From Biogenesis to Bedside: Sources, Isolation and Detection, Formulation Purity, and the Current Limits of Exosome‑Based Drug Delivery

ABSTRACT Background Exosome‐based skin boosters are increasingly recognized in aesthetic dermatology, yet consolidated evidence on their safety and effectiveness remains limited. This scoping review aimed to synthesize available evidence on the clinical safety, efficacy, and practical application of exosome‐based skin boosters for facial rejuvenation in aesthetic medicine settings. Methods A systematic search of PubMed, Scopus, and Embase (2015–2025) was conducted following PRISMA‐ScR guidelines. Inclusion criteria focused on clinical trials or observational studies evaluating exosome‐based products for facial skin rejuvenation. Primary outcomes assessed were adverse events and clinical efficacy measures (skin texture, wrinkles, pigmentation, and global aesthetic improvement). Results Eight studies ( n = 20–60 participants per study, predominantly female, age range 18–80 years) met inclusion criteria. Exosomes from platelets, stem cells, adipose tissue, and bovine milk were delivered topically, via microneedling, or with laser assistance. All products demonstrated favorable tolerability; mild, transient adverse effects (erythema, dryness, petechiae) resolved within 2–14 days without serious complications. Efficacy improvements were reported across studies: skin texture enhancement (76.8%–90.9%), wrinkle reduction (5‐85.5% improvement), and melasma clearance (up to 99% melanin index reduction). Conclusion Exosome‐based skin boosters appear safe and effective for facial rejuvenation with minimal adverse effects. However, heterogeneous study designs, small sample sizes, and short follow‐up periods necessitate larger, standardized clinical trials with extended monitoring to validate long‐term safety and establish treatment protocols for broader clinical application.