This is the Art Beauty podcast, where we are always reaching for truth in beauty. Remember, the brands of the people on the show are not paying to be here, so we get to ask those tough questions. We know you want answered because you deserve to be informed so you can make the best choices for yourself. With that said, I'm Amber, Milk and today, My fabulous co-host is Dr. Saranya Wyles. She's a board certified dermatologist with a Ph.D. in regenerative medicine.
She works at a little place called the Mayo Clinic. So I think we know that she's got some credibility here. She also led the clinical trials for Plated, which is an exosome product that we will be discussing. But before we get into that first. Welcome to the show, Dr. Wyles. Really appreciate you having. Really appreciate you being here with us today. Thanks, Amber. It's great to be here with you.
So, you know, we keep it honest here and I am so excited about this episode today because we we did I did in an episode on Exosome products, specifically in topical products. You take it home, not things that are injected or applied after, you know, you've had some sort of laser treatment and then, you know, it's the beauty business, right? So things are always changing. And then I started to really dive into Exosomes. So I was familiar with the Elevate product. I used it.
I felt like it made my skin a little bit more clear. But then when I started kind of really digging around and doing a little more research, I found that there was a lot of conflicting information on Exosomes. With some doctors who were like, yes, this is that the the the newest, hottest thing to do and other doctors who are like, well, there's things we need to be concerned a bit a little bit about. And I'm hoping today, Dr. Wells, that you can help us kind of clear some of that up.
So to start with, can you give us a very brief explainer and a reminder of what exosomes are? Absolutely. Amber. And I think a lot of the scientific rhetoric that comes around with the terminology is new to people. And when you have a disruptive technology with new information and new terms, you have two camps. Part of the people who understand it, they're onboard because they see it working. And then the other part are skeptical and want to learn more. But there's concerns about it.
So let's break it down, starting from the basics, which is what is an exosome. So and Exosome is just a message from a cell and we could think about it like letters or signals. They have a single signal message that they're communicating to another cell. So it could be anything like repair, restore, it could be multiply or divide for a cell. It could also be harmful, like metastasized. So this is where the key is, the source of the exosome. Where is it coming from?
What are the cell or the source that it's coming from that really distinguishes the product? So the first question when somebody is talking about exosome technology should naturally be, well, what is the source? And there's great variability. So if we kind of think about it as pasta, you can kind of have different types of pasta and with different sauce and different types of dressings and things like that.
So this is really where you just have a blanket terminology and you really want to ask the next steps or the next questions to better understand what it is and how to how to use it. Now, I'm so glad you brought that up because, you know, when you were saying harmful, like you want to make sure that your exosomes aren't being sourced from somebody who is either genetically predisposed to cancer or had cancer.
Because as you said, those exosomes would be sending cells to messages to your cells that could affect them in negative ways. So as consumers, how are we supposed to know this? Because as far as I understand, the FDA is has not approved any exosomes and they've actually sent warnings to consumers about, you know, about using them. Exactly. So let's talk about what the FDA can regulate.
And really, it's a gray area when it comes to cosmetic applications, But as long as we're applying it on intact skin, and that includes really disrupting the skin barrier. So this is where we really have to be cautious and emphasize that there are currently no injectable exosome products that are approved even for cosmetic purposes. You cannot inject exosomes, and that's FDA has been very clear about that.
Now when you apply the product topically on skin for appearance of skin aging, redness for size, etc., that is that lies within that cosmetic realm, which the FDA doesn't necessarily regulate but does surveil. So this is where you need to make sure the company has the right strategies, the right manufacturing, so that the product that they're offering or sharing is under the guidelines of the FDA.
Now, you know, I want to talk about the injectables, because that is something that we sort of heard, you know, k-beauty we know K-beauty a lot of that, but that is actually a very popular treatment in Korea is this idea of injectable skin boosters here. You know, in the States, I think what's much more common is for people to see in-office exosomes being applied after you've had either microneedling some sort of a laser. I myself have had some microneedling before.
