{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T20:54:31Z","timestamp":1788209671663,"version":"build-2803163510"},"reference-count":111,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Periodontology 2000"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Skin aging is a multifactorial process mediated by intrinsic (genetic and metabolic) and extrinsic (environmental) factors leading to functional and structural deterioration, including wrinkles, loss of collagen and elastin, as well as various pigmentation disorders. Exosomes, the smallest subset of extracellular vesicles, have emerged as potent cell\u2010free regulators of intercellular communication with significant regenerative potential. This scoping review synthesized available in\u00a0vitro, in\u00a0vivo, and clinical evidence investigating the role of exosomes in facial esthetics and skin rejuvenation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted up to January 2nd, 2026, using PubMed, Scopus, Web of Science, and Google Scholar. Search terms included ((extracellular vesicle) OR (exosome)) AND ((esthetic) OR (aesthetic) OR (rejuvenation)). All in\u00a0vitro, in\u00a0vivo, and human clinical studies were included without restriction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 54 studies (from 472 records) were included: 27 in\u00a0vitro, 16 in\u00a0vivo, and 29 clinical studies (several overlap). In\u00a0vitro outcomes demonstrated that exosomes improved cell viability, proliferation, and migration, while enhancing extracellular matrix formation (collagen, elastin, fibronectin) and upregulating antiaging\u2010associated gene expression. These impacts were accompanied by alleviated inflammation, oxidative stress, and regulation of senescence and autophagic signaling. Animal research supported these outcomes, showing enhanced fat graft retention, improved angiogenesis, facilitated dermal remodeling, and epidermal thickening, together with expedited wound repair and reduced expression of matrix metalloproteinases and inflammatory regulators. Clinical studies consistently report decreases in wrinkles, pore size, erythema, scarring, and hyperpigmentation, along with improved skin elasticity, texture, hydration, and thickness. Both patient\u2010reported and clinician\u2010assessed outcomes, including the Global Aesthetic Improvement Scale, demonstrate positive outcomes. Additional advantages included decreased acne severity, shorter recovery times, and fewer adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exosomes showed substantial regenerative potential in facial esthetics and skin antiaging. Nevertheless, heterogeneity in study methodologies and the limited number of high\u2010quality RCTs require further well\u2010designed studies to establish optimized protocols and ensure long\u2010term efficacy and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/prd.70053","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:36:21Z","timestamp":1778744181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Understanding exosomes in facial esthetics and skin aging"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3290-3418","authenticated-orcid":false,"given":"Richard J.","family":"Miron","sequence":"first","affiliation":[{"name":"Department of Periodontology University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Davies","sequence":"additional","affiliation":[{"name":"ZD Hair Clinic  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-5477","authenticated-orcid":false,"given":"Anton","family":"Sculean","sequence":"additional","affiliation":[{"name":"Department of Periodontology University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7306-9795","authenticated-orcid":false,"given":"Paras","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Research Advanced PRF Education  Jupiter Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"1","volume-title":"Rook's Textbook of Dermatology","author":"McGrath JA","year":"2023"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1038\/ncb1596","article-title":"Exosome\u2010mediated transfer of mRNAs and microRNAs is a novel mechanism of genetic exchange between cells","volume":"9","author":"Valadi H","year":"2007","journal-title":"Nat Cell Biol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1210\/endrev\/bnae034","article-title":"Endocrine controls of skin aging","volume":"46","author":"B\u00f6hm M","year":"2025","journal-title":"Endocr Rev"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1186\/s13287-025-04620-y","article-title":"Unveiling exosomes in combating skin aging: insights into resources, mechanisms and challenges","volume":"16","author":"Liang C","year":"2025","journal-title":"Stem Cell Res Ther"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.3390\/cells14211727","article-title":"Therapeutic and clinical potential of adipose\u2010derived stem cell Secretome for skin regeneration","volume":"14","author":"Sendera A","year":"2025","journal-title":"Cells"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.molmed.2021.12.003","article-title":"Skin senescence: mechanisms and impact on whole\u2010body aging","volume":"28","author":"Franco AC","year":"2022","journal-title":"Trends Mol Med"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.jaad.2024.08.044","article-title":"Clinical consequences of age\u2010related skin barrier dysfunction. 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