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

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.