cell sources, including the patient’s own cells, making them a potentially personalised treatment option.

Patel also throws light on the other potential benefits of exosome therapy that could extend to various medical fields, including neurology (potentially assisting in the treatment of neurodegenerative disorders), cardiology (assisting in cardiac repair), orthopaedics (healing and regenerating tissue), and more. 

Exosome therapy versus other treatments

Given the compatible and overlapping nature of exosome therapy, it is often compared with its counterpart treatments such as microneedling, stem cell therapy, and PRP. While the delivery of exosomes could transpire indirectly through a treatment like PRP or be used as a healing and soothing final follow-up, its effect and modus operandi is different from the rest. “Stem cell therapy involves directly injecting or infusing stem cells into a patient with the goal of replacing damaged or lost cells. On the other hand, exosome therapy is based on the concept of harnessing the power of exosomes ( derived from stem cells) to stimulate the body’s own healing processes. Therefore, while both are branches of regenerative medicine, the former uses whole cells, while the latter uses the products that these cells release,” says Patel, explaining the difference between exosome therapy and stem cell therapy. 

Upon being asked about the distinguishing factors between microneedling and exosome therapy, Sethi says, “Microneedling is a cosmetic procedure that involves using fine needles to create controlled micro-injuries on the skin’s surface. It stimulates collagen production and enhances the absorption of topically applied substances. While exosome therapy and microneedling can both contribute to skin rejuvenation, they are different in their mechanisms of action.” Sethi opines that exosome therapy primarily focuses on delivering therapeutic exosomes to promote skin regeneration and repair, while microneedling aims to stimulate the skin's natural healing response and enhance the penetration of topical products.

The caveats to make note of  

“Exosome therapy can be particularly appealing for those who prefer natural and biocompatible approaches. However, it may not be suitable for everyone, especially individuals with certain medical conditions or those who have hypersensitivities or allergies to the exosome donor source,” informs Sethi. 

While exosome therapy is a treatment worth considering for those who wish to tackle signs of ageing, hyperpigmentation, dehydration and a compromised skin barrier, however, “those pregnant or breastfeeding, people with compromised immune systems or someone who is susceptible to allergic reactions, should consult with a doctor first,” advises Bijlani. “Pain, swelling, infection and other complications can occur at the injection site,” adds Patel.

Sethi suggests one should make sure that the exosomes used in therapy are obtained from a reliable and reputable source and meet regulatory standards. “Additionally, the long-term effects and optimal dosing protocols of exosome therapy are still being studied, and more research is needed to establish its efficacy in different applications fully.” If you’re mulling over exosome therapy, it’s crucial to discuss the potential risks and benefits with a knowledgeable healthcare provider. “The treatment should be carried out in a reputable, regulated healthcare setting to ensure safety and efficacy,” recommends Patel. Some of the clinics offering exosome therapy in India include ISAAC Luxe, Isya Aesthetics, The Bombay Skin Clinic and Yavana Aesthetics.

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