So. So is it just that we need to be, you know, trusting, I guess, our doctor, that our doctors doing the research to make sure that these are sourced from reliable companies? Yes. So let's talk about sourcing a little bit, because this is unlike any other product that we see on the market. So what do I mean by that?
I mean that when you go into a store to buy a product, whether it's glycolic acid or salicylic acid, so those are active ingredients where you know that those active actives are the same in every single product. The batch to batch chemistry is the same. Now when it comes to Exosomes, these are sourced from humans. So there's great variability in that human source of what cell is it coming from? Is it coming from one donor, one person, or is it coming from batch donors?
Collective combination of multiple pooled donors. And then you have to think about how are they manufacturing it because it can come from human sources.
You have to use good manufacturing practices or clinical very good manufacturing practices, clean labs, clean rooms, product handling gowns, loving all of these things that you wouldn't normally think about in your chemistry of Cosmeceuticals come into play with the bio manufacturing of Exosomes So this is where we really have to think about this as not every product is the same. And how you make the exosomes is really important.
And the sterility safety, the reproducibility meeting batch to batch consistency is is validated. So those are some of the things that you have to ask the manufacturer Where are these manufactured from? Who are the donors? Is it one multiple? And then how are they kind of ensuring that the product is consistent and reproducible with each batch?
I mean, for the regular person at home, is there a way for us to sort of find out that information or is it just writing to, you know, either that the cosmetic company, the parent company, but do you have any that you know or or why I like to do this podcast is bringing on trusted people like yourself, right, who work at the Mayo Clinic, who specialize in this, who are here.
Clearly, you are supporting a brand, but I do think that your credibility does lend to a little bit more trust than necessarily having, you know, somebody hate to say this from PR coming on saying this is the best, greatest thing. Is there anything that we can do at home to kind of ensure that our products are coming from a safe place? Yes. And to get that credibility, the company needs to invest in validating its technology. What does that mean?
That means they need to be doing FDA clinical trials in the product for different medical indications. So even a company like Plated has the parent company region and they have different clinical trials that's ongoing. So this is where the consumer can go. On clinicaltrials.gov, which is an open access public website, and you just type in the source and see if the company has FDA INDs ongoing, meaning do they have medical indications that they're trying this for?
That means they have a good background of manufacturing. You know, that the FDA has really delve deep into making sure that the products are manufactured consistently because they're looking to approve the product for many people and safety, which is a big concern and regulation for FDA. So you want to make sure that the company is has FDA studies ongoing that is separate for medical indications.
And if they have that, then that's good reason to believe that they've invested in and trusted manufacturing processes. Here's a little thing to anybody from Plated who's listening. You guys on your website should have a link to some of these clinical trials because I think that it was kind of hard to find out like, well, wait, where are these coming from? What's going on? But that's another, that's another conversation altogether. Maybe I'll write them a little letter.
So okay, So once we, you know, have this idea of that, we're at least getting trusted source is let's talk a little bit about the different sources that that exosomes come from. So I know that plated comes from platelets versus elevated VI which were taken from the umbilical cord. What's the difference? Why does that matter? Great question. So let's break it down.
So if we were to look at umbilical cord, this is from the cord blood of babies, and you can understand that each cord blood source is different. So you have to understand, is it one or two donors or is it multiple donors that they're combining the cord blood stem cells the other way, that the exosomes are manufactured is that they have to be cultured in a lab.
So if it's coming from stem cells, so look for the buzz word stem cells so they can be bone marrow stem cells, adipose stem cells, umbilical cord blood stem cells. So those stem cell sources need to be taken to a lab where they're expanded over and over and over again. And then they take what's called the culture media or the soup that the cells grow in. They basically take that media out and then they distill the exosomes down from that. So think about that as an intermediate step.
