Not All Exosomes Are Created Equal: Everything You Need to Know

Technology in the world of aesthetic medicine continues to advance, and exosomes are the rising star of cutting-edge treatments. Not only do exosomes promise age-defying rejuvenation abilities, but they have been shown to enhance the efficacy of skin and scalp treatments.

The wide-ranging implications and uses of exosomes have made them highly desirable to aesthetic practitioners worldwide, resulting in an influx of exosome products inundating the market, making it crucial to choose sources with scrutiny. BENEV Company Inc. (Mission Viejo, Calif.) and ExoCoBio (Seoul, South Korea) have made it their mission to lead the way with advanced science and research into exosome technologies to give practitioners confidence in offering exosome treatments.

Exosomes: The Essentials

Exosomes are extracellular nanovesicles often used to enhance aesthetic treatments or outcomes by promoting the regenerative cascade that follows many treatments. Because exosomes function as messenger cells, some researchers believe they may be more important than stem cells for regenerative effects.

“Exosomes are tiny packets of information secreted by cells to communicate with each other,” explained Jessie Cheung, MD, dermatologist and founder of Cheung Aesthetics & Wellness in Willowbrook, Ill. “They have hundreds more growth factors and proteins than platelet-rich plasma (PRP), as well as messenger ribonucleic acid (RNA) and microRNA to initiate specific functions. Exosomes can modulate cellular function and epigenetic programming such as deoxyribonucleic acid (DNA) methylation and are actively being researched as biomarkers for disease diagnosis and vehicles for therapeutic delivery and tissue repair.” Most exosomes used in the aesthetic space are human derived, though there is also a growing body of research examining the efficacy of plant-derived exosomes for cellular activation, she noted. Adult human sources include blood, adipose tissue, bone marrow, perinatal umbilical cords, and placental tissue.

“We use exosomes in the same way that we have used PRP for many years – for scalp rejuvenation and skin rejuvenation,” Dr. Cheung continued. “For skin health, exosomes are applied topically after a procedure that creates inflammation, such as laser or microneedling. I use them to speed up recovery while also decreasing inflammation and exponentially increasing the production of healthy collagen and elastin. I incorporate BENEV x ExoCoBio exosomes, which have multiple patents and clinical studies for skin health, with my treatments for eczema, rosacea, and scarring.”

Board-certified dermatologist Saami Khalifian, MD at SOM Aesthetics (Encinitas, Calif.), also describes exosomes as packages that are delivered by stem cells. Stem cells transport the important instructions inside these packages between cells to promote tissue repair and healthier skin. “While the stem cells are crucial, it is really the exosomes – the packages inside – that contain the signals that help achieve the positive effects we see in cosmetic treatments,” explained Dr. Khalifian. “In cosmetic dermatology, exosomes are often sourced from mesenchymal stem cells (MSCs), which are known for their regenerative properties. In my practice, I use BENEV x ExoCoBio exosomes as a powerful tool to enhance a range of cosmetic treatments.”

The Science and Technology of Exosomes

Exosomes are a cell-free therapy option that can facilitate the exchange of RNA and other proteins between cells, including fibroblasts, immune cells, and keratinocytes, as well as growth factors, cytokines, and other genetic materials that have shown signs of tissue repair and skin cell improvements.

BENEV x ExoCoBio exosome treatments are based on these cutting-edge biotech breakthroughs, harnessed into a line of exosome products that promote a radiant and more youthful appearance. ExoSCRT™ is an innovative technology used in BENEV x ExoCoBio exosomes to separate and refine pure exosomes from stem cells to promote skin cell proliferation by up to 80% in a dose-dependent manner.¹

Exosome Regulation

As of April 2024, there are no FDA-approved exosome products. “The FDA is only concerned with products and devices that are used to diagnose, cure, mitigate, treat or prevent diseases and intended to affect the structure or function of the body,” explained dermatologic surgeon Shino Bay Aguilera, DO (Fort Lauderdale, Fla.). “In the U.S., exosomes are legally used as a topical product like a skincare product. However, there are certain authorized bodies [who can provide guidance] in the cosmetic field similar to the Physician’s Desk Reference or U.S. Pharmacopeia in medicine. This includes the Personal Care Products Council (PCPC) and International Nomenclature Cosmetic Ingredients (INCI), both of which provide guidance on cosmetic ingredients.”

Dr. Aguilera noted that the recently implemented Modernization of Cosmetics Regulation Act (MoCRA) is the most significant expansion of the FDA’s authority to regulate cosmetics since the Federal Food, Drug, and Cosmetic (FD&C) Act was passed in 1938, and manufacturers and distributors should be MoCRA compliant.

Reputably Sourced and Studied Exosomes

Because the exosome market is relatively new, providers should do their due diligence in choosing exosome products and not lean on a company or salesperson to be their source of information, emphasized Dr. Aguilera. “As medical providers we should look at the science for proof and validation of exosome technology. In the medical industry, proof and validation comes to us via peer-reviewed published papers, therefore this should be the starting point for providers,” he remarked.

