Dr Glynis Ablon kicked off our last full day in Miami with an in-depth discussion of 2 popular treatments in hair aesthetics: platelet-rich plasma (PRP) and exosomes. Both PRP and exosomes can act as adjunct treatments to other procedures including with each other. Differentiating between the 2, PRP is an autologous blood component that harnesses the secretory prowess of activated platelets, specifically the alpha-granules they release, which contain growth factors and various other cytokines involved in angiogenesis, remodeling, coagulation, and inflammation. After extraction, PRP remains stable for about 4 hours. Notably, the FDA does not classify PRP as a human cellular/tissue product, and all systems require a 510(k) clearance to be sold. 

Exosomes, on the other hand, are endogenous nanoparticles released by stem cells to create phenotypic change via growth factors to enhance healing and collagen synthesis, miRNA to regulate gene expression, and cytokine to invigorate cells. Since they include mRNA and miRNA, they have effects long after that of cytokines and growth factors alone.  

Exosomes can come purified, which are frozen and contain intact active exosomes, as well as lyophilized in a powder that requires reconstitution, or suspended in a cream. We await studies to demonstrate the integrity of lyophilized exosomes, but they are appealing to consumers in a variety of skin care products. Exosomes also are present in small numbers in PRP and in some plants, though plant-derived exosomes will not bind to human-derived cell receptors and thus efficacy may be limited. Other concerns regarding exosomes include the limited quality control measures, stem-cell sourcing, and the scalability of the extensive and expensive purification process. There also isn’t a set standard for treatment frequency. Unfortunately, as of now, there are few clinical trials involving exosomes related to dermatology, but that may change in 2024.