May 13, 2025
Regenerative therapies offer a more natural and less invasive approach to facial plastic surgery and aesthetic medicine. The use of exosomes (extracellular vesicles) is not a new concept in regeneration. But until recently, exosomes have been unpredictable, hard to access and expensive. However, Mayo Clinic-supported development of platelet-derived exosomes represents a groundbreaking area in medical research. Exosomes can harness the body's natural healing mechanisms, offering hope for innovative treatments in aesthetic medicine, wound care, regenerative medicine, hair restoration and other fields.
Exosomes are small extracellular vesicles, also known as EVs. They are released by all cells, including stem cells. The current understanding is that they carry bioactive molecules, including proteins, microRNAs and lipids, which help to maintain positive cell signaling.
"EVs are the primary form of communication between cells and heralded as 'key messengers' in regenerative medicine," says Deanna C. Menapace, M.D., a facial plastic surgeon working within the Mayo Clinic Cosmetic Center in Jacksonville, Florida. "Exosomes 'push on the gas' for healing factors in the body. Stimulating collagen production, reducing wrinkles and improving skin elasticity are just a few examples of what exosomes can do."
The Cosmetic Center uses platelet-derived exosomes topically in facial plastic surgery and aesthetic treatments, and the center is seeing remarkable outcomes.
Pioneering a new approach to regenerative aesthetics
Stem cells have been at the forefront of regenerative medicine for decades. Their ability to aid in regeneration is undeniable. However, challenges associated with extracting and growing stem cells have pushed researchers to dig deeper. Retrieving exosomes from platelets instead of stem cells provided a solution.
"Mayo Clinic researchers work extensively with stem cells," says Dr. Menapace. "Through this, they discovered that exosomes within the cell are the 'main players' in encouraging regeneration."
Exosomes can come from many sources. However, when extracted from human platelets, exosomes offer regenerative power that is more reproducible, more reliable and easier to process than exosomes derived from other sources. Exosomes are not "alive" and do not replicate, limiting concerns about possible immune reactions or oncogenesis.
"Each person is unique. Therefore, so is their cell quality. The number of exosomes released during other treatments that are thought to contain exosomes can vary between patients," explains Dr. Menapace. "When working with platelet-derived exosomes, the technology and process make it so that you know exactly how many exosomes are in the product. Data on how to best dose exosomes is growing."
Mayo Clinic physicians and scientists pioneered the cell-free technology used for processing and storing platelet-derived exosomes. The patented technology created a clinical-grade product that is sterile, pure and shelf-stable.
"We are witnessing topical exosomes improve skin quality, texture and overall appearance. They also significantly decrease healing times after facial plastic surgeries and procedures."
Harnessing the power of platelet-derived exosomes for skin care
Use cases for topical platelet-derived exosomes in aesthetic medicine are based on a growing body of scientific evidence. Findings suggest that topical exosomes:
- Target cell senescence. Using a topical platelet-derived exosome product for 12 weeks may significantly reduce old (senescent) skin cells, resulting in a 40% reduction in proinflammatory secretions. The findings were documented in a 2024 study published in Dermatologic Surgery.
- Boost overall skin health. After six weeks of topical exosome use, imaging reveals improvements in various clinical factors related to facial photodamage and dermal aging. Platelet growth factors contribute to increased collagen and elastin production as seen in a study published in the Aesthetic Surgery Journal.
- Improve scar appearance. Exosomes reduce inflammation and promote tissue rejuvenation, helping to speed up wound healing and reduce the visual appearance of scars, according to a 2024 study published in Plastic and Reconstructive Surgery-Global Open.
- Supplement hair loss programs. Exosomes from all biological sources significantly induce and prolong the growth (anagen) phase. This results in hair growth as cited in Clinical, Cosmetic and Investigational Dermatology.
To achieve optimum efficacy, a healthcare professional should administer platelet-derived exosome therapy as part of a personalized care approach. "This type of product is very powerful," says Dr. Menapace.
Topical exosomes should be used under the guidance of a duly licensed physician or advanced healthcare professional because its application has several nuances. This product is not currently approved for injection unless part of a Food and Drug Administration (FDA) clinical trial, of which there are many ongoing.
"The product quality, donor source and storage are also critical — where you get it matters," says Dr. Menapace. The Mayo Clinic Cosmetic Center in Florida uses the highest-quality topical exosome products. The center recommends that all people undergoing facial plastic surgery or procedures have a proper skin analysis. Outside of surgery, the Cosmetic Center uses topical exosomes in several ways, including:
- Pre- and post-procedure skin conditioning as part of the center's peel, laser and microneedling procedures.
- Simplifying complex regimens, as this product can replace growth factors and peptides, and even moisturizers.
- Improving tolerance of topical active ingredients, such as retinoids, when used in combination.
- Supplementing hair loss programs to improve hair density and thickness without a prescription.
"We are witnessing topical exosomes improve skin quality, texture and overall appearance," Dr. Menapace says. "They also significantly decrease healing times after facial plastic surgeries and procedures."
Advancing regenerative therapy in aesthetics and beyond
Platelet-derived exosomes should only be used topically. As trials are in progress, there are no FDA-approved indications for injecting these types of exosomes yet. But Dr. Menapace says new clinical indications and methods of use for exosomes extracted from platelets are not far away.
"Platelet-derived exosomes have emerged as a promising therapeutic frontier in aesthetic and regenerative medicine," she says. "There are so many potential applications."
For more information
Wyles SP, et al. Topical platelet exosomes reduce senescence signaling in human skin: An exploratory prospective trial. Dermatologic Surgery. 2024;50;S160.
Proffer SL, et al. Efficacy and tolerability of topical platelet exosomes for skin rejuvenation: Six-week results. Aesthetic Surgery Journal. 2022;42:1185.
Park SY, et al. Exosome-mediated advancements in plastic surgery: Navigating therapeutic potential in skin rejuvenation and wound healing. Plastic and Reconstructive Surgery-Global Open. 2024;12:e6021.
Cheng M, et al. The roles of exosomes in regulating hair follicle growth. Clinical, Cosmetic and Investigational Dermatology. 2024;17:1603.
Refer a patient to Mayo Clinic.