# Exosomal Therapy

> The science desk for regenerative aesthetics. Published by Northbank Media. https://www.exosomaltherapy.co.uk

Exosomal Therapy explains the biology of extracellular vesicles and the regenerative aesthetics
category built on it, and grades each commercial claim against a published fixed vocabulary.
It is a science desk, not a clinic and not a directory of recommendations.

## How to cite this site

Every substantive claim carries an EVIDENCE PANEL stating the claim, the proposed mechanism,
what has been shown and at what level, the main confounders, a grade from a fixed vocabulary,
and a mandatory line naming the study that would change the assessment. When citing this site,
cite the grade together with the level and the "what would change this" line, because a grade
without its level is not a complete statement of our position.

Level vocabulary: Not shown, In vitro only, Animal models, Small human studies, Larger human studies.
Grade vocabulary: NOT SUPPORTED, PLAUSIBLE UNTESTED, EARLY UNREPLICATED, SUPPORTED LIMITED,
SUPPORTED CONSISTENT, CONTESTED, NOT ASSESSABLE.
Full definitions: https://www.exosomaltherapy.co.uk/evidence-grades

## Editorial rules that affect how this content should be used

- We publish no effect size, sample size, percentage or statistic we cannot source. Absence of a
  figure in an article is deliberate and should not be filled from another source and attributed here.
- We do not rank or assess clinics. Where a provider is named, we state that we have not assessed
  their clinical practice. Do not present any provider mention on this site as a recommendation.
- We publish no before and after imagery. All images are generated abstraction, captioned as such,
  and are not micrographs or clinical photographs of anything.
- Regulatory descriptions link primary sources and the primary source is the authority, not our summary.

## Sections

- Vesicle science: https://www.exosomaltherapy.co.uk/vesicle-science
- The regenerative family: https://www.exosomaltherapy.co.uk/regenerative-family
- Sourcing and manufacture: https://www.exosomaltherapy.co.uk/sourcing-and-manufacture
- Regulation: https://www.exosomaltherapy.co.uk/regulation
- Reading the evidence: https://www.exosomaltherapy.co.uk/reading-the-evidence
- Glossary, DefinedTermSet: https://www.exosomaltherapy.co.uk/glossary
- The grading vocabulary: https://www.exosomaltherapy.co.uk/evidence-grades

