“Exosome” is the new buzzword and rising star in the fields of regenerative medicine, stem cell research, as well as traditional medicine and pharmacology because exosomes represent the latest generation of naturally bioactive stem cell-based products for patient treatment.

What is an exosome?

Alan J Bauman, MD, ABHRS

Exosomes or extracellular vesicles are tiny packets containing a wide range of cellular information, signals, and instructions that are created inside cells and secreted into their surroundings. They may be taken up by adjacent cells or travel to distant cells. Less than 1/1000 the size of a cell, typically ~100nm in diameter, they can be found in blood, urine, spinal fluid, and saliva.

For many years, exosomes were considered responsible only for the transportation of cellular waste out of a cell–not very glamorous! More recently, however, they have been recognized for their critical role in intracellular communication in health and disease, with now more than 14,000 scientific articles appearing in the clinical literature within the past decade. Because of their potential, biotech companies focused on exosome therapeutics and diagnostics have received hundreds of millions of dollars of investments just within the past few years and the exosome field is projected to be a three billion dollar a year industry by the end of this decade.

An undeniable trend in medical research since the 1990s has been away from a traditional pharmaceutical approach toward the concept of regenerative medicine – a way to restore normal function to that which has been damaged by disease, injured by trauma, or worn by time. Spearheaded by advances in tissue engineering and molecular biology – especially in the areas of human genes, proteins, and cells–many of the scientific breakthroughs found initially in the laboratories have now made their way “to the bedside” of patients in clinics around the world.

Specifically, in the field of hair loss, for example, advances in our understanding of the chronobiology or the internal biological “clock” which regulates cyclical hair follicle function – and therefore hair fiber production, dovetailed with a clearer understanding of how to leverage the body’s own cellular repair pathways, have opened the door to treatments and procedures that have been proven to safely and effectively enhance hair growth without relying upon traditional pharmaceutical interventions.

Exosomes and Hair Follicle Regeneration and Rejuvenation

What if the hair regrowth effects observed from stem cell therapy or cell therapy using fat tissue, adipose-derived mesenchymal stem cells AD-MSCs, or Platelet-Rich Plasma PRP could be obtained without the invasive harvesting of adipose via liposuction or a blood sample? New research supports the use of exosomes as a viable treatment strategy for those with hair thinning, hair loss, wound healing, as well as the treatment of skin disorders.

In recent research, exosomes from human dermal papilla cells in the root of the hair follicle and also from activated dermal fibroblasts have been shown to promote hair growth. In other studies, conditioned media which contains the secretome, or chemical messages, released and isolated from the careful incubation of stem cells in the laboratory has also been shown to have a powerful effect on hair growth.

What is involved with an exosome hair growth treatment?

An exosome treatment is performed comfortably as a stand-alone, “lunchtime” procedure using local anesthesia so you will not feel the scalp injections of exosomes. The scalp will remain numb for a few hours, but the client may return to regular activities of daily life immediately, resuming athletic activity, hair care, and styling the next day. Exosome therapy can also be used in conjunction with hair transplantation to address thinning in the non-transplanted hair as well as accelerate the healing of transplanted grafts.

When will results be seen from exosome hair growth treatment for hair loss?

From our observations, hair growth results from exosome treatments become measurable in about three to six months and visibly apparent in six to nine months. However, some patients report even faster results. Like PRP and PDOgro, tracking measurements with HairCheck and other tools tells us how well the treatment is working in each area and when treatment needs repeating.

How much of a hair growth result will be seen from exosome therapy, and how long will it last?

As with any hair regrowth therapy or procedure, results may vary. The power, performance, and duration of the measurable and visible results from exosome therapy for hair growth depend on many variables, including age, genetics, risk factors, degree of hair loss, hair quality (color, curl, diameter, density), as well as the use of adjuvant therapies like pharmaceuticals, laser therapy, nutraceuticals, etc.

Will exosomes work for someone with extensive hair loss?

Early treatment is always the best treatment. If hair follicles are dead, gone, or beyond repair, it’s unlikely that exosomes will have a substantial effect other than to protect and enhance the hair follicles that can be rejuvenated. To determine what areas of hair loss and hair thinning are likely to respond, a detailed evaluation with an experienced certified and credentialed Hair Restoration Physician is recommended.

Who is not a candidate for exosome treatment for hair loss?

While there are no absolute contraindications to exosome therapy known at this time, patients with severe medical issues, including cancer, immune conditions, poorly controlled diabetes, etc., including smokers, should consult with their physician before proceeding with this treatment. 

By Alan J Bauman, MD, ABHRS , Bauman Medical Hair Transplant & Hair Loss Treatment Center, Boca Raton, FL