PRP vs exosomes for skin: which is better for rejuvenation and scarring?

PRP (Platelet-Rich Plasma) and exosome therapy are both marketed as biologically-derived skin rejuvenation treatments. They're increasingly offered side by side at med spas — sometimes positioned as "PRP's evolution" — but they work differently, have different evidence bases, and are appropriate for different patients. Here's a direct comparison.

How each works

PRP: Blood is drawn from the patient, centrifuged to concentrate platelets, and the resulting plasma is applied topically (after microneedling) or injected. Platelets release growth factors (PDGF, TGF-β, VEGF, EGF) when activated — these stimulate fibroblasts, accelerate healing, and promote collagen production.

Exosomes: Extracellular vesicles derived from donor mesenchymal stem cells (typically umbilical cord or adipose tissue). They carry growth factors, microRNA, and proteins that influence cell behavior. Applied topically after microneedling or injected. See our full exosome guide for regulatory context.

The key difference: PRP uses your own blood — autologous, with no foreign substance. Exosomes are allogeneic — derived from another person's cells, processed into a standardized product. PRP growth factor content varies by patient; exosome products are standardized but unregulated in the US as to quality.

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Evidence comparison

PRP for skin:
10+ years of aesthetic studies
Multiple RCTs for acne scarring, skin quality, post-procedure healing
Well-understood mechanism
Quality varies by centrifuge system and protocol

Exosomes for skin:
3–5 years of early aesthetic studies
Small case series and manufacturer-sponsored studies predominate
Early RCT data for hair loss (promising); skin data more limited
No FDA-approved products for aesthetic use; quality varies widely between manufacturers

The honest summary: PRP has substantially more evidence. Exosomes have promising early data but haven't been tested at scale with controlled methodology.

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Practical comparison

| Factor | PRP | Exosomes |
|---|---|---|
| Source | Your own blood (autologous) | Donor cells (allogeneic) |
| FDA approval | Not approved as drug (device-processed) | Not approved; regulatory gray area |
| Quality consistency | Variable by centrifuge system | Variable by manufacturer |
| Evidence base | Moderate-strong (10+ years) | Early (3–5 years) |
| Allergic risk | None (autologous) | Theoretical (allogeneic) |
| Cost per session | $400–$1,000 | $500–$3,000 |
| Sessions for skin | 3–4 initial | 1–3 initial |
| Best evidence for | Acne scarring, post-procedure healing, hair loss | Hair loss (early); skin quality (early) |

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When to choose PRP

Acne scarring — the best-evidenced combined use (PRP + microneedling)
Post-procedure healing enhancement (after laser, RF microneedling)
Patients who want the most established biologic treatment
Hair loss (initial series)
Budget-conscious patients (PRP is consistently less expensive)
Patients who prefer autologous treatment (no donor material)

When exosomes might make sense

Patients who haven't responded adequately to PRP for hair loss
Patients who want to try a next-line option after PRP with realistic expectations
Post-procedure enhancement when the provider has a verified, high-quality exosome product (with CoA documentation)
Patients willing to pay a premium for a promising but unproven treatment

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Can you combine them?

Some providers use PRP and exosomes together — PRP injected, exosomes applied topically after microneedling. The rationale: autologous growth factors from PRP combined with the broader signaling cargo of exosomes.

There's no RCT data on the combination. It's practiced by some providers with anecdotal results. The cost adds up significantly.

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The product quality question

This matters more for exosomes than PRP. Before choosing exosomes specifically, ask:
What product are you using, by name?
Can I see the certificate of analysis (particle count, sterility)?
How do you verify product quality between batches?

For PRP, quality is more under your provider's direct control — the centrifuge system and processing protocol determine platelet concentration. Ask: which centrifuge system and what concentration does it achieve?

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Questions to ask before booking either treatment

For my specific concern (acne scarring, general skin quality, post-procedure), which has better evidence — PRP or exosomes?
For exosomes: what product do you use, and can you show me quality documentation?
For PRP: which centrifuge system do you use, and what platelet concentration does it achieve?
Given the cost difference, is the exosome premium justified for my goals?
Would you recommend microneedling plus PRP or RF microneedling plus PRP before recommending exosomes?

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