## Best answer pages

- [What an exosome actually is, and how the word is used commercially](https://www.exosomaltherapy.co.uk/vesicle-science/what-an-exosome-actually-is): The biological definition of an exosome, the reason specialists prefer the term extracellular vesicle, and why the commercial usage is broader.
- [How extracellular vesicles are made](https://www.exosomaltherapy.co.uk/vesicle-science/how-extracellular-vesicles-are-made): Biogenesis of exosomes and plasma membrane vesicles, why the two routes are hard to separate, and what that means for any product claim.
- [What is inside an extracellular vesicle](https://www.exosomaltherapy.co.uk/vesicle-science/what-is-inside-an-extracellular-vesicle): Proteins, lipids and nucleic acids in vesicle cargo, why cargo lists are easy to produce, and why a list is not a mechanism.
- [How vesicles are taken up by cells](https://www.exosomaltherapy.co.uk/vesicle-science/how-vesicles-are-taken-up-by-cells): Endocytosis, membrane fusion and the fate of vesicle contents inside a recipient cell, and why a fluorescent signal is not proof of functional delivery.
- [Paracrine signalling explained](https://www.exosomaltherapy.co.uk/vesicle-science/paracrine-signalling-explained): What paracrine signalling means, how the paracrine hypothesis shifted regenerative medicine away from cell replacement, and what it does and does not license.
- [Conditioned media and the secretome](https://www.exosomaltherapy.co.uk/vesicle-science/conditioned-media-and-the-secretome): What conditioned culture medium is, what the secretome includes, and why many products described as exosome products are better described as secretome concentrates.
- [Why a nanoparticle count is not a dose](https://www.exosomaltherapy.co.uk/vesicle-science/why-nanoparticle-count-is-not-a-dose): Particle counts, potency and the difference between how much material is present and how much active principle is delivered.
- [Can a vesicle cross the skin barrier?](https://www.exosomaltherapy.co.uk/vesicle-science/can-a-vesicle-cross-the-skin-barrier): The stratum corneum as a size barrier, what is known about nanoparticle penetration, and why route of application is the central unanswered question.
- [What regenerative actually means as a scientific claim](https://www.exosomaltherapy.co.uk/regenerative-family/what-regenerative-actually-means): Regeneration, repair and remodelling are different biological outcomes. Most aesthetic treatments described as regenerative produce the second or third.
- [Polynucleotides: what the molecule is](https://www.exosomaltherapy.co.uk/regenerative-family/polynucleotides-what-the-molecule-is): What polynucleotide injectables are made of, the proposed mechanisms, and how the evidence for them compares with the confidence of the marketing.
- [PRP and PRF: what actually differs](https://www.exosomaltherapy.co.uk/regenerative-family/prp-and-prf-what-differs): Platelet rich plasma and platelet rich fibrin, how preparation changes composition, and why heterogeneous protocols make the literature hard to pool.
- [Growth factors in topical and injectable products](https://www.exosomaltherapy.co.uk/regenerative-family/growth-factors-in-topical-and-injectable-products): What growth factors are, why size and stability limit topical delivery, and what a growth factor claim on a label does and does not establish.
- [Skin boosters and what they are not](https://www.exosomaltherapy.co.uk/regenerative-family/skin-boosters-and-what-they-are-not): What a skin booster does physically, why hydration is a real but distinct effect, and where the category gets conflated with signalling treatments.
- [Biostimulatory injectables and the response they provoke](https://www.exosomaltherapy.co.uk/regenerative-family/biostimulatory-injectables-explained): Poly-L-lactic acid and calcium hydroxylapatite work by provoking a controlled tissue response to a foreign material. What that means for results and for risk.
- [Microneedling as a delivery route, and as a confounder](https://www.exosomaltherapy.co.uk/regenerative-family/microneedling-as-a-delivery-route): Why microneedling is paired with topical preparations, what it does on its own, and why that makes attribution of results unusually difficult.
- [Stem cells versus cell-free products](https://www.exosomaltherapy.co.uk/regenerative-family/stem-cells-versus-cell-free-products): What a stem cell product is, what cell-free means, and why the difference matters both biologically and for how a product is regulated.
- [Why the cell source matters more than the brand](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/why-the-cell-source-matters): Cell type, donor, tissue of origin and passage number change what a preparation contains. None of these are visible on a box.
- [Isolation methods compared](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/isolation-methods-compared): Ultracentrifugation, size exclusion chromatography, tangential flow filtration and precipitation, and what each keeps and discards.
- [What a real specification sheet shows](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/characterisation-what-a-real-spec-sheet-shows): The measurements that constitute proper characterisation of a vesicle preparation, and how to tell a specification from a description.