Along with peer-reviewed publications, Dr. Aguilera added that providers should look at the process, reproducibility and batch-to-batch quality assurances, and learn what type of facility the exosomes are manufactured in. “What is more important than the source is the manufacturing process itself with reproducibility in large volumes and quality assurances. A good source with a poor manufacturing process results in a poor product,” he added.

To choose the ideal exosome products, Dr. Aguilera explained that providers should first assess if the exosome source has certain characteristics such as anti-inflammatory properties. He also noted that providers should ensure the exosome products have a track record of three important criteria, including the reduction of inflammation to help reduce discomfort and long-term complications, the reduction of downtime, and an improvement or increase in collagen and elastin.

Dr. Aguilera referenced a study that utilized a CO₂ laser on acne scars with BENEV exosomes that showed a reduction in downtime,² while other studies indicated exosomes reduced post-treatment inflammation and a boost in natural collagen.³

Dr. Khalifian agreed, adding that when choosing exosome products, there are some key qualities to look for. “Ensure that the exosomes are sourced from well-characterized, reputable cells, like MSCs, and that they are highly purified,” he noted. “High-quality exosomes should be consistent in their concentration and content to deliver reliable results. Products should be manufactured under strict guidelines to ensure they are free from contaminants and meet the highest standards of safety and efficacy. Lastly, it is important to choose exosome products that have been studied and shown to be safe and effective, with clear data to support their use.”

BENEV x ExoCoBio Exosomes

“I use the Benev x ExoCoBio products because they are the market leader worldwide,” professed Dr. Aguilera. He pointed out that BENEV x ExoCoBio is heavily steeped in science, having spent over $80 million on exosome research and development, with studies of exosome technology from sources such as human, plant, bacteria and canine, confirming their commitment to the science and development of exosomes.

Sourced from adipose stem cells (ASCs), BENEV x ExoCoBio exosomes are used by thousands of providers around the world to address a wide range of skin concerns, including fine lines, wrinkles, sun damage and even loss of volume, and to reduce post treatment downtime. Exosome Regenerative Complex is an intensive dual-action complex formulated to quickly absorb into the skin to deliver a powerful concentration of stem cell-derived lyophilized exosomes, potent growth factors, peptides, coenzymes, minerals, amino acids, vitamins and irritation reduction agents to rejuvenate and intensely moisturize the skin and scalp.⁴

BENEV exosomes are designed and developed in a collaboration between BENEV Company Inc. (a U.S. FDA-registered manufacturing facility) and ExoCoBio, the fourth largest exosome research company in the world. The patented exosome products are post-care, topical-use cosmetic solutions, and paraben free, steroid free and hypoallergenic technologies. All ingredients have been clinically shown to rejuvenate and regenerate the skin and scalp.⁵ Notably, these products are neither drugs nor intended to prevent, treat or cure any disease or medical condition.

The isolated and purified exosomes in BENEV Exosome Regenerative Complex powered by Exo-SCRT™ and BENEV Exosome Regenerative Complex + powered by Exo-SCRT™ have PCPC and INCI registration, and the term “Human Adipose Stromal Cell Exosomes” is the only name assigned to exosome products in the International Cosmetic Ingredient Dictionary and Handbook (INCI) book.

“BENEV’s FDA-registered manufacturing facility is the only pharmaceutical grade manufacturer of exosomes in the world, which reassures me of the quality and reproducibility with stringent quality assurances,” Dr. Aguilera commented. “BENEV exosomes have scientific validation with 25+ published papers in addition to 1.6 million patients treated worldwide in over 50 countries. This is extremely important in this new and volatile sector of the market.”

In Dr. Khalifian’s opinion, BENEV x ExoCoBio exosomes stand out because of the careful attention to both the stem cells and their exosomes, or “packages.” “These exosomes are sourced from meticulously selected mesenchymal stem cells,” he stated. “The exosomes undergo a proprietary process that ensures the ‘packages’ inside – the growth factors, proteins and other molecules – are of the highest quality. What sets them apart is the consistency and purity of the exosomes, which are produced under stringent standards to ensure they deliver reliable, effective results. BENEV’s commitment to research and development means that these exosomes are not just scientifically advanced, but also safe and versatile for use in a variety of cosmetic post-procedural and stand-alone topical contexts.”

“Exosomes are not FDA-approved for any specific therapeutic benefit, although there are ongoing clinical trials,” added Dr. Cheung. “As a provider, you want the best quality exosomes, and that means looking at how the exosomes are isolated, quantified and characterized, as well as the protein analysis.” In Dr. Cheung’s practice, when BENEV exosomes are used, they see almost immediate decreased redness and inflammation, faster recovery (within days), and healthier, firmer, more even skin tone and improved scalp quality within weeks to months, she shared.

