Exosomes: A Comprehensive Review for the Practicing Dermatologist

This clinical review examines what is known about exosomes and their applicability to aesthetic dermatology. Exosomes are extracellular vesicles with crucial roles in intercellular communication. Their biogenesis is complex and not completely understood, but they are generally formed intracellularly in the endosomal compartment of a cell or through direct plasma membrane release. Several mechanisms of exosome uptake have been described and are dependent on the molecular characteristics of the recipient cell and exosome membrane. Furthermore, there are a multitude of exosome isolation and characterization techniques, each with their own potential advantages and disadvantages. Exosomes have demonstrated promise in preclinical models across various domains of aesthetic dermatology, including as anti-aging and anti-inflammatory therapies and as therapeutics for wound healing, scar reduction, and hair regeneration. However, clinical studies are lacking, and there are substantial safety concerns, such as the potential risk of infections, unwanted inflammatory response, and promotion of malignancy. Further research is needed to develop more precise analytical techniques to better understand the composition of exosomes, their safety profiles, and their potential applications to patient care.