Exosomes vs PDRN: What Should Patients Know Before Choosing a Regenerative Skin Treatment?

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In regenerative and aesthetic dermatology, exosomes and PDRN are frequently mentioned. They are, however, two different, biologically distinct products with different proposed mechanisms of action and should not be regarded as alternative therapeutic options. Treatment should be tailored to the patient's skin condition, treatment objectives, medical history, past treatments, and type of product used and how it is applied.

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We spoke to Dr Nirupama Parwanda, Dermatologist and Founder of Zolie Skin Clinic, who shared things to keep in mind before choosing a regenerative skin treatment.

What Are Exosomes?

"Exosomes are a subpopulation of micro-sized extracellular vesicles that facilitate intercellular communication. They can transport biologically active molecules including proteins, lipids and nucleic acids, which can affect processes in the body such as inflammation, cellular signalling, extracellular-matrix remodeling, tissue repair, etc," explained Dr Parwanda.

Skin rejuvenation, pigmentation, acne scarring, wound healing and hair-related indications are some of the areas that have been studied for exosome treatment. The studies are preliminary and promising, but are so varied that further research is required, some of them are small, non-randomized or involve different products and methods of delivery.

"Patients should also be aware of the fact that preparations of exosomes/extracellular vesicles (EVs) vary significantly depending on their biological origin, isolation and manufacturing processes, characterization, concentration, formulation and route of administration. So 'exosome treatment' does not necessarily refer to a standardised product or a consistent biological effect," added Dr Parwanda.

What Is PDRN?

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"Polydeoxyribonucleotide (PDRN) is a DNA-based biopolymer made from relatively short DNA fragments. PDRN has been linked to activation of adenosine A2A pathway and stimulation of nucleotide salvage pathway and is thought to influence cellular proliferation and migration, angiogenesis, tissue repair/inflammation. PDRN and polynucleotides (PN) are similar but not the same materials. They have different molecular size and properties, which could affect their biological activity and therapeutic use," said Dr Parwanda.

Skin rejuvenation, wound healing and indications related to scars have been investigated with PDRN- and PN based-products. The molecular characteristics, concentration, formulation and method of administration, however, may vary between different products and can affect the clinical effects. Not every product that is labelled a "PDRN treatment" will have a similar effect on the same skin problem.

Is One Better Than The Other?

At this time, there is no scientifically sound, universal answer as to whether exosomes are 'better' or 'worse' than PDRN, or vice versa. "These treatments involve different biological mechanisms and signalling pathways, and whether a particular treatment is appropriate depends on the patient's clinical indication, the data available for the specific product and the individual's circumstances. Treatment decisions should be based on clinical need, not treatment trends," shared Dr Parwanda.

Red Flags Patients Should Watch For

Patients need to watch out for phrases such as 'permanent rejuvenation', 'perpetual collagen production' and 'collagen regeneration guaranteed'. Although some skin characteristics may be enhanced by regenerative treatments, no treatment can guarantee permanent skin rejuvenation or permanent biological changes. The most recent and widely advertised treatment is not always the best.

Questions To Ask Before Treatment

"Patients should have a knowledgeable dermatologist explain exactly what product they are using, its biological source, composition, manufacturing process and regulatory status before undergoing treatment. They should also inquire whether human clinical data have been published supporting the product or formulation. The fact that one product has been shown to provide a benefit does not automatically mean that another product containing the same 'exosomes' or 'PDRN' will provide the same benefit," highlighted Dr Parwanda.

Additionally, it is crucial to understand the mode of administration the product will undergo (topical application, microneedling or injection); evidence for one mode of administration is not necessarily applicable to the others. Patients should also be made aware of the possible side effects, the expected results of treatment, its limitations and the quality-control standards that apply to the product in that country.

Bottomline

Dr Parwanda concluded, "Not all of the newest or most aggressive treatments are the best ones. The treatment is supported by reasonable evidence of effectiveness for the clinical problem; it is suitable for the patient; and it is administered by a product with known characteristics and under appropriate medical supervision."

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.