So you have the cord blood that's taken from the patient. You take it to the lab where this is the biomanufacturing making sure that there are sterility, good manufacturing processes. It's all handled under compliance and then it's expanded. So this takes weeks, two months even. And then your question is, are you using the same source? So after several months you have something called phenotypic deviation.
And the other way to think about it is that it kind of changes when you take something from its normal environment and you put it in a different environment. It tends to adapt to the new environment. So how do you guarantee that that product is the same as when you harvested it in the beginning from the fat tissue or bone marrow or umbilical cord? So that's important to keep in mind for stem cells. Okay. And so what's the difference with platelets? Great question.
So the platelets are a blood based source. So when you get blood, it's from multiple different donors. They're near expiration platelets. So we're not depleting from the source that the patients may need for use. So when you get these platelets, they're pooled. So first you take away the outliers. So people that are poor performers or super performers and you kind of average them in together when you kind of get all the platelets pooled together.
So that's how one way to guarantee that consistency, that batch to batch consistency that we talked about. So pooled platelets and they're processed immediately. So there's no step of going to platelets are actually cell free already. So platelets in a way are kind of exosomes themselves. They come from a parent cell called a mega carrier site, and that's when the bone marrow and then this just kind of spews out. So platelets don't have that DNA, they don't have that.
The genetic information that we are we could be concerned about. It's not a cell in that in that true cell sense. So when you take the platelets, you actually disrupt them and you collect the exosomes that is being released from the platelets. So and the way to do that is proprietary. They actually take out all of the other particles and then what's left is the exosomes.
So it's sort of like a sieve that they kind of sort of distill down all of the non exosome products so that you have exosomes leftover. Okay, So you know what a little light bulb just went off and tell me if I'm right. So essentially when you take brands like Olivia had stem cell based exosomes, these are platelets based exosomes and gosh, it's been a while since they took a science class. But platelets are essentially what your body releases in response to inflammation, correct? Exactly. Yes.
Okay. Okay. Got it. Okay. So amazing. Okay, got it. So it's actually a different type of cell. And you brought up a good point. You know, with the stem cell based ones, they have found in Exosomes DNA and RNA. Right. Like a lot of we have heard these buzz words. So platelets don't have any of that information in them. No DNA. You have a microarray days which are again messengers. So there post there they are a step down so it's not true genetic material.
So it's just a signal and it's actually a mixed bag of signals because sometimes we get asked the question, what's in the next is what exactly is composed in there? What's the message? It's actually pieces of message of a lot of different signals that come together and that they say repair or regenerate. And this is where the source becomes really key because the platelets normally do that. Like you pointed out, they are the first responders to wound healing.
So they naturally have that propensity to regenerate. I'm going to sites of wound, I'm going to repair this site. So they they release signals of repair. So that's where that exosome source is important. Now, you know, I hate to dumb this down because you are obviously brilliant, but is the idea that essentially an exorcism will be applied and tell your own skin cells, the ones that aren't acting in a reparative mode, Hey, wake up and start doing your job. Is that kind of what's going on here?
Yeah, I love this question, Amber, because basically what this is, is disruptive technologies. There's no product that has been this way. So if you think about growth factors, peptides, anything else that you're putting on your skin, they work outside of the cell, so they're kind of creating messages outside Exosomes work inside the cell. They actually have the capacity to go in and deliver a signal. So this is really new because you think about it as a mechanic.
Instead of working on top of the car, the mechanic is now working under the hood and that's really where Exosomes come into play of creating a new way of working with the cells. Okay, So thank you so much for getting into this. I'm so glad we were able to address some of the concerns that people are having. Let's talk a little bit about this technology. So, you know, from personal experience, I had a scar here that came from a laser treatment got wrong.
I had Exosome Microneedling and the scar healed. I mean, is basically invisible now. So I've seen that it can work. But when we talk about topical skin care, how are we making sure that those messages are getting to areas where we where we need them to go? Right where we we haven't had a treatment like a laser or microneedling where we have these little channels now how does that work?
