What’s the big buzz about exosomes (and are they even legal in the UK)?

There’s always something creating a buzz in the world of aesthetic medicine, and right now, it’s exosomes, tiny inter-cellular messengers which have huge potential for rejuvenating the skin by encouraging older skin cells to act like young ones.

Practitioners are offering exosome procedures, medispas have exosome facials, Kim Kardashian has talked about having exosome treatment… but some of the offerings aren’t entirely legal. Intrigued? We certainly are.  

What exactly are exosomes?

Technically, these are tiny, naturally-occurring ‘extracellular vesicles’ which are produced by almost every cell in the body. They’re microscopic – well, nano-sized –  little sacs with a lipid (fatty) casing, and play a crucial role in cell-to-cell communication, shuttling signalling molecules like proteins and genetic material between cells, which influences what’s going on, biologically. So if they find cells that need repairing, they set that repair in motion.

How do exosomes revive the skin?

All these ‘signalling molecules’ help regulate processes like tissue repair. So by transferring these molecules to the cells that need them, exosomes can enhance collagen production, stimulate cell renewal, improve skin texture and tone and reduce the appearance of wrinkles. That’s why they’re attracting so much interest across the whole area of aesthetic medicine and beauty.

Are exosomes much the same as stem cells?

No, in that exosomes aren’t living cells, and they can be collected from different sources.

What are the sources of exosomes that are used for skin rejuvenation?

Some are plant-derived, some come from animal sources, and some from humans. Each country has its own regulations surrounding cosmetic ingredients and, in some countries (e.g. Korea, where much of the latest research on exosomes has been done), it is not illegal to use human-derived exosomes.

Is it legal to use exosomes derived from humans for skin rejuvenation in the UK?

The answer to that rather depends who you ask. Plenty of UK practitioners take the view that as long as you’re just using them topically – i.e. applying them on top of the skin, rather than injecting them into it – it’s ok.

‘The science behind exosomes is incredible,’ says Dr Dev Patel. I’ve trialled exosomes at my clinics after hearing about them in 2019 but I have a lot of reservations about most of the current offerings and how they’ve been manufactured. Their potential in all branches of medicine is huge. We are certainly going to be hearing more and more about exosomes.’

Dr Kate Goldie is fascinated enough by the regenerative potential of exosomes to have funded independent research into the area (you can read the study she co-authored with Dr Owen Davies and Soraya Williams here). ‘In the States, the FDA is not allowing the injection of exosomes, and for a good reason – we don’t 100% know what each product is. Many companies are making exosomes – they are relatively easy to make – but the effectiveness of the exosomes depends on the health of the cell they come from. If they tell a story of youth, then they will get other cells to work in that way, and that’s very attractive. Some companies are very careful on their cell sources, others less so.’

But if you ask Mr Tunc Tiryaki, consultant plastic surgeon and founder of the London Regenerative Institute, the answer is an extremely clear ‘No’. ‘It is illegal for human-derived exosomes to be used topically in the UK,’ he says. ‘According to UK and European law regulation, human-derived ingredients are strictly banned in the UK. All ingredients are regulated for safety and approved ingredients will be outlined on the CosIng database (a European database that offers information on cosmetic ingredients while providing guidance on the use or banning of certain substances in cosmetics). Specific restrictions exist for the use of exosomes of human origin in topical use as a cosmetic product.

What kind of exosome treatment did Kim Kardashian have done?

Kim posted on Instagram in March that she had had an exosome serum applied after a combined laser and broadband light treatment. Why would she have this? Because after a laser treatment has created thousands of tiny perforations in the skin, the serum will sink straight in to where it’s needed. The regenerative benefits of exosomes mean that a) it will supercharge the skin-boosting, pigment-clearing effects of the treatment, and b) it’s hugely anti-inflammatory, so it will speed up healing after the procedure.

Have I tried exosome treatment yet?

I’ve been offered treatment with (human-derived) exosomes a number of times in the past year but have held off, not being sure how I can write about (and by writing about, encourage other people towards) something that isn’t exactly legal even though a great many practitioners seem to see it just as another grey area within the unregulated field of aesthetic procedures.

So what about these ‘exosome facials’?

If you ask the places that are offering exosome facials, eg Le Supreme XO treatments at EF Medispa, they’ll tell you that they are using exosomes derived from plants such as roses, which have measurable effects on human skin, boosting collagen and elastin production enormously.

How much do exosome treatments cost?

A lot. Doctors tell me that applying exosomes after, say, a needling procedure will add £500-£800 to the bill. And the ‘5 Billion exo RF face treatment’ at Urban Retreat in London, which involves radiofrequency microneedling followed by layers of (rose) exosome serum, costs £2,645.

Can exosomes from non-human sources  rejuvenate the skin?

It’s a ‘yes’ from Dr Tunc Tiryaki, though he points out that ‘Animal and human exosomes are the most powerful. With human exosomes being illegal, the only safe and approved sources are from animals and plants, however, plants are not as effective.’

What about skincare containing exosomes?

It’s out there already (I wrote about one exosome skin cream I’d tried recently, which is backed by clinical trials and which gave me great results) – but I think this article is long enough already, so I’ll come back to that another time.

What’s the bottom line on exosomes?

They’re definitely the future and you’ll be hearing a lot more about them. Over to Dr Kate Goldie: ‘We’re on an important journey in regenerative medicine just now. There’s no doubt that in not so many years, we will be able to reverse or prevent ageing, and people will not expect to age as they used to – but we need to be careful how we get there. There’s a real danger that in the rush for commercial success, companies will damage the reputation of exosomes by using products before they are properly researched.’