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Dr. NüchelAesthetics
Exosome therapy at Dr. Nüchel Aesthetik in Mönchengladbach

Regenerative medicine & skin quality

Exosome therapy

Topical, regeneratively oriented accompanying treatment with exosome-containing preparations – applied immediately after microneedling, radiofrequency microneedling or laser, when the skin is particularly receptive. No injection.

Treatable areas

  • After microneedling
  • After laser
  • Fine lines
  • Dull skin
  • Uneven skin texture

Exosomes are tiny vesicles released by cells (extracellular vesicles) that act as messengers between cells, transporting signalling molecules such as proteins, lipids (fats) and short RNA fragments. In skin regeneration, the central idea is that such signals might support the skin's own repair and renewal processes. The preparations used are cell-free – they contain no living cells, only vesicles obtained from cell cultures or plant sources, or their components.

Exosome preparations are currently not approved as medicines in Germany and the EU. We therefore use them exclusively topically – applied externally to the skin, never injected – and only as a cosmetic accompanying treatment immediately after microneedling, radiofrequency microneedling (e.g. INFINI™) or certain laser treatments, when the skin is particularly receptive.

All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.

Indications

Who it is suitable for

Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:

  • As complementary care immediately after microneedling, when the skin is temporarily more receptive
  • As an accompanying treatment after radiofrequency microneedling (e.g. INFINI™) or suitable laser treatments within the scope of medical aftercare
  • In the case of a dull, stressed complexion or fine lines as a cosmetic accompanying measure to a renewal procedure
  • For patients who would like to try a novel, cautiously framed care component
  • Only after an individual medical assessment of whether the accompanying treatment is sensible and suitable in the particular case

Step by step

How the treatment works

This is how the treatment usually proceeds with us – from the first consultation through to aftercare.

  1. Consultation and information

    In a personal conversation we clarify suitability, the regulatory framework (no medicinal approval, exclusively topical application), the origin of the preparation (plant-based or cell-culture-based), the limited body of evidence as well as possible risks and realistic expectations. We determine the base procedure such as microneedling or laser together.

  2. Skin preparation and base treatment

    The skin is cleansed and disinfected. We then carry out the base procedure – microneedling, radiofrequency microneedling or a suitable laser treatment – which creates the finest, controlled microchannels or temporarily makes the skin barrier more permeable.

  3. Topical application of the exosomes

    Immediately afterwards, while the skin is particularly receptive, we apply the exosome-containing preparation externally to the treated areas and work it in gently – expressly without injection.

  4. Conclusion and follow-up

    After working it in, we soothe the skin, cool it if needed and apply a suitable protection. If needed, we arrange a follow-up appointment to assess the healing process of the base treatment; any treatment plan is guided primarily by the base procedure.

Transparency

Prices

pro Sitzung
350 €

All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.

Patient information

Safety & patient information

Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.

  • Redness and temporary irritation

    Very common and usually harmless: the skin may appear reddened and irritated after the treatment – predominantly as a result of the base treatment (microneedling or laser). The application of the exosomes can be accompanied by a temporary feeling of tightness or warmth. The complaints usually subside within hours to a few days.

  • Feeling of tightness, burning or tingling

    A slight burning, tingling or tightness immediately after the application is possible and usually short-lived. It arises predominantly in connection with the preceding base treatment and can often be relieved by cooling and soothing care.

  • Intolerance or allergic reaction

    Rarely, an intolerance or allergic reaction to ingredients may occur – for example with increased redness, itching, wheals or swelling. If you notice such signs, you should contact us; pronounced allergic reactions require prompt medical care.

  • Dryness, flaking and small crusts

    As part of the healing after the base treatment, dry patches, slight flaking or small crusts may occur. These are part of the normal regeneration process and should not be scratched off, so as not to disturb the healing.

  • Temporary pigment changes

    Particularly in darker skin types or those prone to pigment disorders, and with insufficient sun protection, temporary darkening (hyperpigmentation) or, more rarely, lightening may occur after the base treatment. Consistent UV protection reduces this risk.

  • Infection in connection with the base treatment

    As microneedling and laser temporarily open the skin barrier, there is a low risk of infection despite sterile working, which may manifest as increasing redness, overheating, pain or pus formation. Such reactions are rare, but must be treated medically.