So here's my question for you, which is that people have the assumption that a topical exosome product cannot penetrate the skin barrier, but that is incorrect and that's actually what we have found in our clinical study. So when we applied twice daily application of the plated gold and we followed these patients for six weeks and actually even up to six months, we saw considerable improvement in their skin.
But beyond that, at 12 weeks, we biopsied the skin and we looked underneath the hood and saw what was happening. This is where we actually found Exosomes that have been able to be identified in the collagen fibrils. So we're actually getting ready to publish this data soon.
And we submitted our data for the histology studies, which is really exciting because what we're seeing is that you can have physiological change, new collagen, new elastin with just topical application, no microneedling, no lasers, no adjuvant procedures, this is just topical application. So part of that is two things.
One is has it been manufactured appropriately the right way so that the exosomes are intact because you can rupture them and if you rupture them then they are no longer going to be able to produce that signal or share that message. So manufacturing is key there. But the second thing that's important is how the exosome size is. So the size of the exosomes very, very small. And we know that the skin can allow anything less than 500 kill adults and to penetrate into the skin barrier.
So these are very, very small particles and they're carried right in, and that's what our study showed. So now talk a little bit, because your relationship with plated, like I said, you work with the Mayo Clinic, you do clinical trials, right? Correctly through the Mayo Clinic. So how did how did you sort of get involved with plated? Yes.
So this was sort of very fortuitous, right place at the right time, I would say I actually came I thought I was going to be a cardiologist and like Mayo Clinic to do my medical training with Dr. Andre Chozick and Dr. Otto, who are the founders of Plated and Rion. So they are cardiologists and I did my Ph.D. work with them. And when we were doing the work, we were starting to we actually focused in a lot on mesenchymal stem cells, and we later found that actually platelets are the ideal source.
So we had a switch from mesenchymal stem cells to platelets, but the Ph.D. work lend itself to creating some of the research that went into the product design and and then I and I delivered the news that I'm going to become a dermatologist and my cardiologist, advisors and mentors were happy because they had come up with a product that would could be topically applied. And so part of it is right place at the right time.
But I've spent about, I would say, 12 years learning the science, everything starting from Ph.D. to to being in dermatology and then running the clinical trials. So I've really seen that science evolve and really mature, and it's been very exciting because the shift has really gone from stem cells to exosomes, which is really self free. That's, that's, that's what we're hearing.
And despite some of the concerns, which I'm glad we were able to address, you know, I've talked to a lot of doctors who who, like I said, are very supportive of this and do see these types of results. So let let's talk a little bit about plated, because there's, I think, three different products. I've got two of them here. One is the Daily Sarah, one is the intense serum. What are these meant for Who who were these meant for and what are some of the results that you've been seeing?
Absolutely. So I can start by kind of sharing with what we found in our clinical study, which is that the product really works on a very individualized, personalized level. So if you start with greater redness or greater hyperpigmentation, that's where it's going to target. And so this is kind of the holy grail of how can one product do all these different facets of skin aging and skin biology? Well, it's because you're targeting the root cause of skin aging and the root cause of damage.
So if you kind of help the body, give it the right signals to repair, it's going to repair what the damage to the damage that's been there already. So if it's redness, it targets redness. If it's brown pigmentation or size of fine lines, wrinkles, it targets that. And we're seeing those changes that as early as six weeks. So we use the busiest software to evaluate patients, everyone from the age 40 to 85. So we have a whole big group of patients.
Average age was 54. Now, the two products that you have there. So let's talk about how we use it. So product number one is the plated gold, which is the plated intense. That's the product that we used in the clinical study. So the plated, intense, applied twice daily helps repair moderate to severe photo aging. So this is really meant for you to use in the summer time or with significant sun damage.
