Efficacy and safety of exosomes in combination with microneedling or laser resurfacing: data from a comprehensive analysis

In recent years, improving skin quality and stimulating its regenerative potential have attracted substantial attention, including through the use of topical agents. In this context, increasing attention has been paid to exosomes, and exosome-based hybrid formulations have been developed, including those used as part of combined treatment protocols. The aim of this work was to investigate the safety and efficacy of exosomes in combination with CO2 laser or dermaroller treatment in comparison with the application of these methods without exosomes, and to test a course-based protocol combining exosomes and dermaroller treatment in patients with signs of chrono- and photoaging. Four female participants aged 40 to 60 with chronological aging underwent one skin treatment procedure in the décolleté and face area with CO2 laser or dermaroller with or without exosomes. The testing stage included two female patients aged 39 and 40 who underwent three dermaroller sessions with exosome application. Efficacy and safety were assessed using standardized rating scales, dermatoscopy, and 3D skin surface scanning. The results demonstrated that exosome application resulted in faster skin recovery (by 2—3 days) and a more uniform skin tone with less dryness and erythema. In the testing stage, wrinkle smoothing, pore size reduction, improved skin elasticity, and a myorelaxant effect were observed. There were no significant adverse events, and patients reported high satisfaction with the treatment results. These findings suggest that the use of exosomes in combination with CO2 laser or dermaroller treatment accelerates skin recovery, substantially improves skin quality, and results in high patient satisfaction without any significant adverse effects.