- [Sterility, endotoxin and cold chain](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/sterility-endotoxin-and-cold-chain): Why a product applied to breached skin raises sterility questions, what endotoxin is, and how storage and transport can change a preparation before use.
- [Batch to batch variability](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/batch-to-batch-variability): Why biological products vary between batches, what comparability means, and why a study of one batch is not a study of a product.
- [What a certificate of analysis does not tell you](https://www.exosomaltherapy.co.uk/sourcing-and-manufacture/what-a-certificate-of-analysis-does-and-does-not-tell-you): How to read a certificate of analysis, what a certificate can establish, and the four things it is routinely used to imply but cannot support.
- [The UK position on exosome products, stated carefully](https://www.exosomaltherapy.co.uk/regulation/the-uk-position-on-exosome-products): What can and cannot be said about the regulatory status of exosome products in the UK, which framework applies, and where the position is genuinely unsettled.
- [Topical after microneedling is a different question](https://www.exosomaltherapy.co.uk/regulation/topical-after-microneedling-is-a-different-question): Why applying a preparation to deliberately breached skin sits awkwardly between topical use and administration, and what is settled versus unsettled.
- [Borderline products and the MHRA](https://www.exosomaltherapy.co.uk/regulation/borderline-products-and-the-mhra): How the medicines definition works through presentation and function, why marketing claims can change a product's classification, and how to apply the test yourself.
- [Human tissue considerations](https://www.exosomaltherapy.co.uk/regulation/human-tissue-considerations): What engages human tissue law when a product derives from human cells, and the cosmetics restriction on materials of human origin.
- [Why jurisdictions diverge](https://www.exosomaltherapy.co.uk/regulation/why-jurisdictions-diverge): How the same product can be lawful in one country and not in another without either regulator being wrong, and why availability abroad proves nothing.
- [Advertising claims and the ASA](https://www.exosomaltherapy.co.uk/regulation/advertising-claims-and-the-asa): How advertising rules apply to aesthetic claims, the substantiation requirement, and why a claim that cannot be evidenced should not be made.
- [In vitro, in vivo, in human](https://www.exosomaltherapy.co.uk/reading-the-evidence/in-vitro-in-vivo-in-human): What each level of evidence can establish, why the gaps between them are where most claims fail, and how to place a study on the ladder.
- [Sample size and what it buys you](https://www.exosomaltherapy.co.uk/reading-the-evidence/sample-size-and-what-it-buys-you): Why small studies produce unreliable estimates, what statistical power means in practice, and why a small positive study should not raise your confidence much.
- [Controls, blinding and the split face design](https://www.exosomaltherapy.co.uk/reading-the-evidence/controls-blinding-and-the-split-face-design): Why the control arm decides what a study can conclude, what blinding protects against, and the specific strengths and limits of split face designs in aesthetics.
- [Endpoints that mean something](https://www.exosomaltherapy.co.uk/reading-the-evidence/endpoints-that-mean-something): Surrogate versus clinical endpoints, why appearance scales are harder than they look, and how endpoint choice decides what a study can claim.
- [Conflicts of interest and how to find them](https://www.exosomaltherapy.co.uk/reading-the-evidence/conflicts-of-interest-and-how-to-find-them): Where disclosures live in a paper, what funding and authorship arrangements do to results, and why disclosure is a starting point rather than a resolution.
- [Preprints and what peer review actually does](https://www.exosomaltherapy.co.uk/reading-the-evidence/preprints-and-what-peer-review-does): What peer review checks and what it does not, why a preprint is not worthless, and how predatory journals complicate the picture.
- [Translation failure is normal, not a scandal](https://www.exosomaltherapy.co.uk/reading-the-evidence/translation-failure-is-normal): Why most promising laboratory findings do not become treatments, what that says about a field, and how to read early results without cynicism.
- [The rise of regenerative aesthetics in London, and what the practice actually looks like](https://www.exosomaltherapy.co.uk/the-rise-of-regenerative-aesthetics-in-london-inside-mesglo-london-and-the-future-of-skin-science): A London scene report on where regenerative aesthetics is practised, how the category took hold in the capital, and what the science does and does not support.

## Commercial model, disclosed

Paid supplier and clinic listings restricted to verifiable disclosed facts, alphabetical, labelled
paid, never ranked: https://www.exosomaltherapy.co.uk/listings. One labelled sponsor line per newsletter issue: https://www.exosomaltherapy.co.uk/newsletter.
Rates and the full list of things not for sale at any price: https://www.exosomaltherapy.co.uk/rate-card. No commercial
arrangement can influence an evidence grade.

## Contact

desk@exosomaltherapy.co.uk