Understanding the Difference Between Growth Factors, Exosomes, and Stem Cells in Aesthetics

The world of aesthetic medicine is constantly evolving, introducing cutting-edge solutions to combat the signs of aging, improve skin health, and enhance natural beauty. Among the most advanced tools in regenerative aesthetics are growth factors, exosomes, and stem cells. While all three rejuvenate the skin by ultimately releasing growth factors that repair damaged cells and stimulate the production of new, healthy ones, they differ significantly in how they achieve these effects, as well as in their potency and duration of action. These differences often lead to confusion, as their overlapping functions and benefits cause the terms to be used interchangeably, despite their unique characteristics. In this article, we’ll clarify what growth factors, exosomes, and stem cells are, how they differ, and how they’re used in aesthetics to unlock their incredible potential.

Growth Factors

Growth factors are naturally occurring proteins or hormones that regulate cellular growth, proliferation, and repair. These proteins are produced by various cells in the body, including platelets, fibroblasts, and keratinocytes. They are vital for maintaining healthy tissue and promoting healing processes. Growth factors are released by both exosomes and stem cells, but for the purpose of this section, we will focus on products that directly deliver growth factors without involving the other two. These products provide an immediate source of growth factors to stimulate cellular activity and accelerate skin rejuvenation.

Role in Aesthetics

In the context of aesthetics, growth factors stimulate the production of collagen and elastin, essential proteins that give the skin its firmness, elasticity, and youthful appearance. As we age, the natural production of growth factors declines, contributing to wrinkles, sagging, and dull skin. Introducing growth factors topically or through targeted treatments can help reverse these signs of aging by encouraging skin regeneration.

Examples of Growth Factors in Aesthetic Use

Platelet-Derived Growth Factors (PDGF):

• Found in platelet-rich plasma and platelet-rich fibrin (PRP/PRF)
• Utilizes the patient’s own blood tissue

These growth factors are frequently applied topically after microneedling or laser resurfacing treatments, where they work to expedite healing, reduce downtime, and enhance results. Additionally, PRP/PRF therapy can be used as a standalone injectable treatment to rejuvenate the skin, improve texture, and restore firmness.

How Many Growth Factors Are Released?

PRP/PRF contains about 20-30 growth factors, including PDGF, VEGF (vascular endothelial growth factor), and TGF-β (transforming growth factor-beta). These growth factors are released in a self-limiting manner, meaning that once they are released from the product and utilized by the body, their activity ceases. This process typically peaks within 24-48 hours and diminishes after a few days.

Limitations of PRP/PRF and Platelet Quality

While PRP and PRF are popular and effective regenerative treatments, their efficacy is highly dependent on the patient’s age, health, and the quality of their platelets and growth factors. As we age, the concentration and potency of growth factors in our blood naturally decline. The 20-30 growth factors often cited in PRP are most abundant in young, healthy individuals—typically those in their late teens or early twenties. For older patients or those with underlying health conditions, the quantity and quality of growth factors available in their PRP may be significantly reduced. This variability means that PRP/PRF treatments can differ from one session to another, even for the same individual. Factors such as lifestyle, diet, hydration, and overall health at the time of the blood draw can impact the results.

Exosomes

Exosomes are extracellular vesicles that play a vital role in cellular communication. They are derived from and released by stem cells and act as messengers, transporting proteins, growth factors, lipids, RNA, and other molecules between cells.

Role in Aesthetics

Exosomes not only carry and release the growth factors we spoke about earlier, but they also signal nearby cells, such as fibroblasts and platelets, to produce and release their own growth factors. This dual mechanism amplifies their regenerative effects, making exosomes a powerful tool in aesthetics. For example, when applied topically after procedures like microneedling or laser resurfacing, exosomes accelerate the healing process and stimulate collagen production. They achieve this by delivering growth factors directly to the treated area while simultaneously instructing native cells to actively contribute to the tissue repair and regeneration.

Examples of Exosomes in Aesthetic Use

Topical Exosome Serums:

• Applied after treatments like microneedling, laser resurfacing, and chemical peels to accelerate healing and amplify results.
• Applied after hair restoration treatments to improve hair density and quality by stimulating dormant and damaged hair follicles.

How Many Growth Factors Are Released via Exosomes?

Exosome serums contain billions of exosomes, and each exosome carries 200-300 growth factors. Unlike PRP/PRF therapies, which deliver up to 20-30 growth factors, exosomes deliver an exponentially greater amount. The release typically peaks within 7 to 10 days after application, and, like PRP/PRF therapies, the process is self-limiting once the exosomes have delivered their growth factors.

