Currently, there are a few non-surgical injectable options for the treatment of hair loss. One option is platelet rich plasma (PRP) which entails drawing up a patient’s blood and isolating the platelet rich plasma component which is then re-injected into the patient’s scalp. PRP is enriched for growth factors which can stimulate hair follicle growth. In many patients, PRP injection can help promote hair growth. It works best in patients who have thinning (or miniaturized hairs). Another option that has shown some promise is microneedling, which involves using a skin roller with small needles to cause minor injuries in the skin. The growth factors released to heal these injuries have shown positive but variable results in the treatment of hair loss. Enter Exosomes, minute extracellular vesicles that carry messenger RNA, micro RNA and proteins, including growth factors.
The use of exosomes for the treatment of hair loss is brand new and has shown very promising early results in individual patients. However, exosomes have not been investigated in formalized clinical trials yet, which are the gold standard for rigorous testing of new medical treatments. Exosomes are derived from the mesenchymal stem cells that are present in a bone marrow of a human donor. Companies such as Direct Biologics have developed technologies to harvest a large number of exosomes from mesenchymal stem cells from human donors. Although exosomes are considered an acellular material, the tissue donors are tracked and screened for HIV and Hepatitis B and C.
While the mechanism of action of exosomes has not been fully elucidated, many hypothesize that exosomes target existing stem cell in your scalp. Scalp stem cells are mostly located in the “bulge area” of your hair follicles and their activation can result in the growth of existing miniaturized hairs and the growth of new hairs. Hair transplant surgeons that have been early adopters of exosomes have obtained very promising results, with much quicker onset and more robust hair growth than PRP (platelet rich plasma). In addition, there have been anecdotal results of hair growth in completely bald scalps, a feat previously not achieved with other injectable hair loss treatments. There are still many aspects regarding the practical use of exosomes that need to be worked out, including how many injections are necessary. Also, since no clinical trials have been conducted using this new injectable, it has not been rigorously studied in regards to its efficacy (both short and long-term) and potential long-term side effects. Dr. Ratushny likes to stay on the cutting edge of hair loss treatments, and he is currently evaluating this technology further before deciding whether to offer it to his patients.