As the demand for non-invasive aesthetic treatments continues to surge, the incorporation of exosomes into the realm of skincare holds immense promise. Peer-reviewed studies substantiate the potential of exosomes in addressing a spectrum of aesthetic concerns. From enhancing skin quality and reducing pigmentation to promoting hair regeneration and treating acne scars, the scientific community is laying the groundwork for a new era of skincare innovation.

This shift towards cell-free therapies is driven by the desire for effective yet minimally invasive treatments that provide tangible results.

So what is all the fuss about? We caught up with Xytide Biotech, a leading medical aesthetics distributor who recently launched Exomide, an exosome-based solution for dermatological conditions. Xytide discusses the scientific underpinnings, clinical evidence, and exciting possibilities that exosomes bring to the forefront of skin rejuvenation.

What is Exomide?

Exomide is a revolutionary skin and scalp care product that leverages exosome therapy, which uses nano-sized vesicles called exosomes, which are secreted by stem cells and carry essential molecular information for cell-to-cell communication and regeneration. Exomide delivers stem cell-derived exosomes to target skin rejuvenation and hair-growth.

The formula contains:

• 7 types of growth factors: EGF, VEGF, HGF, bFGF, TGF-β1, KGF and PDGF
• 17 types of amino acids: Lysine, Phenylalanine, Valine, Leucine, Isoleucine, Threonine, Methionine, Histidine, Arginine, Glycine, Serine, Proline, Tyrosine, Cysteine, Alanine, Aspartic acid and Glutamic acid
• 6 types of peptides: Copper Tripeptide-1, Hexapeptide-9, Tripeptide-1, Acetyl Hexapeptide-8, Palmitoyl Tripeptide-1 and Palmitoyl Pentapeptide-4
• 8 types of hydrolyzed hyaluronic acid (HA): using ultra-low molecular Hyaluronic Acid manufactured though unique enzymatic decomposition technology.
• Additional active ingredients: Niacinamide (B3), panthenol (B5), glutathione.

What are exosomes?

The communication between cells via their secreted molecules, known as secretomes, is emerging as a unique biological regulation. Secretome consists of soluble factors and extracellular vesicles. Extracellular vesicles are divided into three main classes: exosomes, ectosomes, and apoptotic bodies. Their size and biogenesis are used to classify them.

Exosomes have the smallest size (up to 200nm). They have drawn increased attention in their therapeutic uses for prognosis, diagnostics, drug delivery, and even vaccine development due to their critical role in several physiological and pathological processes.

Exosomes have remarkable properties for drug delivery because they combine the benefits of cell-mediated drug delivery with those of synthetic nanocarriers: owing to biocompatibility, stability in the bloodstream, penetration of the biological barrier, minimal immunogenicity, and toxicity.

Put simply, why Mesenchymal Stem Cell Secretomes (exosomes) have been chosen as the main ingredient of Exomide, is that they are natural transporters contained from stem cells. The size of the exosomes are only about 1/1000th the thickness of human hair, but are full of various elements in skin cells as protein, growth factors, RNA, mRNA and cytokines.

What are the functions and benefits of the Exomide exosomes?

Exosomes perform a wide range of specialised functions. They are essential to numerous physiological and pathological processes. Prognosis, diagnostics, drug and growth factors delivery are some of their frequent clinical applications.

Messenger RNA (mRNA), microRNA (miRNA), and other proteins, including growth factors and immunological components, are all found in exosomes. They trigger cell homing, and regeneration, anti-inflammatory, immunomodulatory, and anti-prostaglandin pathways when are appropriately stimulated. Exosomes can move throughout the body without clumping. When given intravenously, they do not exhibit a first-pass effect into the lungs as is frequently observed with mesenchymal stem cells.

Additionally, because exosomes don’t contain any DNA, they can avoid the immune system’s response and pose no threat of developing into cancer.

Why would we use exosomes in aesthetic medicine?

Treatment with exosomes holds great promise in a wide variety of healthcare needs, including dermatology and aesthetics. Ongoing research is trying to explore the potential of exosomes in different settings for aesthetic purposes.

Driven by a growing sense of self-care in the general public, medical aesthetics treatments are in an all-time high demand. There are different non-invasive aesthetic procedures, such as Botulinum toxin, dermal filler, CO2 laser, to name a few, which are generally used to treat signs of skin ageing. However, the interest in using stem cell-based treatments for skin care has created a controversial trend.

On one side, there is enormous growth in public and industrial interest in the potential of stem cells and related products and services to improve general wellbeing and deliver anti-ageing effects; on the other side, many regulatory bodies around the world are tightening the cell-based therapies due to the numbers of scientific, ethical and legal concerns. These concerns lead to a shift to a new era of research known as cell-free treatments, especially applications of secretomes and exosomes.

Currently exosomes have been used to reduce wrinkles, pores size, pigmentation, oiliness, increase skin elasticity and collagen contents and improvement in evenness of skin and vascularity. Also for hair regeneration and treating acne scars.

Is there enough scientific evidence to support these exosomes in aesthetic medicine?

These are some evidence from peer reviewed journals to support the application of exosome in aesthetics medicine:

Skin quality:
Effect of exosome on moisture content on the U-zone, melanin and erythema of lid-cheek, overall size and depth of eye wrinkles, and skin roughness of healthy individuals have been reported upon applying a cosmetics formula contatining exosomes (Kim et al., 2019).

Skin appearance:
The facial microneedling with immediate topical application of 5 billion exosomes suspended compared to placebo was reported that the exosome treatment group showed improved tone, quality, and clarity of their skin compared to the Control Group (p < .0001), with a reduction in wrinkles, pores, pigment, oiliness, and improvement in evenness of skin and vascularity (Chernoff, 2021).

Acne Scars:
The clinical efficacy and safety of adipose tissue stem cell-derived exosomes as an adjuvant therapy after application of fractional CO2 laser for acne scars was assesed in a 12-week prospective, double-blind, randomized, split-face trial with a total of 25 patients who received three consecutive treatment sessions of fractional CO2 laser to the whole face, with a follow-up evaluation.

Post-laser treatment regimens were applied; for each patient, one side of the face was treated with adipose tissue stem cell-derived exosomes gel and the other side was treated with control gel. Adipose tissue stem cell- derived exosomes-treated sides had achieved a significantly greater improvement than the control sides at the final follow-up visit (Kwon et al., 2020).

Hair Regeneration:

Exosome can stimulate the proliferation of hair follicle, accelerate telogen-anagen transition, and protect hair follicle cells against reactive oxygen species and androgen. In a study with 20 patients (41.9 6 13.4 years old) hair density increased from 105.4 to 122.7 counts/cm2 (P<.001), while mean hair thickness increased from 57.5 to 64.0 mm (P<.001), after12 weeks of treatment. None of the patients reported serious adverse reactions (Huh and Kwon, 2019).

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