摘要

Objectives: Explain molecular mechanisms of exosome action in skin regeneration. Evaluate clinical applications in pigmentation, scars, and recovery. Integrate exosomes with EBDs and injectables to enhance outcomes and reduce complications. Introduction: Exosomes are extracellular vesicles carrying proteins, growth factors, and miRNAs that regulate fibroblasts, angiogenesis, and immune responses. They are emerging as potent tools in regenerative aesthetics, with applications in pigmentation, scars, and post-device recovery. We review mechanisms of fibroblast activation, angiogenesis, and immune modulation. Case vignettes highlight exosome use with lasers, peels, and injectables for pigmentation, scars, and complication rescue. Preclinical and early clinical data on wound healing and scar revision are included. Materials / method: Patients with acne scars, pigmentation disorders, and delayed recovery post-laser were treated (Fitzpatrick I–IV). Protocol: an energy-based device session (fractional laser, IPL, or Nd:YAG depending on indication), followed by microneedling at controlled depth. Immediately post-microneedling, purified exosomes were applied and driven into the dermis through microchannels. Sessions were repeated at intervals (every 4–6 weeks), combined with supportive cosmeceuticals and strict photoprotection. https://doi.org/10.1093/burnst/tkae047 https://doi.org/10.1093/asj/sjab125 Results: Exosome protocols demonstrate faster re-epithelialization, reduced inflammation, improved angiogenesis, and normalized pigmentation compared with device monotherapy. Clinical reports show fewer complications, quicker recovery, and superior patient-reported outcomes in pigmentation and scar cases. Conclusion: Exosomes function as amplifiers and safeguards in regenerative aesthetics. When integrated with energy-based devices or injectables, they accelerate healing, reduce complications, and enhance results. Standardization in sourcing, dosing, and protocols will be key for broad clinical adoption.