Exosomes vs PRP for skin

Last updated: October 2026

PRP (platelet-rich plasma) is your own blood, spun to concentrate platelets and their growth factors, then mostly injected. Exosomes are tiny vesicles taken from donor stem cells, platelets or plants and sold as a manufactured product. For facial skin, both rest on small, mostly uncontrolled studies, and the FDA has approved no exosome product. Neither has shown clear superiority.

What is the difference between exosomes and PRP?

Platelet-rich plasma (PRP) is a platelet concentrate obtained from the patient's own (autologous) plasma, prepared with single-spin or double-spin centrifuge systems². Besides platelets, it contains some inflammatory cells and large amounts of proteins, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-beta), vascular endothelial growth factor (VEGF) and epithelial growth factor (EGF)¹.

Exosomes are a subtype of extracellular vesicles, 30 to 150 nanometers across, that carry proteins, lipids and nucleic acids between cells⁴. They are produced by many cell types, including platelets, mesenchymal stem cells, immune cells, epithelial cells and plant cells⁴, and Health Canada notes they can be derived from human, animal, plant or synthetic sources⁸. In short, PRP comes from the person being treated, while exosome products come from other cells^2,4.

How is each one used on the skin?

In facial rejuvenation studies, PRP has been used alone or combined with hyaluronic acid, fat grafting (lipofilling), microneedling and laser treatments². An umbrella review found that every primary study used autologous PRP, often with fractional laser or fat grafting, and that PRP was injected in all but one study, which applied it topically after fractional laser¹. The number of sessions varied from 1 to 6¹.

Exosome studies in dermatology have mostly used mesenchymal stem cell-derived products, delivered by topical application, microneedling, fractional CO2 laser or injection³.

What does the evidence show for PRP?

A 2024 overview of 13 systematic reviews covered 28 individual studies, 18 of them uncontrolled¹. Only one review pooled results in a meta-analysis, finding that people treated with PRP as an add-on reported more satisfaction than controls, with low certainty of evidence¹. Four reviews concluded descriptively that PRP combined with laser increased satisfaction and skin elasticity and decreased redness, at very low certainty¹.

The authors rated confidence in the results as low or critically low for 12 of the 13 reviews and concluded that the evidence is insufficient for firm conclusions about PRP for facial rejuvenation, alone or combined with other treatments¹. A separate 2021 appraisal of 36 studies with 3,172 patients, with a median of 27.5 patients per study, also found very limited clinical evidence². Both point to the same gap: preparation methods, schedules and follow-up are not standardized^1,2.

What does the evidence show for exosomes?

A 2026 scoping review found 17 human studies published from 2020 to 2025, including cohort studies, comparative trials and case series, for indications such as skin rejuvenation, acne scars, psoriasis and atopic dermatitis³. In 76% of them, investigators recorded improvements in wrinkles, pigmentation, elasticity, hydration or scars³. The authors list small samples, short follow-up, non-randomized single-arm designs and potential conflicts of interest as limits³.

A 2026 systematic review of 21 articles reported improved elasticity, wrinkle depth, hydration and pigmentation with exosome-based treatments from adipose stem cells, platelets, plants and milk, and called for standardized trials with larger groups and longer follow-up⁵. A 2025 review adds that isolation methods are inconsistent and sources vary, so one exosome product is not directly comparable with another⁴.

Can exosomes or PRP be used with microneedling?

Both have been studied with microneedling^2,3, and regulators look closely at the pairing. FDA guidance notes that microneedling products have been promoted with topical substances, including blood products such as platelet-rich plasma, and that such products may be combination products regulated by its drug, biologics and device centers⁷. The class II classification for aesthetic microneedling devices does not include devices intended for transdermal delivery of topical products such as cosmetics, drugs or biologics⁷.

Health Canada's April 2026 notice states that a topical product containing human-derived exosomes is not consistent with a cosmetic if its label or package insert indicates administration through microneedling or injection⁸. The choice of what is applied during a professional procedure, and how, belongs to the treating practitioner.

What side effects and safety questions come with each?

For PRP, one review of 320 people in 16 studies reported only mild, transient effects: post-injection pain or burning in about two-thirds of subjects lasting minutes to an hour, redness resolving within days, and less often swelling and tenderness lasting under a week, with no serious adverse events¹. Most reviews, however, did not set adverse events as a planned outcome¹.

For exosomes, adverse events were uncommon in the scoping review but included granulomas, necrosis and allergic reactions after injection³. Health Canada lists potential toxic effects and, for any material of human origin, the transmission of infectious diseases and adventitious agents among the risks⁸. FDA states that there are no FDA-approved exosome products and asks people who have a bad side effect after a regenerative medicine product to report it to MedWatch⁶.