What are exosomes?
Exosomes are extracellular vesicles that are produced by mesenchymal stem cells which are involved in cell communication. Other cells react to the messaging signals from the exosomes and will change their behavior accordingly. Scientists are now able to isolate and deliver these beneficial signalers directly rather than the stem cells themselves.
Exosomes are extracellular vesicles ranging between 30-150 nm that are produced by virtually every cell type as a means of inter cellular communication. They contain proteins (growth factors), mRNA (blueprint for protein production) and micro-RNA (on-off switch for specific protein production), all contained within a membrane similar to their parent cells that protects exosomal proteins and RNA from degradation until they are delivered to the target cell.
Exosomes are isolated from donated human amniotic mesenchymal stem cells and purified using proprietary processing. The unique benefit of these exosomes is that they are stem cell-derived and bring a wide array of growth factors. Because they’re so small and nimble, exosomes can remain hidden in the bloodstream, and carry multiple doses of proteins across barriers that cells are not able to cross.
What is exosome therapy for hair loss?
By injecting exosomes and growth factors, it has been clinically shown to help regenerate and regrow hair as a treatment for hair loss in both men and women in the earlier stages of hair loss.
Exosomes are stem cells per say. Instead, they are the building blocks of such. They generate within their cells of origin if the multivesicular body fuses with the cell membrane, thereby releasing intraluminal vesicles as exosomes. These small cellular products contain both RNA and, even of greater import, mRNA, the initiator of protein manufacturing.
These protein building blocks’ roles are dependent on their cell of origin. Many act as signalers for bodily functions, such as coagulation, as well as cellular growth to facilitate said bodily functions. Such signaling and growth factors, studies currently show, are a result of the exosome’s origin. Near all, however, have several useful growth factors/signalers:
- MIP-1: A recruiter of mononuclear cells
- VEGF: A stimulator to encourage blood vessel formation
- SCF: An encourager of stem cell and melanocyte growth
- FGF: A growth factor that signals cells to encourage biological development
- TGFß3: A gene variant that, among other things, converts inflammatory T Cells into anti-inflammatory T-Cells
Research into exosomes is happening for several purposes:
How long does it take to see results from exosome therapy for hair loss?
Exosome therapy may begin promoting natural hair growth in as little as two to three months. New hair growth can continue over the course of a year, with the most noticeable results usually being seen six months after treatment has been administered.
How long do I have to wait before another session of exosome therapy for hair loss?
We typically recommend waiting 3 to 6 months after the last treatment to re-evaluate and before potentially performing another treatment of exosome injections if it is necessary.
Are exosomes SAFE to use?
We use exosomes which are procured and processed in the United States according to standards and regulations established by the American Association of Tissue Banks (AATB), and the United States Food & Drug Administration (FDA). All the donors are in the United States.
Donor ethics and non-reactive FDA approved serological screening includes:
- Donor consent prior to collections
- HBsAG (Hepatitis B Surface Antigen)
- HBcAb (Hepatitis B core Antibody)
- HCV (Hepatitis C Antibody)
- HIV 1/11-Ab (HIV Nucleic Acid Test)
- HCV NAt (HCV Nucleic Acid Test)
Similar to the screening process performed by tissue banks, donors are tested for HIV, HTLV, Hepatitis B, Hepatitis C, Syphilis and CMV.
In addition to understanding the rigorous screening and testing process for pathogens, it is important to note that placental mesenchymal stem cells are not a natural reservoir for these viruses. Any possible risk of contamination of donor tissues despite rigorous screening is furtherer reduced during the MSC culture and exosome isolation process. Finally, sterility and endotoxin assays are performed after the final stage of production to confirm the absence of any infectious agents.
How are exosome treatments different from PRP (Platelet Rich Plasma) Treatments?
PRP or platelet rich plasma begins with centrifuging the patient’s blood to concentrate the growth factors and platelets naturally present in the body. The drawback of using PRP is it does not provide any stem cells or exosomes because as we age our bodies contain less and less stem cells in our blood. In addition to age being a factor, the patient’s health is also very critical to the quality of PRP harvested.
Before PRP was developed, stem cells would come from fat collected during liposuction. However, that process was painful and more expensive with the patient having to undergo two procedures. Again, the patient’s age and overall health came into play with the quantity and quality of the stem cells available.
How long do exosomes last in your body?
Exosomes are present 6 to 8 months after the final treatment.
Do exosomes prolong the hair growth cycle?
Yes, exosomes do prolong the hair growth cycle. Hair follicles stuck in the telogen phase (resting phase) convert to the anagen (growth phase) and prolong the cycle of such.
This is of critical benefit, as with every part of our body, hair follicles age. Different than many cells, however, follicular cells age with each cycle of growth. It typically requires decades, but as follicular cells enter and leave each phase they begin to change. Miniaturization, or the shrinking and growing brittleness of hair strands, initiates. From there, without treatment, hair strands continue shrinking after each telogen phase until growth ceases in the complete.
Many hair care products and treatments help prolong hair growth. Few, though, are as capable as exosomes. The hair growth cycle remains intact longer while hair strands become thicker and healthier.
