Regenerative medicine
PBM and exosomes in Lugano
Regenerative medicine with exosomes and photobiomodulation. Photobiomodulation prepares the ground: it stimulates the cells and makes them more receptive. Exosomes then carry the molecular messages that guide tissue repair. In the practice they are used on joints, tendons, skin and hair when there is an indication. Clinical studies of this combination are still preliminary.
- PBM: light at specific wavelengths, without cutting
- Exosomes: vesicles that carry signals between cells, without replicating them
- Indication and protocol are defined after the specialist visit
Two techniques, one pathway
Photobiomodulation (PBM)
Light at specific wavelengths that increases cellular energy production and makes cells more receptive to regenerative signals. It is not a surgical laser: it does not cut tissue.
Exosomes
Small extracellular vesicles that carry proteins and molecular messages between cells and stimulate tissue repair, without multiplying cells. They do not replace stem-cell therapy.
What they are
Exosomes do not replicate cells
They are 40–150 nanometre extracellular vesicles enclosed by a lipid bilayer membrane, released by cells into tissues and body fluids: they hold proteins, lipids and nucleic acids and carry them from one cell to another. In the practice they are used as repair signals, not as cells that divide.
We do not list in-vitro research applications. The indications in the practice are joints and tendons, skin and hair.
Where we use them
Joints and tendons
Osteoarthritis and tendinopathy, when there is an indication for a regenerative pathway.
Skin and hair
Skin quality and hair-growth stimulation, in the same regenerative-medicine setting, not as over-the-counter cosmetics.
Relation to PRP
PRP is another autologous preparation, from the patient's blood. This is not a superiority comparison: two options, chosen at the visit.
What the studies say
A 2024 preliminary study in five volunteers compared intra-articular injection of adipose-derived exosomes with the same injection plus intra-articular 808 nm laser, with six-month follow-up. It is a small series: it does not show that the combination is generally superior. A PBM review describes anti-inflammatory mechanisms of light, not an exosome-plus-PBM protocol. On the skin, a controlled trial of red and near-infrared light improved fine lines and collagen density (Wunsch 2014). On hair, a review of clinical studies of exosomes describes greater hair density, in small and heterogeneous studies (Al Ameer 2025).
The pathway
From the visit to treatment
Specialist visit
History, clinical examination and, if indicated, musculoskeletal ultrasound to clarify the tissue to treat.
Photobiomodulation
The light prepares the cells and makes them more receptive to the signals that follow.
Exosomes
The molecular signals are applied to the indicated tissue, with local anaesthetic or anaesthetic cream when needed.
Review
Regenerative processes take time. Protocol and follow-up are defined case by case.
Frequently asked questions
Why light before the exosomes?
Cells under oxidative stress, that is with an excess of free radicals produced mainly by the mitochondria, respond less well to regenerative treatments. Photobiomodulation acts on the mitochondria and helps regulate that stress: this is why a 2024 review proposes combining light, antioxidants and stem-cell products such as exosomes for better and more stable results. It is a research proposal, not clinical proof: the indication is decided at the visit.
Do exosomes replace stem cells?
No. Exosomes do not replicate cells: they are vesicles that carry proteins and molecular messages. In the practice they are paired with photobiomodulation because the light makes cells more receptive to those signals.
Is the treatment painful?
Exosome injections are done with local anaesthetic or anaesthetic cream when needed; photobiomodulation is painless.
Who cannot have exosomes?
The same contraindications as for PRP apply: exosome injections are not given during pregnancy, with an ongoing infection, with an active tumour or on anticoagulant therapy. Tell us at the visit.
How many sessions are needed?
It depends on the tissue and the aim. Indication, protocol and timing are defined after the specialist visit.
Is it covered by insurance?
The physician holds the RME quality label for acupuncture and Chinese medicine, and in Ticino the practice bills complementary insurers: with complementary insurance, under certain conditions, the treatment can be reimbursed. Patients with basic insurance only receive a clear cost estimate at the visit and pay directly.
News on this treatment
Nobel 2026 · 8 October 2026
The 2026 Nobel Prize in Medicine: what optogenetics is and what it has to do with laser therapy
The 2026 Nobel Prize honours optogenetics, which activates nerve cells with light. What it is, and why it is not laser therapy.
Exosomes · 1 October 2026
Exosomes: are they all the same? What a 2026 review found
A review of 70 studies: the cells of origin matter, but no source is the best overall.
Scientific sources
- Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4:337–361. doi:10.3934/biophy.2017.3.337
- Weber M, et al. Intra-Articular Exosome and Intraarticular Laser Therapy for Osteoarthritis; Preliminary Non-Surgical Approach. Sch J App Med Sci. 2024;12(5):607–616. doi:10.36347/sjams.2024.v12i05.016
- Asgari R, et al. Management of oxidative stress for cell therapy through combinational approaches of stem cells, antioxidants, and photobiomodulation. Eur J Pharm Sci. 2024;196:106715. doi:10.1016/j.ejps.2024.106715
- Wunsch A, Matuschka K. A controlled trial to determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase. Photomed Laser Surg. 2014;32:93–100. doi:10.1089/pho.2013.3616
- Al Ameer MA, et al. Exosomes and Hair Regeneration: A Systematic Review of Clinical Evidence Across Alopecia Types and Exosome Sources. Clin Cosmet Investig Dermatol. 2025;18:2215–2227. doi:10.2147/CCID.S543451
Related treatments
This therapy is part of Regenerative medicine and PRP for joints and tendons.
Not sure which treatment is right for you?
For musculoskeletal pain the practice follows several routes, often combined. The specialist visit, with ultrasound when needed, clarifies which one is indicated in your case.
Rheumatology
Diagnosis and treatment plan: the first visit when the pain is in the joints, back or tendons.
Acupuncture
Needles, needle-free laser or ear acupuncture, performed by a specialist physician.
Interventional pain therapy
Ultrasound-guided injections of joints and soft tissues, with hyaluronic acid or PRP when indicated.
Laser therapy
Laser light applied locally, in the joint or in the bloodstream, without drugs.
The information on this page is for general information only and does not replace medical advice. The indication, expected benefits and risks of every treatment are assessed individually during the specialist consultation.
Let's assess PBM and exosomes together
Indication, protocol and timing are defined after the specialist consultation.
We accept referrals and second-opinion requests from your physician, via HIN. dr.djordjevic@hin.ch
How to reach us
In Lugano, a short walk from USI and EOC
The practice is centrally located in Italian-speaking Switzerland, also reachable by car and by train from Mendrisio, Bellinzona, Locarno and Chiasso.
By car: the practice's own car park is right in front. By public transport: a short walk from USI.
Address
Via Alessandro Volta 1
6900 Lugano
Opening hours
Monday–Friday 08:00–16:30
Saturday and Sunday closed
Phone
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