Exosomes are extracellular vesicles, the small packets cells release to carry proteins and genetic material to other cells. In aesthetics they are used as a topical preparation applied to skin immediately after microneedling, while the channels created by the needling are still open.
Here they are used topically and only after microneedling, as an addition to that treatment. Nothing is injected.
What the published work reports
A 2026 systematic review in the Journal of Cosmetic Dermatology gathered the clinical studies of microneedling with exosomes. It found eight studies covering 171 patients, screened from 256 references.
Across those studies, investigators reported increases in hair density in androgenetic alopecia, wrinkle reduction in the range of 12 to 14 percent, and improvement in pigmentation measures, with objective dark spot coverage falling from 40 percent to 27 percent in the studies that measured it. No patient in any of the studies discontinued treatment because of an adverse effect. Redness, swelling and small areas of bruising occurred and resolved within days to a week.
The shape of that work
The authors point to larger randomized trials as the next step.
How this is offered
As an optional addition to microneedling, at additional cost, discussed at consultation. Declining it changes nothing about the microneedling itself.
What a session is like
- How it is given
- Applied topically, immediately after microneedling. Never injected.
- Added time
- A few minutes on top of the microneedling appointment.
- Sensation
- Nothing beyond the microneedling itself.
- Downtime
- The same as microneedling alone. Redness for 24 to 48 hours.
- Reported onset
- Studies assessed results over weeks to months.
- Follow-up studied
- No published study beyond 6 months.
- Published evidence
- Eight studies covering 171 patients. Reported as well tolerated, with no safety signal across them.
- Cost
- An addition to the microneedling fee, discussed beforehand.
Before, during and after
Aftercare is the microneedling protocol, since that is the procedure being performed.
Common questions
Can it be added to any microneedling appointment?
Yes, and it is decided at the appointment rather than in advance. It adds a few minutes and an additional fee, and it does not change the microneedling protocol, the settings used or the aftercare.
Do you inject exosomes?
No. Only topical application after microneedling. Injection is not offered here.
How much evidence is there?
Eight studies covering 171 patients, with follow-up out to six months. The reported results were positive across skin texture, pigmentation and hair density, and no patient in any of them stopped treatment because of a side effect. They are early studies rather than large randomized trials, and the authors point to larger trials as the next step.
Is it better than PRP?
They have not been compared head to head, so there is no answer from the evidence. PRP has a larger evidence base and uses your own blood rather than a manufactured product. Which suits you depends on what is being treated, and that is decided at consultation.
Who should not have this?
The exclusions are those for microneedling itself: active infection or inflammatory skin disease in the treatment area, certain wound-healing disorders, and pregnancy. Anyone with a history of significant allergic reaction should raise it before anything is applied.
This page is for general education and is not medical advice. It does not establish a physician-patient relationship, and it cannot account for your individual history, medications or skin. Suitability for treatment is decided at consultation following examination.