# Exosome-Based Therapeutics in Dermatology and Beyond: A Narrative Review

**Authors:** Grant M. Pham

PMC · DOI: 10.3390/biomedicines14020338 · Biomedicines · 2026-02-01

## TL;DR

Exosomes, tiny cell messengers, show promise in dermatology for wound healing, hair growth, and skin rejuvenation, but more research is needed for standard use.

## Contribution

This review highlights recent preclinical and early clinical findings on exosome-based therapies in dermatology and regenerative medicine.

## Key findings

- Exosomes regulate skin processes like inflammation and hair cycling in preclinical models.
- Early human studies show exosomes as safe and beneficial when used with microneedling or lasers.
- Exosomes are being explored as alternatives to traditional therapies like platelet-rich plasma.

## Abstract

Exosomes are small extracellular vesicles that package DNA fragments, several classes of RNA, lipids, and proteins, and are now regarded as active messengers between cells rather than as cellular debris. This narrative review synthesizes dermatologic and related regenerative applications reported between 2020 and 2025, drawing on PubMed and Scopus searches. In skin, exosomes regulate inflammation, angiogenesis, matrix remodeling, pigmentation, and hair cycling. Preclinical models show faster wound closure, improved scar architecture, attenuation of photoaging changes, and stimulation of hair growth, with additional signals in inflammatory dermatoses and fungal skin disease. Early human studies in wound care, rejuvenation, scars, and alopecia suggest acceptable safety and a recurring pattern of benefit when exosomes are used as adjuncts to microneedling, lasers, or standard dressings, although products, dosing, and outcome measures remain heterogeneous. Beyond dermatology, early work in osteoarticular and soft tissue repair points toward meaningful regenerative potential, but clinical programs are still at an early stage. In practice, exosomes are being positioned as acellular alternatives or add-ons to platelet-rich plasma, bone marrow aspirate concentrate, and conventional topicals and as emerging carriers for small molecules and biologics. Key limitations include low yields, product and cargo heterogeneity, lack of agreed quality and potency metrics, and uncertain regulatory status. Whether exosomes remain boutique adjuncts or become part of standard dermatologic and musculoskeletal practice will depend on what happens next: consistent manufacturing, agreed-upon characterization panels, meaningful potency assays, robust pharmacokinetic and biodistribution data, and comparative trials that track outcomes and safety over years rather than weeks.

## Linked entities

- **Diseases:** fungal skin disease (MONDO:0004678)

## Full-text entities

- **Genes:** NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, CD63 (CD63 molecule) [NCBI Gene 967] {aka AD1, HOP-26, ME491, MLA1, OMA81H, Pltgp40}, MITF (melanocyte inducing transcription factor) [NCBI Gene 4286] {aka CMM8, COMMAD, MI, MITF-A, WS2, WS2A}, CD9 (CD9 molecule) [NCBI Gene 928] {aka BTCC-1, DRAP-27, MIC3, MRP-1, TSPAN-29, TSPAN29}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, TLR2 (toll like receptor 2) [NCBI Gene 7097] {aka CD282, TIL4}, TIMP1 (TIMP metallopeptidase inhibitor 1) [NCBI Gene 7076] {aka CLGI, EPA, EPO, HCI, TIMP, TIMP-1}, IL23A (interleukin 23 subunit alpha) [NCBI Gene 51561] {aka IL-23, IL-23A, IL23P19, P19, SGRF}, CD81 (CD81 molecule) [NCBI Gene 975] {aka CVID6, S5.7, TAPA1, TSPAN28}, PDCD6IP (programmed cell death 6 interacting protein) [NCBI Gene 10015] {aka AIP1, ALIX, DRIP4, HP95, MCPH29}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, ELN (elastin) [NCBI Gene 2006] {aka ADCL1, SVAS, WBS, WS}, CTNNB1 (catenin beta 1) [NCBI Gene 1499] {aka CTNNB, EVR7, MRD19, NEDSDV, armadillo}, FLG (filaggrin) [NCBI Gene 2312] {aka ATOD2, FLG-1, FLG1}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, TSG101 (tumor susceptibility 101) [NCBI Gene 7251] {aka TSG10, VPS23}, TYR (tyrosinase) [NCBI Gene 7299] {aka ATN, CMM8, OCA1, OCA1A, OCAIA, SHEP3}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, IL13 (interleukin 13) [NCBI Gene 3596] {aka IL-13, P600}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}, CD1A (CD1a molecule) [NCBI Gene 909] {aka CD1, FCB6, HTA1, R4, T6}
- **Diseases:** Inflammatory Dermatoses (MESH:D012871), pain (MESH:D010146), tendinopathy (MESH:D052256), eczema (MESH:D004485), pressure sores (MESH:D003668), Disease (MESH:D004194), injury to (MESH:D014947), diabetic foot and (MESH:D017719), inflammation (MESH:D007249), ulcer (MESH:D014456), anterior cruciate ligament (MESH:D000070598), onychomycosis (MESH:D014009), knee osteoarthritis (MESH:D020370), Hair (MESH:D006201), synovitis (MESH:D013585), diabetic (MESH:D003920), keloid (MESH:D007627), Skin Infections (MESH:D007239), venous leg ulcers (MESH:D014647), liver toxicity (MESH:D056486), atrophic acne scars (MESH:D002921), hypertrophic (MESH:D002312), Alopecia (MESH:D000505), obesity (MESH:D009765), hair and scalp disorders (MESH:C538225), Cartilage (MESH:D002357), burns (MESH:D002056), infectious (MESH:D003141), invasive (MESH:D009361), alopecia areata (MESH:D000506), itch (MESH:D011537), acne (MESH:D000152), erythema (MESH:D004890), osteoarticular disease (MESH:D014394), AD (MESH:D003876), psoriasis (MESH:D011565), fungal skin disease (MESH:D003881), Fungal Disease (MESH:D009181), Osteoarthritis (MESH:D010003)
- **Chemicals:** finasteride (MESH:D018120), glycosaminoglycans (MESH:D006025), Cargo (-), terbinafine (MESH:D000077291), minoxidil (MESH:D008914), lipid (MESH:D008055), CO2 (MESH:D002245), hyaluronic acid (MESH:D006820)
- **Species:** Cutibacterium acnes (species) [taxon 1747], Candida albicans (species) [taxon 5476], Homo sapiens (human, species) [taxon 9606], Cucumis sativus (cucumber, species) [taxon 3659], Bos taurus (bovine, species) [taxon 9913]

## Full text

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## References

86 references — full list in the complete paper: https://tomesphere.com/paper/PMC12937894/full.md

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Source: https://tomesphere.com/paper/PMC12937894