Exosomes are a hot topic in aesthetic medicine. Lots of folks are using them to improve healing and results from different kinds of skin procedures like laser and microneedling. They are very expensive! What are they? What do they do? Are they worth it? In this article I’ll explain what they are, why some are better than others, and what to look for if you are going to use them.
The cells in your body connect and communicate with each other. One of the big ways they do this is through exosomes. Every cell in your body has an outer layer called the cell membrane. You might remember this from Biology class in high school. The cell membrane is made up of lipids (fats) that contain and protect the inside of the cell and all its parts. The cell membrane has channels that can selectively allow certain substances to pass into and out of the cell. It also has receptors for signals coming from other cells. Other cells emit these signals in the form of hormones, peptides and lots of other kinds of signals. For the most part, those signal molecules are contained in tiny particles called exosomes. Exosomes look like a tiny cell, with a round membrane containing their contents. But exosomes don’t have a nucleus or organelles like cells do. They just have signal molecules inside. When one cell signals another to do something, it sends out an exosome with the right proteins inside of it to cause a certain effect.
Some exosomes are great for healing and maintaining healthy tissues. For example, exosomes from platelets are all about healing. However, cancers can also secrete exosomes, promoting cancer growth. So, absolutely not– exosomes are not all good for you! The kind of cell making the exosome matters a lot. If exosomes are going to be used for healing and maintaining healthy tissues, they have to have the right signals in them. Exosomes from many different tissues can have “mixed messages” contained inside. Making sure exosomes are safe and effective is critical if you are going to use them to promote healthy skin.
Platelets are small cell fragments that are made in the bone marrow and float in the bloodstream. They respond to injury and cause blood clots. Platelets send out exosomes that are involved in healing injuries. These exosomes contain healing signals that help the body heal itself. The reason platelets have been singled out as an important source of exosomes is because their purpose is singular: to heal and repair. There is an additional advantage of platelet-derived exosomes: they are stable for long periods of time at room temperature. This allows them to be shelf-stable and used in serums and toplicals.
Mesenchymal stem cells are stromal cells that have the ability to self-replicate and that have the ability to differentiate into different kinds of mature cells. These cells can be found in the umbilical cord, fetal tissue, placenta and fat, to name a few. Many of the companies producing exosome products for aesthetics derive these exosomes from stem cells found in fat. There are some disadvantages of mesenchymal stem cell-derived exosomes. First is the messaging– which can be variable depending on the stem cell line. Second is that they are highly susceptible to breakage and degradation. They generally have to be kept at cold temperatures, and once opened, must be used immediately. Thus, to date, these types of exosomes have remained single-use and cannot be packaged into a serum for daily use.
It sounds like a lot of science, right? It is! A lot of lab work goes into obtaining and preserving sensitive particles that come from living cells. Having a process that collects billions of exosomes and keeps them sterile and stable is quite complicated. As a result, the product is very costly, and most exosome products are available as a single-use application, usually placed on the skin immediately after a skin procedure like laser or microneedling, so that they are absorbed well and aid in healing. If the exosome preparation is well-made, it can boost the yield from the procedure itself.
As described above, to date, the only preparation of exosomes manufactured that is shelf-stable and packaged into a daily serum is made from platelet-derived exosomes. The good news is that these preparations are also the best in terms of uniformly positive signaling for healing and repair. This may change as science progresses; however, the only product currently on the market, called plated and made by a company called Rion, is also the least expensive. Win Win.
It is definitely early in the game, but my prediction is that exosomes are going to be a game-changer in the world of aesthetics. I have been watching this area of research for a couple of years, and until recently I would have said no, it is not worth it. The single-use vials only provide one moment of signaling to the skin. And many cost thousands of dollars per vial! But now that we have good data on the effectiveness if daily serums using platelet-derived exosomes, and the cost is much less than the single-use vials derived from fat. With daily application of the serum, the skin receives the signals for healing and repair once or twice each day. Studies have shown that within 8 weeks of twice daily application of the plated product, there are marked improvements in skin texture, decreased redness and sun damage.
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