So this is going to be targeting that considerable damaged skin, actinic damage, anything that you know, post laser like you talked about, if you have more concerns or even three laser. So I actually prime my patients with plated gold before they come in for their CO2 ablative laser or another type of laser. And I say use this product twice daily for six weeks that primes the skin and then you're going to get better results from a CO2 or any other laser that you're kind of looking into.
So I love that gold for that purpose. Is this also good? You know, I mean, now we are in the colder months when a lot of people are going for those laser treatments. Is this is this what you want to use? If you've had something like you said, you can prime your skin before, Would you also use this after? Absolutely. We have a product called Plated Calm, which is meant specifically for post procedure, but those are interchangeable. And to a certain degree.
So you can if you don't have the come with you, you can certainly use the plated intense for that purpose. I have to tell you. So, you know, I did the lab I used L-O-V-E for quite some time. And what I noticed for me was a lot more of the clarity, a lot of the not that I had very, very red skin, but that's where I noticed the biggest difference. But one of the things we were honest about was it had a certain smell. This does not this is not as Yes. It's not.
As that. And it does have a really nice texture. I think I just put it on. It's kind of like a gel jelly. But, you know, he talked about one of the things that he talked about when we did this with Dr. Blues was how hard it is to keep that shelf stable because Exosomes are are fragile. How have you managed to do that with Plated? Yes. And this is again, goes back to sourcing.
If you are able to isolate the product and are sourced in a way that the exosomes are stable, you can keep them shelf stable and and it should last year. So when the time the product is manufactured, we have up to two years that it can remain shelf stable for. But the studies and if you're using it consistently, even from the study that we did twice daily application at six weeks, that takes you through one bottle.
So technically you don't want to have this in your drawer for too long because you want to be applying it to get the effect. But if you if you do have it, it also is okay because of the source, because of the manufacturing and the way that it is kept intact. So I kind of do sometimes use the example of of an egg. So if you think about an egg and it's kind of kept at room temperature and is kept on your counter, it can it can remain stable because the outer shell is intact.
But if you crack that egg, then that egg is immediately not viable. You have to get rid of it or less than you know. So that's that goes into the consideration of is the exosome outer shell damaged or is it intact? Okay. And then we've got the daily serum, so “Calm” is for which I don't have here is specifically for post-treatment. But really you could use any of these, but you do have one that's targeted specifically for post treatment. What about the daily?
So the Daily I love the daily for two types of users. One is for our younger patients who are considering this prejuvenation concept. They want to have something where they're getting ahead of it. You know, it's a little bit less of two X compared to the four X, so that the concentration is a little bit less, it's a little bit more hydrating in the sense too. And so you can you can see how that is so beautifully applied. And it goes on very nicely glides on. I love this product.
In fact, I recently had a baby and I. Congratulations. Thank you. So plaited daily has been my go to for my stretch marks which has worked beautifully. So that's another area that you know because you can get more spread with it. So it's it's great for the younger patient and I would even say the postpartum patient. That's amazing to hear. And you know what? I love that you brought that up because so many things are marketed for our our face and we think face only.
But yeah, of course, if you've got stretch marks, I'm sure like post scarring, that wound repair is probably going to be very beneficial too. So, you know, we have to mention price but I think, you know, these, these range from what I think this is in the two hundreds. Yes. And this will be variable based on your dispenser. But yes, that's about what we see. Okay. And then the daily. It's priced similarly and that's because you're getting the volume there is a little bit more. Yep. Yep.
But both and I was like you said, it should last like six six weeks. Yes. And if you're consistently applying it. So the way that I apply, if you start with a goal, so I kind of use the gold as pulsing because it's going to deliver really good signals. So you want to pulse with the gold twice daily for six weeks, then you're going to achieve this beautiful maximal effect, glowing skin, all the good stuff.
Then you can switch to the daily and you can go three times a week or once a day, whatever, to kind of maintain that effect. And then you can go again with the gold. And after a month or so. So just kind of using the gold intermittently, this is for the average user, right? For for more mature skin, I say just stick with the gold for younger skin.
