Exosomes For Hair Loss

By age 80, nearly 80% of men will experience some level of hair loss (Asfour et. al., 2023). Female patients suffer a similar fate, with 50% demonstrating noticeable loss at some point in their lives (Olsen, 2001). What’s more troubling? The majority of this hair loss is caused by inevitable genetic factors. Despite these grim statistics, treatments for genetic hair loss – sometimes called androgenic alopecia or male/female genetic patterned hair loss – remain limited. 

This overwhelming problem creates demand for new treatments. And while many ethical researchers investigate evidence-based, promising treatments, others seek a “quick buck” promoting “to good to be true” treatments to a desperate population willing to try anything. Enter “exosomes:” a new – and seemingly advanced – treatment for genetic male and female pattern hair loss. But what are exosomes? Do they work? What do patients need to know? 

Read on and discover if exosomes are a revolutionary new hair loss treatment or just the newest hair restoration scheme. 

Exosomes for hair loss therapy is considered a high-end treatment, and its cost can vary based on factors such as location, clinic expertise, and the number of sessions required. On average, a single session of exosome therapy for hair loss may range between $3,000 to $10,000. Since this treatment is relatively new, prices tend to be on the higher end, and insurance usually does not cover it as it’s considered cosmetic. However, as the therapy becomes more mainstream, these costs might become more accessible.

The number of exosome therapy sessions required for hair loss depends on individual factors such as the extent of hair loss, underlying conditions, and the body’s response to the treatment. Generally, one to three sessions are recommended, with follow-up treatments spaced several months apart. Some patients report visible improvement after a single session, while others may require multiple treatments to achieve their desired results. Doctors usually assess progress after each session and adjust the treatment plan accordingly.

The two clinical studies examining exosome injection (both via needle and injection and microneedling) into the scalp reported no serious adverse effects. This included no reports of fever, myalgia, chills, fatigue, or scalp cellulitis (Gupta et. al., 2023). A recent study examined the safety of exosomes specifically. The group found injected exosomes in the liver, kidneys, brain, and lungs without any adverse localized reactions (Gupta et. al., 2023). No blood abnormalities — aside from slight elevation of inflammatory cells — were noted either. 

However, the US Food and Drug Administration (FDA) issued a statement in December 2019 warning patients about potential safety concerns with exosome treatment. Concerns revolve around the non-standardized isolation of exosomes from human tissue and accidental inclusion of any allergic or infectious material. Exposure to this material may cause a dangerous allergic reaction or blood-borne infectious disease. Most manufacturers of exosomes adhere to good manufacturing practices (GMP) and produce a “cell free” product. However, several cases of severe infection were reported from sub-standard exosome manufacturing in 2019 (Gupta et. al., 2023). The FDA further reaffirmed that exosomes are not approved to treat any medical condition. 

As previously stated: exosome therapy is generally considered safe, with minimal side effects reported. Exosomes are well tolerated and typically derived from carefully screened donors — which makes the risk of adverse reactions and infections low. However, some patients may experience mild and localized side effects including:

• Scalp redness or irritation at the injection site
• Mild swelling or discomfort
• Temporary hair shedding, which should regrow

These side effects are usually temporary and resolve within a few days..

Platelet Rich Plasma (PRP) is a popular injected treatment for hair loss. Naturally, it is often compared to exosome treatment. However, the two are significantly different treatments: 

• PRP Therapy: PRP involves drawing the patient’s blood, processing it in a centrifuge to concentrate platelets, and injecting it into the scalp. Once activated (lysed) platelets release growth factors that stimulate hair follicles. PRP is an “autograft” treatment, meaning it is a transplant from one part of the body to another. This creates no risk for transfer of allergic or infectious material. However, PRP does contain a number of unnecessary tissue like red blood and inflammatory cells. This makes it less specific and more reactive. It may be less potent compared to exosomes but is more affordable and well-studied. It is not US FDA approved for the treatment of hair loss. 
• Exosome Therapy: Exosomes contain a wide range of signaling molecules and growth factors, many of which are more potent, specific, and concentrated than those found in PRP. These molecules can significantly boost follicle cycling, making exosomes potentially more effective. Exosome therapy tends to work faster, with noticeable results often seen sooner compared to PRP.

References: 

Asfour. L. (2023). Male Androgenetic Alopecia. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/

Gupta, A.K. (2023). Systematic review of exosome treatment in hair restoration: Preliminary evidence, safety, and future directions. Journal of Cosmetic Dermatology. V. 22;9: 2424-2433. 

Olsen, E.A. (2001). Female pattern hair loss. J Am Acad Dermatol. 45:S70-80.