Exosomes are the latest hi-tech, fast-acting skin regenerator to land in clinics and skincare. We go behind at the hype and test the ‘Exo Facelift’
They may sound like UFOs from outer space, but exosomes are the latest ingredient creating a buzz in the world of aesthetics and skincare.
These nano-particles, suspended in a gel, are being teamed with popular in-clinic treatments such as radiofrequency micro-needling (eg Morpheus 8) and lasers to reduce downtime and turbo-charge results. They are being feted for their remarkable ability to firm the skin, smooth out wrinkles, even out skin tone and calm redness and inflammation in conditions eczema, and even used to boost hair growth. They are also starting to feature in face creams.
Exosome therapy is “at least a hundred times more potent than PRP if you use a reputable make of exosomes,” claims regenerative aesthetic physician Dr Shameema Damree, creator of the ‘5 Billion Exo Facelift’, an exosome radiofrequency micro-needling combinations she offers at the London Exosomes Clinic at Urban Retreat.
That’s a bold claim, given that PRP, known as the ‘Vampire Facial’ (which infuses growth factors from your own blood plasma back into skin) has long been praised, alongside lab-created growth factors, as one of the most effective skin-regenerating substances to needle into the skin.
“We’re only seeing the tip of the iceberg when it comes to exosomes,” says Dr Damree. She says they have been intensively researched in the medical field for quite some time already and that we’ll see them being used in orthopaedics and to treat cancer and neurodegenerative diseases. When it comes to aesthetics, she believes that believe they will be regarded as a must when you’re having a medical aesthetic device treatment for use with “to ensure minimal inflammation and maximum skin regeneration.”
In an industry where hype follows hype, could these minute carriers of skin-healing cargo be the missing link when it comes to getting guaranteed great results from your clinical procedures or getting next level skincare? And are they worth forking out nearly £2000 for a treatment and north of £150 for a cream? Let’s take a closer look.
What are exosomes?
They may sound alien but exosomes are naturally secreted by our stem cells and are the body’s key messengers for all cell communication.
They are miniscule ‘bubbles’ that contain precious cargo such as growth factors, ceramides and RNAs - molecules that help cells make proteins such as collagen.
Wait, haven’t we heard this ‘collagen boosting molecule’ stuff before? To a degree, yes. It’s a trick that skincare actives such as retinoids, peptides and growth factors perform up to a point. But “this degree of fibroblast [collagen-producing] activation has not been seen before in regenerative aesthetics,” Damree maintains.
Because of their small size and molecular makeup, exosomes can penetrate the skin’s deepest layers to deposit their cargo and transmit their cell-activating messages. Once they have been absorbed into the cell, they switch on the fibroblasts “to produce up to 600 per cent more collagen and 300 per cent more elastin,” says Dr Damree.
How does exosome therapy work?
For truly effective absorption, exosomes need extra help to get past the skin barrier. So in-clinic, they’re used in combination with medical micro-needling or other devices that open microchannels in the skin surface, such as non-ablative laser or Morpheus 8. This gets you the double whammy of the collagen stimulating ‘controlled damage’ of device, alongside the regenerative and downtime-reducing power of the exosomes.
What are exosomes made of?
Exosomes are lab-made and – here’s the snag – the ones that have been studied to show the results that Dr Damree talks about are made from human-origin ingredients such as bone marrow, blood and fat from willing donors – although it’s so purified and processed that no genetic material is present.
Human-derived ingredients are not licensed for cosmetic use in the EU (rules which the UK follows). However, many doctors I spoke to still consider exosomes made in this way to be no-risk or low-risk and are happy to use them off-label in aesthetics treatments, because of the superior results. (Off-label is a term doctors use when they use meds for purposes they are not yet licensed for. An example is using Botox to treat excessive sweating)
“There is no cellular matter in exosomes, so any risk of disease transfer or cell rejection does not apply,” says Dr Damree.
But as you can see, it’s a grey area and a matter of consumer choice. There are plant derived/vegan exosomes, which “have the ability to mimic the collagen and elastin-boosting signals of fibroblasts cells to some extent,” says Dr Damree.
But the research isn’t there yet to show their efficacy. Other doctors such as Dr Sophie Shotter say they are excited by exosomes, but are waiting for more evidence and clarity. It’s a similar situation with collagen supplements – the evidence is there for the animal-based bovine and marine versions. For the vegan collagen alternatives, evidence is still emerging.
What are the benefits of exosome therapy?
The three core superpowers of exosomes, according to Damree, are their regenerative, anti-inflammatory and immunity-boosting properties. For skin, it means they can downregulate pigmentation, calm redness and increase the thickness of the dermis – meaning they help lay on more collagen, elastin and hyaluronic acid for firmer, plumper and smoother skin.
Clinically proven makes of exosomes (ie the human-derived ones backed by independent clinical research) are especially prized for their ability to quell inflammation and soothe skin.
It makes them a perfect partner for heat-based tweakments such as radiofrequency microneedling and laser, where they can settle heat and irritation fast and significantly speed up the healing process.
They can also relieve the symptoms from hard-to-treat conditions such as psoriasis, eczema and rosacea: “ExoCoBio, the brand I work with has published the world’s first scientific publication on the use of its exosomes to relieve atopic dermatitis,” says Damree.
Can exosome therapy help with hair growth?
Cosmetic physician Dr Dev Patel tells us he is impressed by reports from his American colleagues, who report that exosome therapy produces superior results for hair growth compared to PRP. “And if you’re older and the quality of your own plasma is already poor, it certainly stands to reason exosomes will be the more potent rejuvenating option for skin as well,” he notes.
