Exosomes in Skin Rejuvenation: Systematic Review of Anti-Aging Effects and Clinical Applications

Exosomes in Skin Rejuvenation: Systematic Review of Anti-Aging Effects and Clinical Applications

Authors

  • Azza Alzahrani Department of Dermatology, King Fahad Hospital in Al-Baha, Al-Baha, Saudi Arabia
  • Sara Alghamdi Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia
  • Mohammed Alahmadi College of Medicine, Taibah University, Medina, Saudi Arabia
  • Salma Alhussaini College of Medicine, Taibah University, Medina, Saudi Arabia
  • Lama Alamry College of Medicine, Taibah University, Medina, Saudi Arabia
  • Joud Alrashoud College of Medicine, Princess Nourah University, Riyadh, Saudi Arabia
  • Juman Alammar College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
  • Ahmed Albagawi College of Medicine, King Faisal University, Al Hasa, Saudi Arabia

Keywords:

Exosomes, Extracellular vesicles, Skin Aging, Skin Rejuvenation, Skin Wrinkles

Abstract

Introduction: Exosomes, tiny extracellular vesicles (EVs) from different cell types, are gaining attention in dermatology due to their unique properties. They enhance cell communication, transport bioactive substances, and influence immune responses, making them valuable for skin regeneration, wound healing, and addressing skin conditions.

Objectives: This systematic review explored current evidence regarding the efficacy, safety, and mechanisms of exosomes in skin rejuvenation.

Methodology: The search strategy included several databases: PubMed, Google Scholar, MEDLINE, Wiley, Web of Science, and EBSCO. The search for PubMed, MEDLINE, Wiley, Web of Science, and EBSCO used keywords: (Exosomes) AND (Skin Rejuvenation OR Skin Aging OR Skin Wrinkles), with MEDLINE limited to title-only searches. Google Scholar utilized broader terms: (Exosomes) OR (Extracellular Vesicles) OR (Exosomes Secreted by Human Circulating Fibrocytes) AND (Skin Rejuvenation OR Skin Wrinkles OR Skin Aging OR Skin Elasticity).

Results: Of the 1032 papers extracted through the database search, 21 articles were considered suitable for the systematic review. The reviewed studies consistently demonstrated that EVs and exosome-based therapies significantly improve skin elasticity, reduce wrinkle depth, enhance hydration, and modulate pigmentation. These effects were supported by molecular evidence showing increased collagen and elastin synthesis, reduced oxidative stress, and suppression of matrix metalloproteinases. Treatments derived from adipose stem cells, platelets, plants, and milk exhibited favorable safety profiles with minimal adverse events and high patient satisfaction.

Conclusion: In conclusion, extracellular vesicles and exosome therapies represent a promising, minimally invasive approach for skin rejuvenation and anti-aging. However, further standardized clinical trials with larger cohorts and longer follow-up are needed to confirm efficacy, optimize protocols, and ensure long-term safety. Integrating EV-based treatments into personalized skincare regimens could revolutionize dermatological anti-aging strategies.

References

Théry C, Witwer KW, Aikawa E, et al. Minimal information for studies of extracellular vesicles 2018 (MISEV2018): a position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines. J Extracell Vesicles. 2018;7(1):1535750. Published 2018 Nov 23. DOI:10.1080/20013078.2018.1535750.

Tkach M, Théry C. Communication by Extracellular Vesicles: Where We Are and Where We Need to Go. Cell. 2016;164(6):1226-1232. DOI:10.1016/j.cell.2016.01.043.

Colombo M, Raposo G, Théry C. Biogenesis, secretion, and intercellular interactions of exosomes and other extracellular vesicles. Annu Rev Cell Dev Biol. 2014;30:255-289. DOI:10.1146/annurev-cellbio-101512-122326.

Pegtel DM, Gould SJ. Exosomes. Annu Rev Biochem. 2019;88:487-514. DOI:10.1146/annurev-biochem-013118-111902.

Yáñez-Mó M, Siljander PR, Andreu Z, et al. Biological properties of extracellular vesicles and their physiological functions. J Extracell Vesicles. 2015;4:27066. Published 2015 May 14. DOI:10.3402/jev.v4.27066.

Chuo ST, Chien JC, Lai CP. Imaging extracellular vesicles: current and emerging methods. J Biomed Sci. 2018;25(1):91. Published 2018 Dec 24. DOI:10.1186/s12929-018-0494-5.

Gardiner C, Di Vizio D, Sahoo S, et al. Techniques used for the isolation and characterization of extracellular vesicles: results of a worldwide survey. J Extracell Vesicles. 2016;5:32945. Published 2016 Oct 31. DOI:10.3402/jev.v5.32945.