  • Reactivation of cold sores

    In treatments on the face, a base treatment can reactivate a cold sore (herpes simplex) in predisposed individuals. In the case of a known tendency to herpes, preventive medication may be sensible – please raise this with us in advance.

  • Absent or unsatisfactory additional benefit

    As the standalone benefit of the topical exosome application is not scientifically established, an effect beyond the base procedure may be absent or fall short of expectations. We expressly point out that we do not promise any particular results here.

  • Uncertainties due to product heterogeneity

    Because cosmetic exosome preparations differ in origin, composition and standardisation and no uniform quality standard exists, tolerability and effect cannot be predicted across the board. We select preparations carefully and provide transparent information about the product used in each case.

  • Unknown long-term risks

    There are so far no comprehensive data on the long-term safety of cosmetic exosome preparations in humans. Long-term risks that cannot be entirely ruled out in theory currently cannot be conclusively assessed scientifically. We name this knowledge gap openly and include it in the joint decision.

When we do not treat

In certain situations we do not carry out a treatment, or only at a later time – for your safety.

  • Pregnancy and breastfeeding – for want of sufficient safety data, we refrain from the accompanying treatment during this time.
  • Acute infections, inflammations, open skin areas or an active cold sore in the treatment area; the treatment is postponed until they have completely subsided.
  • Known allergy or intolerance to ingredients of the preparation used.
  • Reservations about the origin of the preparation (e.g. cell-culture-based production) – in this case we clarify in advance whether a suitable alternative exists or whether the application is refrained from.
  • Existing contraindications to the intended base procedure (e.g. to microneedling or laser), as the exosome application does not take place without a base treatment.
  • Active autoimmune or chronic inflammatory skin conditions in the treatment area that speak against an irritating base treatment – an individual medical assessment is required here.
  • A tendency to excessive scar formation (keloids) in the planned treatment area.
  • Acute, unresolved skin irritation, fresh tanning or sunburn in the treatment area.
  • Unrealistic expectations or a treatment wish for which, from a medical point of view, there is no sensible indication.

This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.

In depth

Medical details & background

How it works & the evidence

Exosomes belong to the extracellular vesicles – small, membrane-enclosed vesicles in the nanometre range that almost all cells of the body release to the outside. Their biological function is communication between cells: they transport messenger substances such as proteins, lipids (fats) and short RNA segments, which can influence signalling pathways in recipient cells.

The cosmetic principle of action is based on the assumption that these signalling molecules might support the skin's own regeneration and repair processes – such as the formation of structural proteins like collagen and elastin. The preparations are expressly cell-free (no living cells) and are obtained from plant sources or from cell cultures. Composition, purification and standardisation differ markedly between products; a uniform, generally recognised quality and efficacy standard is lacking, which is why results from one product cannot readily be transferred to others.

The intact skin barrier limits the penetration of large molecules. Microneedling, radiofrequency microneedling or certain laser treatments create the finest channels in a controlled manner, or temporarily make the barrier more permeable; it is in this time window that exosomes are applied. How much actually reaches which skin layers, and what effects result, has not been conclusively clarified scientifically. The well-studied mechanism of action is that of the base procedure itself; the exosomes are a complementary, regeneratively oriented care component that we describe without promises of cure.

Research into exosomes is young and rapidly developing. In basic research and preclinical investigations (cell cultures, animal models), extracellular vesicles have aroused interest as carriers of regenerative signalling molecules; such results are, however, not to be equated with a proven benefit in humans. Robust clinical studies on the cosmetic application are so far limited, mostly small and inconsistent, and the preparations are heterogeneous – no clear, generally valid proof of efficacy can be derived from this.

We therefore deliberately phrase the possible benefit cautiously: a visible skin result is attributable primarily to the better-studied base procedure; any isolated additional benefit of the exosomes is not scientifically established, and we make no binding promises of effect or success. There are also no comprehensive data on the long-term safety of cosmetic exosome preparations in humans; should the evidence or the regulatory framework change, we will adjust our approach accordingly.

Preparing for your treatment

A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.

