Adipose Mesenchymal Stem Cell-Derived Exosomes Versus Platelet-Rich Plasma Treatment for Photoaged Facial Skin: An Investigator-Blinded, Split-Face, Non-Inferiority Trial

Abstract

Background

Exosomes, an emerging treatment of interest to aesthetic dermatology, have therapeutic applications in skin rejuvenation, alopecia, atopic dermatitis, acne scarring, and wound healing. Platelet-rich plasma has been widely utilized for the same indications, among others. Currently, there are no trials comparing the two regenerative modalities in aesthetic dermatology.

Aims

To compare the efficacy and safety of adipose mesenchymal stem cell-derived (ASC) exosomes versus platelet-rich plasma for photoaged facial skin.

Methods

An investigator-blinded, split-face trial was conducted. Participants with mild to moderate photoaging underwent three radiofrequency microneedling treatments with PRP and topical exosomes each applied to one half of the face.

Results

Both exosomes and PRP equally improved wrinkling, dyschromia, erythema, texture, and overall skin appearance. Histological analysis confirmed increased collagen I and glycosaminoglycans, without significant differences between treatment arms.

Conclusion

ASC exosomes are a promising PRP-alternative that may be attractive to needle-averse patients and can hasten the office visit duration, as phlebotomy and centrifugation are not required.