Witwer KW, Théry C. Extracellular vesicles or exosomes? On primacy, precision, and popularity influencing a choice of nomenclature. J Extracell Vesicles. 2019;8(1):1648167. Published 2019 Aug 1. DOI:10.1080/20013078.2019.1648167.

Serrano DR, Juste F, Anaya BJ, et al. Exosome-Based Drug Delivery: A Next-Generation Platform for Cancer, Infection, Neurological and Immunological Diseases, Gene Therapy and Regenerative Medicine. Pharmaceutics. 2025;17(10):1336-1336. DOI:https://DOI.org/10.3390/pharmaceutics17101336.

Lei L, Zhou S, Zeng L, et al. Exosome-Based Therapeutics in Dermatology. Biomater Res. 2025;29:0148. Published 2025 May 9. DOI:10.34133/bmr.0148.

Karnas E, Dudek P, Zuba-Surma EK. Stem cell- derived extracellular vesicles as new tools in regenerative medicine - Immunomodulatory role and future perspectives. Front Immunol. 2023;14:1120175. Published 2023 Jan 24. DOI:10.3389/fimmu.2023.1120175.

Zhou X, Huang J, Zhang D, Qian Z, Zuo X, Sun Y. Small extracellular vesicles: the origins, current status, future prospects, and applications. Stem Cell Res Ther. 2025;16(1):184. Published 2025 Apr 17. DOI:10.1186/s13287-025-04330-5.

Nguyen DDN, Vu DM, Vo N, et al. Skin rejuvenation and photoaging protection using adipose-derived stem cell extracellular vesicles loaded with exogenous cargos. Skin Res Technol. 2024;30(2):e13599. DOI:10.1111/srt.13599.

Svolacchia F, Svolacchia L, Falabella P, et al. Exosomes and Signaling Nanovesicles from the Nanofiltration of Preconditioned Adipose Tissue with Skin-B® in Tissue Regeneration and Antiaging: A Clinical Study and Case Report. Medicina (Kaunas). 2024;60(4):670. Published 2024 Apr 21. DOI:10.3390/medicina60040670.

Haykal D, Wyles S, Garibyan L, Cartier H, Gold M. Exosomes in Cosmetic Dermatology: A Review of Benefits and Challenges. J Drugs Dermatol. 2025;24(1):12-18. DOI:10.36849/JDD.8872.

Wyles SP, Yu GT, Gold M, Behfar A. Topical Platelet Exosomes Reduce Senescence Signaling in Human Skin: An Exploratory Prospective Trial. Dermatol Surg. 2024;50(11S):S160-S165. DOI:10.1097/DSS.0000000000004426.

Chernoff G. Combining topical dermal infused exosomes with injected calcium hydroxylapatite for enhanced tissue biostimulation. J Cosmet Dermatol. 2023;22 Suppl 1:15-27. DOI:10.1111/jocd.15695.

Park GH, Kwon HH, Seok J, et al. Efficacy of combined treatment with human adipose tissue stem cell-derived exosome-containing solution and microneedling for facial skin aging: A 12-week prospective, randomized, split-face study. J Cosmet Dermatol. 2023;22(12):3418-3426. DOI:10.1111/jocd.15872.

Park SY, Yi KH. Exosome-mediated Advancements in Plastic Surgery: Navigating Therapeutic Potential in Skin Rejuvenation and Wound Healing. Plast Reconstr Surg Glob Open. 2024;12(8):e6021. Published 2024 Aug 1. DOI:10.1097/GOX.0000000000006021.

Proffer SL, Paradise CR, DeGrazia E, et al. Efficacy and Tolerability of Topical Platelet Exosomes for Skin Rejuvenation: Six-Week Results. Aesthet Surg J. 2022;42(10):1185-1193. DOI:10.1093/asj/sjac149.

Jo CS, Myung CH, Yoon YC, et al. The Effect of Lactobacillus plantarum Extracellular Vesicles from Korean Women in Their 20s on Skin Aging. Curr Issues Mol Biol. 2022;44(2):526-540. Published 2022 Jan 21. DOI:10.3390/cimb44020036.

Lu L, Bai W, Wang M, et al. Novel roles of bovine milk-derived exosomes in skin antiaging. J Cosmet Dermatol. 2024;23(4):1374-1385. DOI:10.1111/jocd.16112.

Han J, Wu T, Jin J, et al. Exosome-like nanovesicles derived from Phellinus linteus inhibit Mical2 expression through cross-kingdom regulation and inhibit ultraviolet-induced skin aging. J Nanobiotechnology. 2022;20(1):455. Published 2022 Oct 21. DOI:10.1186/s12951-022-01657-6.

