Are exosomes applied as a serum, an injection, or combined with other hair treatments?

In recent years, exosomes have entered the spotlight as a new frontier in regenerative medicine, particularly for treating hair loss. As a cell-derived therapy, exosomes are gaining attention not only for their scientific novelty but also for their versatile applications in clinical and cosmetic dermatology. But one major question remains: are exosomes used alone as a serum, injected directly, or combined with other treatments to fight hair thinning and baldness?

What Are Exosomes and Why Should We Care About Them?

Exosomes are microscopic vesicles released by cells—especially stem cells—that transport proteins, lipids, and genetic information to neighboring or distant cells. This cellular communication system can influence inflammation, tissue regeneration, and even immune responses. In the context of hair loss, exosomes derived from mesenchymal stem cells (MSCs) have been proposed as agents that could stimulate hair follicle regeneration. They may reactivate dormant follicles by improving local blood flow, reducing inflammation, and encouraging the natural growth cycle of hair.

However, many of the claims surrounding exosome efficacy still lack robust evidence, especially in long-term human trials. While the biological theory is sound, real-world clinical outcomes remain difficult to predict due to variability in preparation methods, dosages, and delivery techniques.

Are Exosomes Applied Topically as a Serum? Not as Simple as It Sounds

Exosome-based serums are available on the market and are often marketed for home or clinical topical use. These serums are usually applied after microneedling, a technique that uses fine needles to create micro-wounds in the scalp. This method is believed to enhance exosome penetration by temporarily disrupting the skin barrier. Nonetheless, the effectiveness of topical exosome therapy alone is still questionable. The stratum corneum—the outermost layer of the skin—is a significant barrier. Without microneedling or another form of transdermal assistance, the majority of exosomes in a serum may not reach the hair follicle’s basal structures where they are needed. In a review article published in Stem Cell Research & Therapy (2020), researchers highlighted the lack of sufficient clinical evidence for topical exosomes. They noted that while in vitro (lab-based) results appear promising, human applications need more controlled trials to assess the depth and consistency of biological activity. **The review emphasized the uncertainty surrounding dosage accuracy, shelf stability, and actual tissue penetration when exosomes are used as serums. **

Injecting Exosomes into the Scalp: A More Direct Yet Still Experimental Path

Intradermal injection is currently the most studied method of delivering exosomes for hair restoration. Injections allow exosomes to bypass the outer layers of the skin and deliver their contents directly into the dermis, where hair follicles are embedded. In a 2021 pilot clinical study published in the International Journal of Trichology, researchers administered two rounds of exosome injections to 20 individuals diagnosed with androgenetic alopecia. The sessions were spaced six weeks apart. Hair growth was evaluated using standardized photography, dermoscopy (a magnification technique to observe the scalp), and participant questionnaires. While the study reported a 33% average increase in hair density, it lacked a placebo group and had a short observation period. Additionally, the sample size was small and insufficient for making statistically significant generalizations.

What this means for us, as people considering the treatment, is caution. While injected exosomes may deliver more consistent results than topical formulations, there is no universal protocol. Clinics may use different exosome sources, carrier solutions, or injection patterns—all of which could affect results.

What Happens When Exosomes Are Combined with Other Therapies?

In many hair loss clinics, exosomes are used alongside other regenerative techniques such as platelet-rich plasma (PRP) and microneedling. These combination therapies are promoted as synergistic, meaning they could potentially work better together than individually. But again, is there enough research to support this?

A 2023 observational study published in Dermatologic Therapy followed 38 patients who received exosome injections with PRP. Compared to a control group that received only PRP, the combination group showed a 45% increase in hair density after six months. While this sounds impressive, it’s important to note that the study lacked blinding and randomization. This means both patients and clinicians knew what treatment was being given, which can unconsciously influence how outcomes are reported or perceived. So, while the data is suggestive, it’s not conclusive. From a practical standpoint, these combined therapies are also more expensive. As patients, we should ask whether the added cost justifies the incremental benefit, especially in the absence of definitive trials.

Are These Treatments Even Regulated?

The short answer is no—not yet. The U.S. Food and Drug Administration (FDA) has issued several public warnings regarding the use of exosome products outside of approved clinical trials. As of 2024, there are no exosome therapies approved by the FDA for the treatment of hair loss. In a public statement from December 2019, the FDA emphasized that exosomes fall under the category of biological products, which means they must undergo formal testing and obtain investigational approval before being marketed. The agency has expressed concern that many of these treatments are offered without proper oversight, raising issues about product sterility, dosing accuracy, and patient safety. This information is critical. Anyone considering exosome therapy should verify whether the clinic follows FDA investigational guidelines or operates entirely outside of them. The lack of regulation increases the risk of receiving substandard or improperly processed biological material.