Can the patient take NSAIDS?
No. It is ideal for the patient to stop taking NSAIDS for 72 hours prior to the injection and for 4 days after. NSAIDS will NOT destroy the injected cells, but they can potentially lessen the effects.
Are there any contraindications for exosome injections?
There are no contraindications for exosome injections.
Are there any restrictions after the procedure?
The only restriction is to avoid aspirin, naproxen, ibuprofen, and other NSAIDs for 3 weeks following the procedure. Following the procedure, you may go home and shower after 24 hours you can wash your hair. Be aware the treated area may be tender. Many patients return to work the next day and resume their daily routine the same day.
Can I combine exosome therapy with other hair loss modalities?
Absolutely, we recommend Nutrafol, or Minoxidilin conjunction with exosome therapy for hair loss. We strongly encourage all our patients to optimize their hormones and micro-nutrients for maximum hair growth.
A proper diet is critical for healthy hair. Essential proteins like Arginine, Histidine, and Lysine are found in meat, fish, poultry, and eggs and are important for new hair growth. Essential fatty acids, like Omega-3are found in salmon, sardines, herring, and mackerel and are the most important for shiny, healthy hair. Adequate levels of flax, antioxidants, and vitamins, (especially B and D vitamins) make the difference between a full, thick, shiny head of hair and thin, brittle, dull hair that sheds and breaks easily. Green tea can also reduce inflammation in a follicle if inflammation is present. While a healthy diet is critical, supplements are also becoming popular for the management of all forms of hair loss.
Below are my favorite hair products:
The FDA approved concentration of 5% minoxidil, available over the counter, is now the same for both men and women with androgenetic alopecia. Men need to use it twice a day and women only once a day.
Nutrafol contains a blend of ingredients shown to have data supporting hair growth. It contains:
- Rhodiola, Schisandra, and Rishi Mushrooms: adaptogens that lowers elevated stress hormones triggered by emotional and physical stressors and protect the body from the effects of stress with powerful immune modulating properties.
- Tocomax 20%™: can increase hair growth on average by 34%
- Sensoril® Ashwagandha: decreases the levels of hair damaging stress hormone, Cortisol
- BCM-95® BioCurcumin: a potent anti-inflammatory and antioxidant clinically proven to lower inflammatory biomarkers, like CRP.
- Cyantine® HNS: provides the building blocks of hair to improve hair strength and brightness
- Hydrolyzed Marine Collagen & Hyaluronic Acid: rebuild the structural integrity of the hair follicle environment, improve moisture, and promote diffusion of nutrients.
This is a supplement to nourish thinning hair and promote existing hair growth. It has excellent clinical data, and the formulation includes:
- Amino Mar Marine Complex: provides the essential proteins needed to nourish thinning hair and encourage growth of existing hair
- Horsetail Extract: an organic form of silica which increases the strength of the hair and revitalizes lifeless hair
- Vitamin C from the Acerola Cherry (one of the richest sources of Vitamin C available)
- This contains fish and shellfish and is not appropriate for those allergic to these ingredients or for those with celiac disease.
What else can I do for my hair loss?
Fotona Laser Hair Restoration can take only weeks, not several months, to see results. Using a customized protocol, the energy from the laser stimulates dormant hair follicles without anesthesia or surgery. The Fotona PS03 hand piece is moved back and forth directly on the scalp several times in a crosshatch pattern. The area will appear red for 24 hours and it is recommended that you do not take a hot shower immediately post-treatment. The treatment area(s) may feel a little tight or swollen, but this subsides within a few days. No one will be able to tell you had anything done except for you! After about 8-12laser sessions, at 2-week intervals, you can expect a fuller head of hair and renewed confidence. For more severe cases, Dr. Page may recommend combining Hairlase with PRF/exosome therapy, a great treatment option that has delivered dramatic results to our patients.
Can exosomes be used for Alopecia Areata?
Yes. Clinical and anecdotal results have shown tremendous efficacy for when exosome therapy is utilized.
What preparation do I need to do prior to & the day of my procedure?
- Have your hair color procedure done 2 weeks prior to your exosome hair restoration procedure as you won’t be able to have your hair colored for 4 weeks.
- Avoid Aspirin, Naproxen, Ibuprofen, and other NSAIDs 3 days prior to the procedure and 3 weeks after the procedure.
- Wash your hair the day before you come to your procedure and make sure your scalp is clean.
- Drink plenty of water the night before (60 ounces) & the day of your procedure (36 ounces) since we need to draw your blood. If you are a “hard stick” have something salty the night before to help fluid stay in the veins.
- Have breakfast the morning of their procedure if hungry.
- If it’s cold outside bundle up to keep your extremities warm for your blood draw.
- Bring a soft hat or baseball cap as your head will be wet when you leave.
- Wear layers. When your scalp is wet, we tend to get cold.
- You can’t wash your hair for 24 hours after your procedure so plan your activities accordingly.
- Your procedure will take about 60 mins but plan to be at the clinic for 90 mins as it takes time to spin your blood & prep your scalp.