One Generations Trash – Another Generations Treasure: Clinical Perspective of The Use of Exosomes In Hair Loss

Previously ignored as a byproduct of biologic waste, exosomes have garnered much attention from the scientific community over the past two decades1. The physiological purpose of exosomes remains obscure. However, recent research has positioned exosomes as a major player in regulating cell-to-cell communication2,3. These findings have spurred a growing number of studies, including active investigations into the therapeutic implications related to exosomes. These include studies in the fields of immune response and infection, cardiovascular diseases, neurodegeneration, cancer and aesthetics2,4.

Within the world of hair science, each new year brings further studies investigating the potential role of exosomes in hair loss. Through the upregulation of various mediators, multiple studies have demonstrated an exosome-produced promotion of hair cycling4.

Given the infancy of the field, while there has been a plethora of molecular and animal studies, there remains a paucity of clinical studies.

Pilot5 and anecdotal evidence have demonstrated exosomes to have much promise both alone6 and as an adjunct to follicular unit extraction7 in the future management of alopecia. Yet, currently more work is necessary. There is no standard related to the products origin, isolation, purification, identification and storage4. Further, on the clinical side, there have been no robust trials demonstrating safety and efficacy; without standardization of manufacturing, the development of dosing protocols will be challenging4.

From a safety and compliance perspective, many manufacturers are Good Manufacturing Compliant but not certified. Side effect profiles have been promising in the body of literature, with the caveat that the field remains very young.

Providers looking to offer exosomes to their patients should use their best judgment as they investigate the various non-FDA approved products on the market. Performance indicators in terms of bang-for-the-buck are noted on each product, yet without standardization, they remain difficult to compare.

Once the product is selected, providers should select a dosing protocol based on the available literature, which is scant. Providers will then leverage anecdotal data as they fine-tune their protocols. For instance, at AlviArmani we have reported a number of patients with bimodal shock loss after receiving exosomes within a defined period after Follicular Unit Extraction. As such, the protocols have been shifted to only provide exosomes after a such period of recovery post -FUE has passed.

AlviArmani Genomics Corp has removed some of the guesswork by leveraging our Microscalp technology. Microscalp technology allows researchers to efficiently test various products against one another, as it pertains to their ability to promote hair growth.

Using subsequent molecular studies, various pathways related to hair growth can and have been elucidated.

Exosomes were previously regarded as waste and are now thought to play significant roles within cellular communication. There is much research demonstrating its promise within the future management of alopecia. Currently, further progress needs to occur in the field to allow for standardization of products and formation of clinical protocols. AlviArmani’s Microscalp technology provides us with confidence in knowing we have the most efficacious product on the market for our needs. Further work around regulation and further standardization, needs to be performed to optimize safety and efficacy alike.

  1. Waste not, want not: how exosomes went from trash to Pharmaceutical Technology. Nov 2018. https://www.pharmaceutical-technology.com/comment/exosome-trials/
  2. Raghu Kalluri and Valerie LeBleu. The biology, function, and biomedical applications of exosomes. Science. 2020.
  3. Bruno S et al. Mesenchymal stem cells derived microvesicles protect against acute tubular injury. J Am Soc Nephro. 2009.
  4. Yinghui Zhou et al Exosomes for hair growth and Journal of Bioscience and Bioengineering. 2024.
  5. Sasaki, Gordon. Clinical use of extracellular vesicles in the management of male and female pattern hair loss: A preliminary retrospective institutional review board safety and efficacy study. Aesthetic Surgery Journal. 2022.
  6. AlviArmani Exosomes Alone- Crown Result. https://www.alviarmani.com/exosome- injection-therapy-to-treat-crown-hair-loss/
  7. AlviArmani with FUE https://www.alviarmani.com/2400-grafts-fue- exosomes/