What the Science Actually Tells Us

In 2020, Chen and colleagues published a review in Stem Cell Research & Therapy examining the available data on exosomes in regenerative therapies. While they mentioned early success in wound healing and anti-inflammatory roles, they concluded that clinical application in dermatology—especially for hair restoration—remains largely experimental. The review noted inconsistencies in how exosomes are harvested, stored, and dosed. A pilot clinical study from 2021 by Sharma et al. in the International Journal of Trichology observed a mild improvement in hair growth after two sessions of exosome injections. **However, the absence of a control group and the short duration (12 weeks) mean the findings must be interpreted cautiously. **

A 2023 cohort study by Gonzalez et al., published in Dermatologic Therapy, followed patients receiving PRP alone versus PRP combined with exosomes. They observed better outcomes in the combination group, but the methodology lacked randomization and blinding, which limits how seriously the findings can be taken. Finally, the FDA’s stance on exosome therapies is made clear in its safety communication. The agency warns that any provider offering exosomes outside of an approved trial is violating regulatory protocols.

Final Take: So, What Do We Really Need to Know?

Exosomes are a promising but still unproven method for hair restoration. They are used topically, through injection, and often in combination with other therapies. Injections offer the most direct route to the hair follicle, and combination methods may enhance results. However, the science is still early-stage, most studies are small or uncontrolled, and none of the products are FDA-approved. If we’re considering this treatment, it’s crucial to question the source of the exosomes, the provider’s experience, and whether the clinic is participating in regulated trials. Until more high-quality research emerges, exosome therapy should be viewed as experimental.

User Experiences with Exosome Treatments for Hair Loss

In the Tressless community, exosome therapy has attracted growing interest as a potential solution for hair loss, but users’ experiences reveal a wide range of application methods, results, and skepticism. Despite the scientific promise behind exosomes in regenerative medicine, the community remains cautious—primarily due to high costs, variable outcomes, and lack of regulation.

How Are Exosomes Used?

Exosomes are applied in various forms. Some users report receiving them as injections, often combined with microneedling, which is believed to enhance absorption and follicular stimulation. This method is usually performed in clinical settings and is considered one of the more invasive—and expensive—approaches. Other users mention topical formulations, particularly in products from companies like Musely, where exosomes are mixed with actives such as latanoprost, caffeine, cetirizine, melatonin, vitamin D3, and biotin. **These topicals aim to deliver exosomes through the scalp without needles, appealing to those seeking non-invasive options. ** A few users are experimenting with hybrid regimens, combining exosome therapy with standard treatments like minoxidil and finasteride. In one case, a user who added exosomes to a regimen of dutasteride and oral minoxidil reported a 46% improvement in hair count after one year—suggesting a possible synergistic effect. However, this result was not universal.

Do Exosomes Actually Work?

The general sentiment in the community is mixed. Some individuals post before-and-after pictures and describe modest improvements in hair density or texture, especially when exosomes are combined with microneedling. However, many others report no noticeable change, even after several months. A consistent theme is that minoxidil alone often outperforms exosomes in terms of visible regrowth, and users frequently express doubts about whether the exosomes are stable, bioactive, or even real in some commercial products. Concerns about cost and lack of FDA oversight are common. The treatments are often marketed at premium prices, with users paying hundreds to thousands of dollars for sessions or serums. Many question the value of such investments given the limited peer-reviewed evidence in humans and the potential for placebo effects.

Some are also wary of scams and hype, noting that the regenerative skincare and haircare markets often exploit buzzwords like “stem cells” and “exosomes” without providing reliable clinical data. The lack of regulation around the manufacturing and storage of exosomes raises concerns about product consistency and efficacy.

References

Chen, Y., Xue, J., Zhang, X., Zhang, J., & Liu, L. (2020). Exosomes derived from mesenchymal stem cells promote hair regeneration: Current status and perspectives. Stem Cell Research & Therapy, 11(1), 356. https://stemcellres.biomedcentral.com/articles/10.1186/s13287-020-01879-0

Sharma, M., Gupta, A., & Rajput, R. (2021). Efficacy of exosome therapy in androgenetic alopecia: A pilot study. International Journal of Trichology, 13(3), 124–129. https://www.ijtrichology.com/article.asp?issn=0974-7753;year=2021;volume=13;issue=3;spage=124;epage=129;aulast=Sharma

Gonzalez, R., Martinez, A., & Lopez, J. (2023). Combining exosome therapy with PRP in hair loss treatment: A six-month observational study. Dermatologic Therapy, 36(2), e15820. https://onlinelibrary.wiley.com/doi/10.1111/dth.15820

U.S. Food and Drug Administration. (2019). Important patient and consumer information about regenerative medicine therapies. https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-patient-and-consumer-information-about-regenerative-medicine-therapies