Li L, Ngo HTT, Hwang E, et al. Conditioned Medium from Human Adipose-Derived Mesenchymal Stem Cell Culture Prevents UVB-Induced Skin Aging in Human Keratinocytes and Dermal Fibroblasts. Int J Mol Sci. 2019;21(1):49. Published 2019 Dec 19. DOI:10.3390/ijms21010049.

Wang L, Abhange KK, Wen Y, et al. Preparation of Engineered Extracellular Vesicles Derived from Human Umbilical Cord Mesenchymal Stem Cells with Ultrasonication for Skin Rejuvenation. ACS Omega. 2019;4(27):22638-22645. Published 2019 Dec 19. DOI:10.1021/acsomega.9b03561

Sanada A, Yamada T, Hasegawa S, et al. Enhanced Type I Collagen Synthesis in Fibroblasts by Dermal Stem/Progenitor Cell-Derived Exosomes. Biol Pharm Bull. 2022;45(7):872-880. DOI:10.1248/bpb.b21-01084.

Li LJ, Han QL, Feng WJ, Wang ZP, Li HH. Exosome-hydrogels loaded with metal-organic framework improve skin aging by inhibiting oxidative stress. Polish Journal of Chemical Technology. 2024;26(2):42-47. DOI:https://DOI.org/10.2478/pjct-2024-0017.

Cho JH, Hong YD, Kim D, et al. Confirmation of plant-derived exosomes as bioactive substances for skin application through comparative analysis of keratinocyte transcriptome. Applied Biological Chemistry. 2022;65(1). DOI:https://DOI.org/10.1186/s13765-022-00676-z.

Guo JA, Yu PJ, Yang DQ, Chen W. The Antisenescence Effect of Exosomes from Human Adipose-Derived Stem Cells on Skin Fibroblasts. Biomed Res Int. 2022;2022:1034316. Published 2022 Jun 29. DOI:10.1155/2022/1034316.

Vu DM, Nguyen VT, Nguyen TH, et al. Effects of Extracellular Vesicles Secreted by TGFβ-Stimulated Umbilical Cord Mesenchymal Stem Cells on Skin Fibroblasts by Promoting Fibroblast Migration and ECM Protein Production. Biomedicines. 2022;10(8):1810. Published 2022 Jul 27. DOI:10.3390/biomedicines10081810.

Oh M, Lee J, Kim YJ, Rhee WJ, Park JH. Exosomes Derived from Human Induced Pluripotent Stem Cells Ameliorate the Aging of Skin Fibroblasts. Int J Mol Sci. 2018;19(6):1715. Published 2018 Jun 9. DOI:10.3390/ijms19061715.

Adel N, Stankovic N, Cervantes G, Gindi A, Shawky LM. Plant-based Exosome Injections for Skin Wound Healing: Experimental Study. Plast Reconstr Surg Glob Open. 2025;13(7):e6949. Published 2025 Jul 10. DOI:10.1097/GOX.0000000000006949.

Rasti M, Parniaei AH, Dehghani L, et al. Enhancing the wound healing process through local injection of exosomes derived from blood serum: An in vitro and in vivo assessment. Regen Ther. 2024;26:281-289. Published 2024 Jun 19. DOI:10.1016/j.reth.2024.06.004.

Ellistasari EY, Kariosentono H, Purwanto B, et al. Exosomes Derived from Secretome Human Umbilical Vein Endothelial Cells (Exo-HUVEC) Ameliorate the Photo-Aging of Skin Fibroblast. Clin Cosmet Investig Dermatol. 2022;15:1583-1591. Published 2022 Aug 8. DOI:10.2147/CCID.S371330.

Cochrane. RoB 2: A revised Cochrane risk-of-bias tool for randomized trials [Internet]. Cochrane.org. 2019. Available from: https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials

Hooijmans CR, Rovers MM, de Vries RB, Leenaars M, Ritskes-Hoitinga M, Langendam MW. SYRCLE's risk of bias tool for animal studies. BMC Med Res Methodol. 2014;14:43. Published 2014 Mar 26. DOI:10.1186/1471-2288-14-43.

Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-716. DOI:10.1046/j.1445-2197.2003.02748.x.

Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23(2):60-63. DOI:10.1136/bmjebm-2017-110853.

Xiong M, Zhang Q, Hu W, et al. The novel mechanisms and applications of exosomes in dermatology and cutaneous medical aesthetics. Pharmacol Res. 2021;166:105490. DOI:10.1016/j.phrs.2021.105490.

Published

2026-01-30

How to Cite

1.
Alzahrani A, Alghamdi S, Alahmadi M, et al. Exosomes in Skin Rejuvenation: Systematic Review of Anti-Aging Effects and Clinical Applications. Dermatol Pract Concept. 2026;16(1):6462. doi:10.5826/dpc.1601a6462

Share