Hair and scalp evidence

Extracellular Vesicles and Dermal Papilla Signalling

Reviewed by ExaVeyra Sciences editorial team · Updated 15 September 2026

Extracellular vesicles, usually called exosomes in the aesthetic market, are membrane-bound particles of roughly 30 to 150 nanometres that carry proteins, lipids and RNA from the cell that released them. There are no FDA-approved exosome products, the FDA’s December 2019 public safety notification states so and describes exosomes used to treat diseases and conditions in humans as drugs and biological products subject to premarket review, and the human literature on vesicles and the hair follicle consists of two 2025 systematic reviews, a small number of pilot and open-label studies, and registered trials that are still recruiting. This page reports that literature at the level the studies support, describes the registered trials, and states the regulatory position. ExaVeyra supplies exosome material for research use, described by its available formats.

It is an evidence reference. The exosome product pages on this site list the available formats and the certificate of analysis that accompanies each lot; the state guides describe what a licensed practice in each state may source. Neither says what the material does, and neither does this page.

Why the dermal papilla is where the research looks

The dermal papilla is the cluster of mesenchymal cells at the base of each follicle that regulates the growth cycle through paracrine signals to the surrounding epithelium. The Wnt and beta-catenin pathway is the most studied of those signals, as the Cold Spring Harbor review by Lim and Nusse describes, and its activity is associated with entry into the growth phase. Vesicles are studied in this context because they are a paracrine signalling vehicle: they carry cargo from one cell to another, and the research question is whether cargo from a given cell source changes what dermal papilla cells do.

The preclinical literature is where that question has mostly been asked. Oh and colleagues reported in Stem Cell Research and Therapy in 2024 on vesicles secreted from hyaluronic-acid-stimulated induced mesenchymal stem cells in a mouse model of androgenic alopecia, and the 2025 review by Wu and colleagues in Annals of Medicine surveys the wider animal and in vitro work. Cargo composition varies with cell source, culture conditions and isolation method, which is the reason the reviews below are careful about comparing studies that used different material.

What the two 2025 systematic reviews found

Al Ameer and colleagues, in Clinical, Cosmetic and Investigational Dermatology, systematically reviewed the clinical evidence across alopecia types and vesicle sources and characterised it as early, heterogeneous in source and preparation, and short on randomised controlled trials. Darwish and colleagues, in Cureus, systematically compared the vesicle literature with platelet-rich plasma and minoxidil in androgenetic alopecia and reached a similar characterisation of the vesicle evidence: promising signals in small studies, with PRP and minoxidil carrying the larger and more standardised trial base.

Both reviews are cited here for their characterisation of the field rather than for any pooled effect, because neither could pool across the heterogeneous preparations it found. That distinction, between a review that describes a literature and one that quantifies it, is the one a reader most needs when a supplier hands over a citation list, and the clinic-launch guide on reading the evidence walks through it.

The human studies, by design

The table describes designs and materials, and the difference between rows is the point. A plant-derived formulation, an exosome complex applied with microneedling, and umbilical cord vesicles in a registered trial are three different materials, and a result from one does not transfer to another. The study design badges beside the literature citations below carry the same information in a form a reader can scan.

The registered trials

ClinicalTrials.gov lists interventional trials of mesenchymal stem cell-derived exosomes in androgenetic alopecia that are recruiting as of this review, including a study of umbilical cord mesenchymal stem cell-derived exosomes at a Chinese university hospital with an estimated primary completion date in 2026. The Shenzhen protocol published in the FASEB Journal in 2026 describes a randomised controlled trial in 59 men aged 18 to 35 with a dose-escalation phase. Registration establishes that a trial was planned and registered; it establishes nothing about the result, and the regulatory reference on this site on exosome clinical trials sets out that distinction across the whole registry.

The regulatory position

The notification was issued after reports of serious adverse events in patients who received unapproved products marketed as containing exosomes, and the FDA’s consumer alert on regenerative medicine products restates the position for stem cell and exosome products together. The agency has since issued warning letters to marketers of unapproved exosome products, and the regulatory references on this site describe the 351 biologic pathway and the CMC expectations that apply to an investigational vesicle product.

ExaVeyra supplies exosome material for research use only, with a lot-specific certificate of analysis, and describes it on this site by its available formats. Whether a given practice may use the material, and for what, is governed by federal law and by the practitioner’s own licence, which is what the state guides on this site are for.

Sources

1. FDA, Public Safety Notification on Exosome Products (December 6, 2019) (accessed 15 September 2026)
2. FDA, Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes (accessed 15 September 2026)
3. ClinicalTrials.gov, NCT07373054, umbilical cord mesenchymal stem cell-derived exosomes in androgenic alopecia (accessed 15 September 2026)

Scientific literature

Each source carries the kind of study it was and, where the study enrolled people, how many. Study design decides what a result can establish, so it is stated rather than left to be inferred. Each line also says what that source is carrying on this page.

