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.