I could say stick with the daily, but if you kind of want to, if you're in the middle and you're kind of wanting to get a bit of benefits of both, you can do it that way where you kind of pose with the skin cycle, with the gold or the intense, and then go back to the daily for maintenance. And you said you're going to be publishing clinical your clinical trials for the gold with the Visio before and after. The we've already published that of the esthetic surgery journal.
So we do have those results out. We have submit and we also have results for the hand. So I love that you brought up other areas that you can treat self with the back of the hand. Yeah. So we we recently published that study as well in the Plastic and reconstructive surgery journal where you can see that is has had considerable improvement in brown spots especially because it does have that antioxidant effect. So it does both where it kind of is antioxidant but also builds collagen.
Man, you have to link to those on the website. So that's all I'm going to say is I would say link that out because I think that that is very compelling. And for people who are looking for this type of skin care, the science matters, the research matters, the results matter. You know, I always tell people and I'm sure you can say this as a dermatologist, you have to manage expectations when it comes to sort of these these miracle creams. Right. Because I don't know. Do you agree with me?
I feel like you're never going to get in a bottle. What you're going to get from a laser, what you're going to get from a knife. So manage expectations. But from what I saw from some of the before and after, they were very compelling in terms of fine lines and wrinkles. Hyperpigmentation and certainly with redness. Absolutely. And I think redness really like knocked it out of the park, which is where I have actually replaced my laser with this product.
The PDF laser, the pulse eye laser is what I use for my patients with rosacea or facial redness. And now what I've done is that I provide my patients with the bladed intents and have them use it after, and they're just coming in maybe twice a year for their PDF laser instead of once every three months. Amazing. That was going to my next question. So for people with sensitive skin with rosacea is this this is something you'd recommend? Yes, definitely recommend.
It's not it wasn't tested for that indication, but we know that redness considerably improves. So I love using it for that patient population here. Great. And thank you for being specific about, you know, the claims that you can and cannot make with this. So what is next now inflated? Is there are there new exciting things on the frontier for you? Yes. So first, I'm very excited that the product is the first and only now of renewable and recyclable products.
So it's a clean brand of the new packaging which we'll send to you is actually uses reusable inserts. So actually eliminating a lot of the waste and kind of becoming the first physician dispense product that is truly green initiative and and hopefully will continue to inspire other brands to do the same. So that's very exciting for us. The second thing is looking at here, so developing a hair scalp serum, we know that the product is able to penetrate through the skin.
So you would have the same type of effects in the hair and we're kind of getting ready to launch that product this year. Very, very exciting. I want to thank you so much, Doctor Wyles. If people want to know more about Plated, if they want to purchase it, where can they go? They can go to plated skin science dot com and and get more information. They can purchase it. Also, there's several physician offices that are dispensing the products.
So just ask your local dermatologist and if you can't find it, follow us on Instagram at plated skin science and we'll be able to connect you. And what about you? If we want to follow what you're up to, you know, is there a way that we can do that maybe through the Mayo Clinic? Yes, certainly You can go on the Mayo Clinic and find my profile. And we definitely do post more information about our lab. We are 3D bioprinting skin. We're understanding skin cells, senescence.
So there's a lot of exciting things. You can also follow me on, Dr. Wyles, w yl e s dot derm on Instagram. Amazing. I want to just thank you so much for your time. Clearly, you have dedicated your life to this and I think that you were really able to shed some light on some of the confusion that might be surrounding Exosomes. I look forward to seeing what's going to happen in this sort of new, I don't know, the future of skincare. It's always changing. It's always getting more exciting.
If you at home have any questions you want me to pass on to Dr. Wyles, I'm happy to do so. You can email me at Hello at Art Beauty podcast dot com. You can find us on Facebook, Instagram and YouTube @ArtBeautyPodcast, and as always, we will see you next Tuesday. Hopefully just feeling a little bit more educated. Bye!