  • In the consultation, openly discuss your medical history, allergies, skin conditions, any tendency to cold sores as well as your expectations, so that we can carefully assess suitability.
  • In the days before the treatment, avoid intensive sunbathing and tanning beds; freshly tanned, irritated or sunburnt skin should completely subside before the base treatment.
  • After consultation, pause irritating care products (e.g. retinoids, fruit-acid or other peels) in the treatment area in good time before the appointment.
  • Do not adjust the intake of blood-thinning medication on your own initiative, but only in consultation with us and your treating physician; in the case of a known tendency to herpes, preventive medication before a facial treatment may be sensible.
  • Come if possible without make-up, or expect a thorough cleansing of the skin before the treatment.
Aftercare

The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:

  • Keep the treated skin clean in the first few days and treat it gently; avoid vigorous rubbing, peels and irritating cosmetics until the skin has calmed down.
  • Use a mild, soothing and moisturising care according to our individual recommendations and avoid aggressive or perfumed products.
  • Protect the skin consistently from UV radiation and use a high sun protection factor (SPF 50+) in the days after the treatment; avoid direct, intensive sun exposure and tanning beds.
  • For about 24 to 48 hours, avoid intensive exercise, sauna, steam bath and very hot baths, as heat and increased circulation can intensify the irritation.
  • Do not scratch or remove any small crusts or flaking, but let them heal off by themselves, in order to prevent scarring or pigment disorders.
  • On the day of treatment, avoid alcohol if possible, as this can promote skin irritation and swelling.
  • Contact us immediately if unusual complaints occur – in particular increasing redness with overheating, severe pain, pus formation, pronounced swelling or signs of an allergic reaction.
  • Attend any follow-up appointment offered, so that we can assess the healing process of the base treatment and coordinate the further course of action with you.

FAQ

Frequently asked questions

Answers to questions we are asked particularly often about “Exosome therapy”.

No. We apply exosomes exclusively topically, that is, externally to the skin – never injected or introduced into the body. The background is their lack of medicinal status in Germany and the EU; we therefore use them only as a cosmetic accompanying treatment following procedures such as microneedling or laser.

Exosome preparations are currently not approved as medicines in Germany and the EU; the regulatory status is evolving. For this reason we use them exclusively topically as a cosmetic accompanying treatment, deliberately refrain from promises of cure, and inform you individually about the origin and status of the specific preparation used.

Depending on the product, the vesicles come from plant sources or from human or animal cell cultures. We openly inform you of the origin and composition of the preparation intended for you; if the origin is important to you – for ideological reasons, for example – please actively raise this with us.

The exosome application alone is usually painless. A temporary tightness, burning or tingling usually stems from the preceding base treatment – for example microneedling or laser – not from the exosomes themselves.

The costs depend on the base procedure, the area treated, the preparation used and the effort involved; we give you a guide value in advance. Billing is as a private medical service according to the German scale of fees for physicians (GOÄ). Aesthetically motivated treatments are generally not covered by the statutory health insurance funds.

Consultation, information and the base treatment are carried out by physicians or under medical responsibility by appropriately qualified specialist staff. Precisely because the field of exosomes is new in regulatory and scientific terms, we attach importance to a careful medical assessment and honest information about benefits, limits and the legal framework.

Sources & guidelines

  • AWMF guideline register – register of the scientifically grounded guidelines of the medical specialist societies (www.awmf.org).
  • German Dermatological Society (DDG) – specialist society for dermatology with recommendations and patient information.
  • Federal Institute for Drugs and Medical Devices (BfArM) as well as the European Medicines Agency (EMA) – information on the regulatory status of novel preparations and biological products.
  • Generally recognised review articles and controlled studies on extracellular vesicles and regenerative dermatology, taking into account the so far limited clinical evidence in humans.

Personal consultation

Arrange a personal consultation

In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.

More treatments

You might also be interested in

As exosomes serve as an accompanying treatment, the choice of the appropriate base procedure is the priority – such as microneedling or radiofrequency microneedling (e.g. INFINI™), whose effect is better studied, as well as, depending on the findings, ablative or other laser procedures (e.g. CO₂ or the gentler Erbium:YAG laser, pigment and vascular lasers). As regenerative options, after careful medical consideration an autologous-blood-based treatment and, for volume or contour matters, hyaluronic acid fillers may also be considered.

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