Current FDA Position (June, 2025)

• No FDA-Approved Exosome Products:
  As of 2025, the FDA has not approved any exosome product for injection, intravenous (IV) use, implantation, or even for cosmeceutical (skincare) applications 1,2,4,5,6.
• Regulation as Biological Drugs:
  Exosomes intended for systemic use (injection, IV, implantation) are regulated as biological drugs under Section 351 of the Public Health Service Act. They can only be legally used in FDA-authorized clinical trials (under an Investigational New Drug, or IND, authorization) 2,3,8.
• Topical Use – Regulatory Gray Zone:
  Topical exosome products (e.g., used with microneedling) are not FDA-approved but may be marketed under cosmetic regulations. Even so, these products must comply with safety substantiation, facility regulation, and good manufacturing practices under the Modernization of Cosmetics Regulation Act (MoCRA)6. Their use still requires clear patient consent and risk disclosure due to the lack of formal approval 2,6.

Why This Matters to Aesthetic Clinics...

Legal and Regulatory Risk

• Injectable/IV Use Is Illegal Outside Trials:
  Using or marketing exosomes for injection or IV use outside of an FDA-authorized clinical trial is illegal. This exposes clinics to FDA warning letters, regulatory investigations, license suspension or revocation, and malpractice liability 2,3,5,8.
• Topical Use Still Requires Caution:
  Even though topical use is not explicitly banned, it falls in a regulatory gray area. Clinics must ensure robust patient consent and risk disclosures, and should verify that suppliers meet cosmetic regulatory standards 2,6.

Patient Safety and Product Quality

• Lack of Standardization:
  The FDA’s hesitancy is partly due to the current lack of standardized protocols for exosome isolation, characterization, and quality control. This means product composition, safety, and efficacy can vary widely between suppliers, increasing the risk of adverse events or ineffective treatments 5.
• No Guarantee of Safety or Efficacy:
  Without FDA approval, there is no official validation that exosome products are safe or effective for aesthetic or medical use 3,5.

Marketing and Reputation

• Risk of Misleading Claims:
  Marketing exosome therapies as “FDA-approved” or making unsubstantiated medical claims can lead to regulatory action and damage to clinic reputation 2,6.
• Patient Trust:
  Patients are increasingly aware of regulatory status and may ask about FDA approval. Transparent communication is essential to maintain trust.

Compliance Best Practices

• Due Diligence:
  Clinics should thoroughly vet suppliers for compliance with cosmetic regulations, demand safety and quality documentation, and avoid injectable/IV exosome products unless part of a registered clinical trial 2,6.
• Documentation:
  Maintain clear records of patient consent, risk disclosures, and supplier credentials to mitigate liability.

Summary:

No exosome products are FDA-approved for any use in the U.S. as of 2025. Aesthetic clinics must avoid injectable or IV exosome therapies outside clinical trials, carefully vet topical products, ensure regulatory compliance, and provide clear patient disclosures to protect their business, license, and reputation 1,2,3,4,5,6,8.