Limitations of Exosome Therapy

Because exosomes are harvested from live stem cells, their production involves complex manipulation processes. As a result, the FDA classifies exosomes as drugs, which subjects them to strict regulations. While topical applications of exosomes are FDA approved, widely used, and highly regarded for their benefits, injectable exosome therapies are not currently FDA-approved in the United States. This is primarily due to a lack of sufficient clinical trials; however, such trials are currently in progress. These regulatory hurdles limit the availability of stronger, more effective treatment options for aesthetic patients.

Stem Cells

Stem cells are the foundation of the regenerative processes we’ve discussed, acting as the starting point for both exosomes and growth factors. These undifferentiated live cells possess a unique ability to develop into various specialized cell types and to self-renew.

Stem cells can be derived from several sources, including bone marrow, adipose tissue (fat), amniotic fluid, umbilical cord blood, and—our personal favorite—umbilical cord tissue. Umbilical cord tissue, in particular, is highly valued in aesthetics due to its abundance of mesenchymal stem cells, which are renowned for their powerful regenerative capabilities and ability to produce a high volume of exosomes and growth factors.

Role in Aesthetics

In the world of regenerative aesthetics, stem cells sit at the top of the hierarchy. These live cells give rise to exosomes, which then, in turn, release growth factors. Unlike exosomes or PRP/PRF therapies, which are self-limiting in their effects, stem cells are not. They continuously self-renew and release bioactive molecules, such as exosomes and growth factors, as long as they remain viable in the tissue. This continuous regenerative process makes stem cells a highly potent and versatile tool in aesthetic medicine.

Examples of Stem Cells in Aesthetic Use

1. Autologous Stem Cell Therapy (Your Own Tissue)
   Stem cells are extracted from your own harvested tissue, processed to isolate the stem cells, and then reinjected back into the body for regeneration.
   1. Pros:
      1. Sourced from your own body, eliminating the risk of immune rejection.
   1. Cons:
      1. Stem cells are older and less abundant due to aging, meaning you are reinjecting “old” cells.
      1. The harvesting process can be invasive, involving discomfort and downtime.

• Allogenic Stem Cell Therapy (Donor Tissue)
  Stem cells derived from donor tissue, particularly umbilical cord tissue, are considered the gold standard in aesthetics. Umbilical cord tissue is rich in mesenchymal stem cells, which are the youngest and most potent stem cells available. These cells are “immune-naïve,” lacking surface markers that can trigger rejection, making them universally safe for injection without matching.
  • Pros:
    • Younger, healthier, and significantly more regenerative than those sourced from aging tissue.
    • No invasive harvesting procedures, making the process much easier and pain-free.
  • Cons:
    • The quality of the stem cells depends on the practices of the lab where they are sourced. It’s essential to ensure the stem cells are harvested, processed, and packaged under stringent, ethical, and safe conditions, and not manipulated or expanded in any way.

How Many Growth Factors Are Released via Stem Cells?

Depending on the type of stem cells used, a typical population can range from 1 to 2 million cells. Each stem-cell generates hundreds of thousands of exosomes, which in turn each release between 200 and 300 growth factors. As discussed earlier, unlike PRP/PRF and exosome therapies, stem-cells continue to regenerate themselves every 24 hours for an extended period, typically 3 to 4 months. This continuous cycle of production and renewal leads to a long-lasting effect, reducing the need for frequent office visits.

Key Differences Between Growth Factors, Exosomes, and Stem Cells

• Growth Factors:
  • Found in PRP/PRF
  • Contains 20-30 growth factors, with effectiveness based on age and platelet quality
  • Effects are short-lived, typically peaking within 24-48 hours before diminishing
• Exosomes:
  • Act as messengers, delivering signals to various cells in the body
  • Each exosome contains 200-300 growth factors
  • Effects last slightly longer, typically peaking 7-10 days post-application
  • Available for topical use only, as injectable exosome therapies are not yet FDA-approved in the U.S.
• Stem Cells:
  • Best sourced from mesenchymal stem-cells from umbilical cord tissue
  • Continuously self–renew and produce hundreds of thousands of exosomes every 24 hours
  • Provide prolonged effects, lasting up to 3-4 months, reducing the need for frequent treatments.

Which One Is Right for You?

Choosing the right treatment depends on your aesthetic goals and needs. To determine which therapy is right for you, it’s essential to schedule a consultation with one of our providers at The Aesthetic Retreat who can assess your unique needs and recommend the best approach tailored to your skin. Book your appointment with us at The Aesthetic Retreat and discover the glow-up power of microneedling!