Exosomes vs Hair Loss: Do They Really Work?

Dr. Andrea Suarez, dermatologist, talks us through the science:

The Exo factor

First, what exosomes actually are: tiny membrane-bound packages naturally released by cells that carry an assortment of proteins, lipids, DNA fragments, messenger RNA, microRNA, growth factors, and other signalling molecules whose function is to communicate with nearby cells. They are being investigated as a regenerative treatment for hair loss.

No, they are not the same as stem cells: exosomes are not living cells. Unlike stem cells, they cannot divide, become new cells, or create new hair follicles. Instead, they (as best we currently understand it) rather influence the behaviour of existing cells.

As for why researchers are looking into them for treating hair loss, studies (mentioned in the video but sadly not actually given as references) do suggest exosomes can stimulate dermal papilla cells, encourage blood vessel formation, reduce inflammation, and activate pathways involved in hair growth, including Wnt, VEGF, and TGF-beta signalling. These effects could help keep hair follicles in the active growth (anagen) phase.

However: current human evidence is limited. For example, at best, a systematic review found that only 11 clinical studies met quality criteria from more than 2,000 screened studies. Altogether, they included fewer than 300 patients, and only two were randomized controlled trials*.

^{*We wish she’d given the link to this systematic review, as we’re curious as to the soundness of the methodology of those two RCTs, and also who paid for them (a lot of this kind of research is funded by beauty companies, which introduces a conflict of interest, and even in the absence of outright corruption, introduces a publication bias as the company can pull funding of studies that aren’t going the way they want, or cut funding at just the right time to do p-hacking of the results).}

It’s also worth noting the heterogeneity of studies, as no single exosome treatment exists. Unlike medications such as minoxidil, “exosome therapy” is not one standardized product. Different manufacturers use exosomes from different sources, including fat tissue, placenta, umbilical cord, bone marrow, hair follicles, foreskin, and even plants. That makes it hard to compile a meaningful amount of data if one study’s about one kind of exosome and the next is about another.

All that said, early results are encouraging, so far: most studies reported improvements in at least one measure of hair growth, including increased hair density, thicker hairs, and high patient satisfaction. No serious side effects were reported within these small studies. So that is all superficially looking promising; it’s just very far from compelling as yet.

In short, the honest answer to the question posed in the title is “we don’t know yet”.

And that may seem a disappointing answer, but we believe it’s far better than just spinning things one way or the other to make for a more exciting answer.

Perhaps more importantly, “we don’t know yet” can be followed up with “and if anyone claims they do know, examine where that answer of theirs is coming from”!

For more on all of this as well as some alternatives (nothing that will surprise regular 10almonds readers, as we’ve talked about all the alternatives before), enjoy:

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Want to learn more?

You might also like:

How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

Take care!