Integrating Exosomes to Optimize Patient Outcomes

Today’s forward-thinking aesthetic physicians are using BENEV EXO-XOM Facials with Exosome Regenerative Complex and Exosome Regenerative Complex + powered by ExoSCRT™ in treatments for scalp and skin. The advanced technologies seamlessly integrate with cosmetic procedures including microneedling, non-invasive laser, radiofrequency (RF) microneedling, PRP treatment, and chemical peels to enhance and optimize patient outcomes for skin revitalization, dermal remodeling, and scalp revitalization.

“Whether I am performing microneedling, laser resurfacing, or post-chemical peel care, BENEV x ExoCoBio exosomes are the ultimate delivery system, bringing a concentrated dose of recovery and anti-inflammatory signals right where they are needed most,” reported Dr. Khalifian. “By applying them during or after these procedures, my patients achieve faster recovery and more noticeable improvements in their skin’s texture and tone. The results speak for themselves as patients often report a quicker recovery time and a more radiant complexion.”

“To get the best results with exosomes, I recommend that providers start by understanding the science behind them – the ‘packages’ of signals they deliver are what truly make a difference in patient outcomes,” Dr. Khalifian continued. “Make sure the skin is well-prepared through treatments like microneedling or lasers to maximize the absorption and effectiveness of the exosomes. Combining topical exosomes with other treatments like PRP can further enhance their benefits. And, of course, choose exosome products that have a proven track record of safety and effectiveness. Patient education is also key to help them understand the value of these treatments and what to expect, which can greatly enhance their satisfaction.”

According to Dr. Aguilera, achieving the best possible aesthetic outcomes while minimizing patient downtime is the priority in his practice. “This is why we incorporate BENEV exosomes into our treatment protocols following any controlled injury that compromises the skin, such as microneedling, laser treatments, or chemical peels. By introducing exosomes into the recovery process, we enhance tissue repair, promote faster recovery, and ultimately deliver superior results in a shorter period of time.

"Beyond skin rejuvenation, we also utilize exosome therapy in our approach to scalp rejuvenation,” Dr. Aguilera continued. “By applying exosomes to the scalp, we can improve scalp health and address scalp issues more effectively. This regenerative approach is ideal for patients seeking non-invasive, cutting-edge treatments to restore both skin vitality and scalp health.”

The Future of Exosome Technology

BENEV x ExoCoBio is igniting innovative advancements in aesthetic medicine with regenerative treatments that can be used throughout the aesthetic space. Their exosomes represent a trend towards efficacy and safety in an affordable modality for modern practices and their patients. But where will this technology lead, exactly?

“I take a bioregenerative and functional aesthetic medicine approach in my practice, focusing on understanding the aging process at a cellular level,” shared Dr. Aguilera. “I firmly believe that the emerging field of exosomes holds the key to unlocking many answers about aging and tissue regeneration at a cellular level. By understanding how cells communicate and repair themselves, we can better harness these biological mechanisms to slow down or even reverse the signs of aging. Given my commitment to use treatments that closely mimic the body’s natural processes, it makes sense to prioritize human-derived exosomes for all my dermatological and aesthetic needs. Human exosomes have an unmatched ability to deliver targeted regenerative messages to cells, making them a powerful tool in skin rejuvenation and repair.”

Human-derived exosomes are not yet an option in many other countries due to regulatory restrictions, which has led to the exploration and use of plant-derived exosomes as an alternative. While they do not originate from human cells, plant-derived exosomes have demonstrated efficacy in supporting and enhancing the results of dermatologic procedures in some studies. “There is still so much to learn about how exosomes interact with our cells and the profound messages they carry. As research progresses, exosomes may offer solutions to longstanding dilemmas in aesthetic medicine, bringing us closer to more effective and holistic approaches to skin and cellular health,” Dr. Aguilera noted.

For Dr. Khalifian, exosomes represent an emergent paradigm in aesthetic technology with BENEV x ExoCoBio leading the industry. “While the science is still evolving, what we know so far is incredibly promising. Exosomes are a significant advancement in cosmetic dermatology, offering a new way to enhance the skin’s natural restorative processes,” he affirmed. “BENEV x ExoCoBio focuses on delivering results today while investing in the future of exosome technology to ensure that it remains safe, effective and on the cutting edge of aesthetic medicine. I am excited to see where this journey takes us and how it can continue to benefit patients in the years to come.”

References:

1. Exosome by BENEV. In Vitro Testing. Data on File. Available at: https://www.benev.com/exosome. Accessed September 9, 2024.

2. BENEV. Data on File.

3. Kwon HH, Yang SH, Lee J, et al. Combination Treatment with Human Adipose Tissue Stem Cell-derived Exosomes and Fractional CO₂ Laser for Acne Scars: A 12-week Prospective, Double-blind, Randomized, Split-face Study. Acta Derm Venereol. 2020;100(18):adv00310. doi:10.2340/00015555-3666

4. BENEV. Data on File.

5. BENEV. Data on File.