CPD Article: Advancing Regenerative Approaches in Trichology
Combination Platelet Rich Plasma and plant exosomes for hair treatment
Platelet Rich Plasma (PRP) has become a widely recognised treatment of regenerative hair restoration, supported by robust evidence demonstrating its ability to stimulate follicular stem cells, enhance angiogenesis, and improve hair density. Despite this, clinical outcomes remain variable, influenced by differences in patient physiology, preparation techniques, and protocols. Plant-derived exosomes, a novel class of extracellular vesicles, have recently emerged as a complementary therapy with promising regenerative and anti-inflammatory properties. This article explores the scientific rationale, mechanisms of action, clinical applications, and potential synergies of combining PRP with plant exosomes for the treatment of hair loss.
Hair loss, particularly androgenetic alopecia (AGA), remains one of the most prevalent aesthetic and psychological concerns globally. Affecting both men and women, its impact extends beyond cosmetic appearance, influencing confidence, identity, and overall quality of life. Traditional therapeutic approaches, including topical minoxidil, oral finasteride, and hair transplantation, offer partial solutions but come with limitations in efficacy, tolerability, or invasiveness.
PRP therapy has established itself as a leading minimally invasive option for hair restoration, with multiple clinical trials demonstrating improvement in hair density, thickness, and patient satisfaction.1 However, variability in response highlights the need for adjunctive treatments that can stabilise outcomes and enhance regenerative efficacy. Plant-derived exosomes, which are extracellular vesicles secreted by plants, offer a promising bioactive adjunct. They are rich in lipids, proteins, and small RNAs that exert antioxidative, anti-inflammatory, and reparative effects.2
The combination of PRP and plant exosomes represents a synergistic approach that harnesses both the patient’s intrinsic regenerative capacity and the bioactive molecules of plant vesicles.
PRP in hair regeneration
PRP is obtained through centrifugation of autologous blood, concentrating platelets and growth factors. These bioactive molecules, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), act on follicular stem cells, dermal papilla cells, and endothelial cells.
Key mechanisms include:
- Angiogenesis: VEGF stimulates new microvessel formation, improving follicle oxygenation and nutrient delivery.
- Stem cell activation: PDGF and insulin-like growth factor (IGF-1) stimulate proliferation of follicular stem cells.
- Anti-apoptotic effects: PRP reduces follicular cell death, prolonging the anagen (growth) phase.
- Collagen remodelling: TGF-β promotes extracellular matrix renewal, enhancing scalp health.3
Plant exosomes in regeneration
Plant-derived exosomes are extracellular vesicles secreted by fruits, vegetables, and medicinal herbs. They are structurally similar to mammalian exosomes and have been shown to be taken up by mammalian cells via endocytosis.4
Mechanisms relevant to hair restoration include:
- Antioxidant activity: Plant exosomes contain polyphenols and flavonoids that counter oxidative stress a contributor to follicle miniaturisation.
- Anti-inflammatory signalling: Exosomal microRNAs downregulate NF-κB pathways, reducing inflammatory mediators implicated in alopecia.5
- Cellular communication: Vesicles enhance fibroblast and keratinocyte cross-talk, promoting scalp tissue health.
- Nutrient delivery: Plant-derived lipids and proteins support cellular energy metabolism and barrier repair.
Synergy of PRP and Plant Exosomes
While PRP delivers autologous growth factors, its efficacy can vary based on platelet count, preparation method, and patient health status. Plant exosomes offer a consistent bioactive adjunct that complements PRP by:
- Stabilising the regenerative microenvironment through anti-inflammatory pathways.
- Enhancing angiogenesis and tissue repair by amplifying PRP growth factor effects.
- Reducing variability in outcomes by providing standardised bioactive vesicles.
PRP Alone in Hair Restoration
Multiple meta-analyses confirm PRP’s efficacy in improving hair density and thickness in AGA. For example, Gupta et al. (2019)6 demonstrated significant improvement in mean hair density with PRP compared to placebo. However, approximately 20–30% of patients show minimal response, highlighting the need for adjuncts.
Exosomes in Hair Therapy
Research into plant exosomes is growing. Preclinical studies demonstrate that plant-derived vesicles can be absorbed by mammalian cells and modulate gene expression related to oxidative stress and inflammation.7 In vitro data suggest improved proliferation of dermal papilla cells in the presence of exosomes, indicating potential for hair growth stimulation.
In a recent study carried out by Dr David J Goldberg8 on DE|RIVE exosomes for hair, the results demonstrated that DE|RIVE induced hair growth and regrowth through the Wnt-1 pathway; increasing β-catenin, VEGF, PDGF, TGF-β1, and Collagen I. It also showed that with the addition of the daily support serum, inflammation was reduced by 61% with each application. In a six-month study, the results demonstrated a 60% increase in hair thickness, a 50% increase in hair density, and a 50% stabilisation of hair loss. The study also demonstrates a significant increase in Cytokeratin 15.
Combined Protocols
Emerging clinical practice incorporates plant exosomes with PRP via either injecting PRP followed by topical or microneedling delivery of exosomes, or by applying exosomes after microneedling or laser scalp treatments to accelerate healing post-procedure. This layered approach is designed to leverage the regenerative properties of PRP while simultaneously providing the anti-inflammatory and signalling benefits of exosomes.
In clinic, results using a combination of PRP with plant exosomes have shown that patients who apply DE|RIVE Daily Support Serum twice daily experience reduced inflammation, optimised scalp health, and sustain the benefits of the PRP. This at-home continuation helps extend therapeutic effects and maintains a favourable microenvironment for hair follicle activity.
Preliminary data from clinics adopting this combined approach suggest enhanced patient satisfaction, reduced post-procedural inflammation, quicker recovery, and a faster onset of visible results compared to PRP or exosomes used alone.
As protocols continue to evolve, the integration of plant-derived exosomes with established regenerative treatments like PRP may represent the next step in achieving more predictable and durable outcomes in hair restoration therapy.
Safety and Tolerability
PRP is autologous, reducing risks of allergic reaction or disease transmission. Adverse effects are generally limited to mild pain, swelling, or transient erythema. Plant exosomes, being non-immunogenic and plant-derived, carry minimal risk. To date, no major adverse events have been reported in applications.
Standardisation remains critical, as exosome quality varies depending on extraction method, plant source, and storage conditions. Clinicians must select products with robust quality control and evidence of safety.2
Conclusion
PRP remains a highly effective, evidence-based therapy for hair restoration. However, variability in outcomes necessitates the development of novel adjunctive strategies. Plant-derived exosomes represent a safe, biologically active, and sustainable addition to regenerative medicine. When combined with PRP, they may reduce inflammation, stabilise the regenerative microenvironment, and enhance follicular stimulation.
Although clinical evidence is still emerging, the integration of PRP with plant exosomes offers a compelling, future-focused approach to hair loss management, bridging natural regenerative medicine with sustainable innovation. For clinicians, this combination may represent the next evolution in trichology, delivering more predictable and durable outcomes for patients.