1. Al Ameer MA, et al. Exosomes and hair regeneration: a systematic review of clinical evidence across alopecia types and exosome sources. Clinical, Cosmetic and Investigational Dermatology, 2025. doi:10.2147/CCID.S543451 PMID:40955427Systematic reviewSource 1 supports: The systematic review of clinical evidence across alopecia types and vesicle sources, cited for its characterisation of the human literature as early and heterogeneous.
2. Darwish R, et al. From cells to strands [a systematic review of exosome-based, platelet-rich plasma and minoxidil approaches in androgenetic alopecia]. Cureus, 2025. doi:10.7759/cureus.87875 PMID:40821339Systematic reviewSource 2 supports: The systematic comparison of the vesicle literature with PRP and minoxidil, cited for the relative size and standardisation of the three evidence bases.
3. Amini F, et al. A pilot randomized controlled trial (RCT) evaluating the efficacy of an exosome-containing plant extract formulation for treating male alopecia. Life (Basel), 2025. doi:10.3390/life15030500 PMID:40141845Randomised controlled trialSource 3 supports: The pilot randomised trial of a plant-derived exosome formulation, cited as the one randomised human study with reported results and for the material it studied.
4. Ablon G, et al. An exosome regenerative complex plus microneedling promotes hair growth in subjects with self-perceived thinning hair. Journal of Drugs in Dermatology, 2025. doi:10.36849/JDD.9244 PMID:41037530Clinical studySource 4 supports: The open-label study of an exosome complex applied with microneedling, cited for its design and the population it enrolled.
5. Koumprentziotis IA, et al. Microneedling radiofrequency followed by topical exosome application therapy for pattern hair loss: a scoping review and prospective study. Clinical Dermatology, 2025. doi:10.1016/j.clindermatol.2025.07.006 PMID:40744280Clinical studySource 5 supports: The scoping review with a prospective series on radiofrequency microneedling followed by topical exosome application, cited for the sequencing it describes.
6. Tian R, et al. A randomized controlled clinical trial protocol of umbilical cord mesenchymal stem cell-derived small extracellular vesicles for the treatment of androgenetic alopecia in young males. FASEB Journal, 2026. doi:10.1096/fj.202504430 PMID:41591820Randomised controlled trial59 participantsSource 6 supports: The published protocol of a randomised trial of umbilical cord vesicles, cited for its planned enrolment and dose-escalation design and for the fact that results are not yet reported.
7. Oh HG, et al. Improvement of androgenic alopecia by extracellular vesicles secreted from hyaluronic acid-stimulated induced mesenchymal stem cells. Stem Cell Research and Therapy, 2024. doi:10.1186/s13287-024-03906-x PMID:39256806PreclinicalSource 7 supports: The mouse-model study of vesicles from stimulated induced mesenchymal stem cells, cited as representative of the preclinical literature and its dependence on cell source.
8. Wu X, et al. Advances in the extracellular vesicles treatment of alopecia. Annals of Medicine, 2025. doi:10.1080/07853890.2025.2543517 PMID:40768606Narrative reviewSource 8 supports: The narrative review of the wider animal and in vitro literature, cited for its survey of cargo and cell-source variation.
9. Lim X, Nusse R Wnt signaling in skin development, homeostasis, and disease. Cold Spring Harbor Perspectives in Biology, 2013. doi:10.1101/cshperspect.a008029 PMID:23209129Narrative reviewLandmarkSource 9 supports: The reference review of Wnt signalling in skin and the follicle, cited for the dermal papilla biology that frames the research question.
10. Gupta AK, Wang T, Rapaport JA Systematic review of exosome treatment in hair restoration: preliminary evidence, safety, and future directions. Journal of Cosmetic Dermatology, 2023. doi:10.1111/jocd.15869 PMID:37381168Systematic reviewSource 10 supports: The 2023 systematic review, cited as the earlier survey of the same literature so a reader can see how little the human evidence base moved between 2023 and 2025.
11. Gupta AK, Wang T, Welter R, et al. Promises and pitfalls of regenerative therapies for androgenetic alopecia: platelet-rich plasma, photobiomodulation, stem cells, and exosomes. Medical Sciences (Basel), 2025. doi:10.3390/medsci14010005 PMID:41562895Narrative reviewSource 11 supports: A 2025 review placing vesicles beside PRP, photobiomodulation and cell-based approaches, cited for the comparative framing.
12. Lee KWA, Sydorchuk O, Song JK, et al. Exosomes in trichology: a literature review. JPRAS Open, 2026. doi:10.1016/j.jpra.2025.11.011 PMID:41561359Narrative reviewSource 12 supports: The 2026 trichology review, cited for its survey of vesicle sources and preparations reported in the hair literature.