In the past there have been popular treatments for hair regrowth such as PRP used alone or in conjunction with a variety of other products that contain highly concentrated growth factors.   At Ageless MD we have used these modalities in the past with somewhat good results.  But “good” is not enough.  We constantly striving for and seeking out the best of the best that our existing technologies have to offer.   Exosomes is the latest frontier in hair loss therapies.

Using exosomes for hair regrowth is a relatively newer treatment approach that depends primarily on stimulating the remnant hair follicles to grow on their own.  Exosomes are microscopic structures that comprise nutrients and many growth factors. The net effect is hair growth enhances and hair becomes stronger and thicker. This treatment is gaining popularity owing to the promising results it produces in a shorter span of time.   According to what we have witnessed visible results are seen much sooner such as 8-10 weeks rather than 5-6 months with the previously mentioned therapies.

What are exosomes?

Exosomes are not cells. Exosomes are tiny lipid vesicles (1/1,000th the size of a cell) that are secreted from a cell which are normally present within a cell, that are involved in direct cell to cell communication.1

However, owing to their healing and growth-promoting properties, they are now being used for the treatment of many medical conditions, like wound healing, anti-aging, bone problems, and hair restoration. 2,3 Exosomal treatment is attributed to be the most advanced development in the field of regenerative medicine.  For therapeutic purposes, they are derived from the donated human bone marrow mesenchymal stem/stromal cells (MSCs) , which are purified using proprietary cGMP processing and are sterile filtered and tested per USP <71> sterility testing.  by an FDA approved company like Direct Biologics.  The mesenchymal cells are used purposefully because they are pluripotent cells, which means they have the potential to grow into different cell types.

The exosomes consist of more than two hundred growth-promoting factors that stimulate the cells for healing and regeneration. The most important of these factors are vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and fibroblast growth factor (FGF). All these substances are known to stimulate the hair follicles, resultantly promoting hair growth, and thickening. The mesenchymal derived exosomes also stimulate a special signaling pathway, known as Wnt-3a, which activates other pathways of hair growth and regeneration.

How do exosomes work?

The body cells grow and divide in response to nutrition and signaling. Adequate nutrition provides the cells with metabolites necessary for their growth, and the signaling molecules give out constant signals for sustaining the metabolism. Usually, after a certain period of time, the cell growth stops and it kills itself. This programmed cell suicide is for the benefit of the body. Before dying, therefore, the cell should multiply and produce a sufficient number of daughter cells to compensate for the functional loss, which will occur after parent cell death.  The division of cells also requires nutrition and signals. This is how most of the body cells work, including those that are responsible for hair production.

The treatment of degenerative conditions, thus, relies on the provision of good nutrition and signaling factors, stimulating the process of regeneration. The older techniques such as PRP, cytokine rich plasma, and stem cell treatments focus more on the nutrition for follicular cells. Even though they also contain some amount of exosomes, it is not enough to fulfill the signaling requirement. The processed exosome treatment is, therefore, introduced that contains both the nutrition and stimulants for cell growth and division. For hair loss, the exosomes specifically stimulate the Wnt pathway, which is the most crucial stimulant for hair growth.

When injected into the desired area, the exosomes cross the cell barrier easily because of their relatively smaller size and compatible structure. They carry proteins (growth factors), too large to cross the lipid bilayer membrane of the cells, and the nutrients, essential for cell growth. The proteins then activate the different signaling mechanisms to produce the desired effect.

The exosomes also affect the duration of cycle length. It has been shown that exosomes prolong the hair growth cycle. The hair cycle has three phases of growth:

  • Anagen phase – when hair is growing actively
  • Catagen phase – a transitional stage
  • Telogen phase – hair growth is stopped
  • The exosomes stimulate the hair follicles stuck in the telogen phase to enter the anagen phase. 4

    How is the treatment carried out?

    The actual treatment process is very simple.  The Exosomes are stored in a special freezer keeping the product stored at extreme below freezing temperatures.   Prior to the treatment the Exosomes are “thawed” or “defrosted” to room temperature.  We draw up the exosomes which is in a clear liquid form and injected it with a very small needle directly in the scalp focusing on the areas of concern.    Pain control is achieved with our Frozen C device which uses liquid nitrogen spray to cool down the skin similar to applying an ice pack prior to the injections.

    Possible side effects include swelling, bruising, mild bleeding, or allergies.  There is only mild soreness for a few days which subsides and you can continue your normal daily activities immediately afterwards.

    Generally, the results are variable with other therapies like PRP in different individuals after the first dose, probably because of different genetic makeup, the effect of anti-hair losing medications, and some other factors.  With exosomes, however, the outcome is obtained quite rapidly and the results last even longer.

    What are the benefits of treating hair loss with exosomes?

    Exosome therapy is a highly advanced innovation in regenerative medicine. The basis of regenerative medicine is to cure the ailments by utilizing the body’s natural healing and regenerating capabilities. Exosomes, therefore, target and stimulate hair growth by delivering numerous growth factors into the fair follicles. The exosomes not only promote hair growth but also improve hair quality. They have been shown to increase hair density and make it stronger.

    They work on hair restoration by enhancing the hair follicle’s growth potential. This means once the hair growth has started, it will continue. The conventional medicine, on the other hand, needs to be taken regularly, and if stopped, the re-grown hair will fall out.

    Further, when compared with another method like PRP, which is also widely used for hair restoration, the exosomes have certain benefits. The introduction of platelets and stem cells into the scalp also adds unnecessary substances in it that later have to be metabolized and removed by the body. The exosomes injection is highly targeted and is focused to deliver the right substance in the right quantity. 5

    Who can use exosomes for treating hair loss?

    Exosome therapy is comparatively a safer option with no known major adverse effects. 3 It can be used by all healthy individuals suffering from hair loss. People who have specific medical conditions, like cancer, autoimmune disorders, and infections, should consult their doctor before considering this treatment.

    References:

    1. Zhang, Y., Liu, Y., Liu, H., & Tang, W. H. (2019). Exosomes: biogenesis, biologic function, and clinical potential. Cell & bioscience9, 19.
    2. Wang, J., Sun, X., Zhao, J., Yang, Y., Cai, X., Xu, J., & Cao, P. (2017). Exosomes: A Novel Strategy for Treatment and Prevention of Diseases. Frontiers in pharmacology8, 300.
    3. Gupta, A. K., Renaud, H. J., Halaas, Y., & Rapaport, J. A. (2020). Exosomes: A New Effective Non-Surgical Therapy for Androgenetic Alopecia?. Skinmed18(2), 96–100.
    4. Rajendran, R. L., Gangadaran, P., Bak, S. S., Oh, J. M., Kalimuthu, S., Lee, H. W., Baek, S. H., Zhu, L., Sung, Y. K., Jeong, S. Y., Lee, S. W., Lee, J., & Ahn, B. C. (2017). Extracellular vesicles derived from MSCs activates dermal papilla cell in vitro and promotes hair follicle conversion from telogen to anagen in mice. Scientific reports7(1), 15560.
    5. Guo, S. C., Tao, S. C., Yin, W. J., Qi, X., Yuan, T., & Zhang, C. Q. (2017). Exosomes derived from platelet-rich plasma promote the re-epithelization of chronic cutaneous wounds via activation of YAP in a diabetic rat model. Theranostics7(1), 81–96.

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