What is an ‘exosome facelift’?
Dr Damree’s ‘5 Billion Exo Facelift’ infuses five billion exosomes per treatment. Numbers are important as “the success of exosomes is concentration-dependent,” she says – something Patel agrees with.
She uses exosomes with the Virtue RF microneedling device, a version of machines such as Morpheus 8. She says the combined treatment “can even tighten and brighten eyelids, double chins and neck wrinkles.”
She uses ExoCoBio Exosomes which, she says, are rose stem cell-based. She notes they are manufactured “in a GMP (Good Medical Practice) facility, which is important to check for, and proven to be effective by scientific publications.” She doesn’t go so far as to say that they are non-human derived.
Like any RF microneedling treatment, it’s not a spa-like experience. You need a decent numbing cream in order to tolerate the micro-wounds and intense heat of the microneedling handset, which is used after the exosome gel is applied.
Dr Damree’s ‘5 billion exo facelift’, is a cool £1950 a pop, requiring three sessions.
What happened when we tried it?
Get The Gloss co-founder Sarah Vine was concerned about her jowls and under-eye bags (“my turkey neck and eye chasms!”) and has had two treatments with Dr Damree, the latest three weeks ago. She says the first treatment improved both her ‘problem’ areas “by around 20 per cent.” It also helped reduce pigmentation.
“What I was impressed by was that there was absolutely no pain and no downtime - the machine has a cooling plate which really helps. Compared to Morpheus 8, which friends tell me can be very painful, it was a breeze. My face felt tight and a bit pink for about an hour afterwards, and that was it. The machine makes several passes over the face, each time needling at different depths. You can have it on your brow bone, hands and chest too.”
She noticed an immediate brightening plus a gradual tightening and sculpting of the jawline. “I’d describe it as a super-SUPER facial. If you don’t want fillers, or a thread lift (which I’ve had and which is painful and a little bit scary) this is somewhere in between.” She says she’d have it twice a year in place of all other facials, if the costs wasn’t so high. “At the moment, it’s too expensive.”
If you want something cheaper or less invasive, simple no-heat microneedling with a SkinPen or Dermapen or non-ablative laser combined with exosomes will still deliver better results than using a device on its own, says Dr Damree.
Where else can you find exosome therapy?
Dr Patel is switching to the 100 per cent plant stem cell-derived exosome brand Exo|E in his Portsmouth clinic, which he says is sufficiently powerful “to truly boost human cell communication.”
“Up until now, the benefits from exosomes have not been much greater than those I get for my patients from using growth factors,” he says. “But because exosomes are currently extremely costly, I have to charge my patients a lot more for them.”
He charges £150 for in-clinic growth factor therapy, and £450 for exosome therapy.
I’m not sure about exosomes – what alternatives can I try?
Exosomes aren’t the only substances credited with reducing skin irritation, whether that’s after a cosmetic procedure such as Morpheus8 or due to an inflammatory skin disease such as eczema.
As Dr Patel says, growth factors (messenger molecules that each carry a very specific cell-activating message) are ace at this too, and they are cheaper and more widely available than exosomes. Dr Patel has long used his own Cellderma GF5 growth factor blend in his clinic.
Surgeon and cosmetic physician Dr Apul Parikh combines ‘healing’ growth factors with microneedling to “deep-hydrate, assist in wound regeneration and promote skin health.”
Even hydrating skin boosters such as Profhilo are used to settle upset skin, as aesthetic doctor Dr Ayah Siddiqi explains in this feature
What about exosome cream? Does exosome skin care work?
At home exosome creams and serums are beginning to enter the market, but can they work?
"Exosomes’ benefits are multiplied when you needle them into skin,” says Damree. “However, they can still be beneficial when used as a topical cream, as some of it will penetrate.”
Freshness of the exosomes is important in her experience, so she favours products that come in powder form and are freshly mixed before use. ExoBalm, an at-home product by ExoCoBio she recommends, is a kit with an exosome powder and a base you blend yourself and keep in the fridge for maximum potency. Another thing to look out for is a high number of exosomes. The ExoBalm has 2.5 million of them - a lot more than most topicals.
Exosome creams you can try at home
The pro cream: ASCE+ ExoBalm, £240
It has 2.5 billion exosomes, five growth factors, six peptides, NAD+, tranexamic acid and glutathione - that’s a lot of powerful skin regenerators. Prepare to do some at-home science-experimenting: you’ll have to mix it up, put it in the fridge and use it in a matter of weeks.
The Hollywood favourite: Dr Barbara Sturm Exoso-metic Face Serum, £410
Sturm made her name with blood plasma creams made from the patient’s own plasma and has now translated this knowledge of stem cell technology into an ‘exosome’ range. This serum, a favourite of GTG columnist Elle Macpherson, doesn’t necessarily have exosomes in it (according to the INCI list) but instead has epidermal growth factor (EGF), which is one growth factor that can be contained in exosomes.
The entry-level exosome: Celltweet Firming Moisturiser, £150
Created by Dr Damree as a more accessible cosmetic exosome product, this is based on rose stem cell exosomes (more than 10,000 of them) with added peptides, hyaluronic acid, ceramides and white tree mushroom to firm, restore elasticity and soothe.
My verdict:
There is no doubt that healing, regenerative molecules such as exosomes (and growth factors) are the future of anti-inflammatory and age-preventative aesthetic treatment. They make sense both on their own and as an add-on to often-aggressive tweakments. But exosome science is still in its infancy and alternative options such as growth factors have been better-proven - and that’s worth remembering when you are deciding how to spend your money.