Exosomes in Cosmetic Dermatology: A Review of Benefits and Challenges

Exosomes, a specific subtype of extracellular vesicles (EVs) ranging from 30 to 150 nanometers, have emerged as powerful tools in intercellular communication, transporting proteins, lipids, and nucleic acids between cells.¹ Their potential applications in the field of aesthetics and cosmetic dermatology have garnered significant attention due to their ability to influence a variety of cellular processes, including skin rejuvenation and hair restoration. These nanoscale vesicles, formed within the endosomal system of cells, play a critical role in paracrine signaling by effectively delivering bioactive molecules to target cells and modulating their function. Exosomes are naturally produced by a wide variety of cell types, each contributing unique bioactive molecules to these vesicles. Their sources include platelets, mesenchymal stem cells (MSCs), immune cells, epithelial cells, and even plant cells, termed plant-derived extracellular nanoparticles (PDENs), each of which imparts distinct properties to the exosomes.^2-5 Recent research has highlighted the utility of exosomes, especially as a cell-free alternative to traditional regenerative therapies. This has led to a surge in studies exploring their efficacy in clinical and preclinical settings, particularly in plastic and reconstructive surgery, wound healing, and skin care.^6,7 Despite the growing interest and promising early results, the use of exosomes remains under stringent regulatory scrutiny. In the US, for instance, the FDA has not yet approved any exosome-based products for clinical use, largely due to concerns about their safety, purity, and batch-to-batch consistency.⁸ Similarly, in Europe, strict regulations limit the use of human-derived exosomes, pushing researchers to explore plant-