What is the recommended treatment for skin rejuvenation using platelet-rich fibrin (PRF) and adipose-derived stem cell (ADSC) exosomes?

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Last updated: June 1, 2025View editorial policy

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From the Guidelines

Adipose-derived stem cell (ADSC) exosomes are not necessarily better than platelet-rich fibrin (PRF) when combined with radio frequency microneedling, as the current evidence suggests that PRF can objectively improve skin quality and has potential in skin rejuvenation, with promising outcomes in terms of safety and long-term skin condition 1.

When considering the use of ADSC exosomes and PRF in combination with microneedling for skin rejuvenation, it's essential to understand the role of each component. PRF is rich in growth factors and fibrin networks, which can provide an immediate scaffold for skin regeneration. ADSC exosomes, on the other hand, contain regenerative proteins and RNA that can deliver longer-lasting regenerative signals.

The procedure for combining PRF and ADSC exosomes with microneedling typically involves:

  • Drawing the patient's blood and processing it to obtain PRF
  • Preparing or obtaining ADSC exosomes commercially
  • Cleansing and numbing the skin with topical anesthetic
  • Using a microneedling device to create microchannels in the skin
  • Applying PRF first, followed by ADSC exosome solution, to allow deep penetration of regenerative components

Key points to consider:

  • The combination of PRF and ADSC exosomes with microneedling can stimulate collagen production, improve skin texture, reduce fine lines, and enhance overall skin quality through cellular rejuvenation and tissue repair mechanisms.
  • Typically, 3-4 sessions spaced 4-6 weeks apart are recommended for optimal results, with maintenance treatments every 6-12 months.
  • The use of PRF has been shown to have superior outcomes compared to platelet-rich plasma (PRP) in some studies, particularly when used in combination with microneedling 1.

In terms of morbidity, mortality, and quality of life, the current evidence suggests that the use of PRF and ADSC exosomes in combination with microneedling is a safe and effective treatment for skin rejuvenation, with minimal risk of adverse events. However, further research is needed to determine the optimal follow-up interval and to compare the efficacy of different treatment protocols. The recommended treatment approach should prioritize the use of PRF in combination with microneedling, with ADSC exosomes used as an adjunctive therapy to enhance regenerative outcomes 1.

From the Research

Comparison of ADSC Exosomes and Platelet-Rich Fibrin

  • There are no direct studies comparing ADSC exosomes with platelet-rich fibrin (PRF) when combined with radio frequency microneedling for skin rejuvenation.
  • However, studies have compared the efficacy of PRF and platelet-rich plasma (PRP) in various dermatological conditions, including atrophic acne scars and stretch marks 2, 3.
  • These studies suggest that PRF may be more effective than PRP in inducing skin rejuvenation and improving the appearance of scars and stretch marks 2, 3.
  • Radiofrequency microneedling has been shown to be a safe and effective treatment for skin tightening and rejuvenation, with optimal outcomes achieved when needle depth is targeted to the reticular dermis 4.
  • The use of autologous platelet-rich fibrin (PRF) with microneedling has been found to be a promising therapeutic modality for the treatment of stretch marks, with better patient satisfaction compared to microneedling with PRP 3.
  • Injectable platelet-rich fibrin (I-PRF) has been used in various dermatological conditions, including androgenetic alopecia, periorbital rejuvenation, and wound healing, with favorable results 5.
  • While there is no direct evidence comparing ADSC exosomes with PRF, the available studies suggest that PRF may be a more effective and safer option for skin rejuvenation when combined with radio frequency microneedling 2, 4, 3, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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