Regenerative dermatology: stem cells, exosomes and PRP for the skin

Regenerative dermatology is the use of cells, growth factors and the signals cells release to repair skin rather than only treat its symptoms. It ranges from treatments already used in clinics, such as platelet-rich plasma (PRP), to approaches still in clinical trials, such as exosomes. The common idea is to help the skin rebuild its own tissue: collagen, blood vessels and the cells that keep it healthy.

Which treatments does it include?

• Platelet-rich plasma (PRP) is a concentrate of platelets from the patient's own blood, prepared by centrifugation. Platelets release growth factors that support healing. PRP is used for scars, skin quality and hair, alone or with other treatments such as non-cross-linked hyaluronic acid.
• Cultured fibroblasts are the patient's own collagen-producing cells, grown in a laboratory from a small skin sample and injected back. In a split-face study led by Professor Nilforoushzadeh's group, fibroblasts combined with PRP improved atrophic acne scars more than PRP alone.
• Mesenchymal stem cells (MSCs) are cells, often taken from fat tissue, that can support repair. Much of their effect seems to come from the signals they release rather than from the cells themselves.
• Exosomes, also called extracellular vesicles, are tiny particles that carry those signals. They are being studied as a way to get the benefit of stem cells without transplanting cells. See exosomes for the skin.

What can these treatments be used for?

Scars

Acne scars and burn scars are among the best-studied uses. Trials by Professor Nilforoushzadeh's group combined fractional CO2 laser with PRP, hyaluronic acid or both, and found improvements in scar measures and patient satisfaction, especially with the combination. The details are in PRP and hyaluronic acid for scars and acne scar treatment with fibroblasts and PRP.

Wounds and burns

Chronic wounds, such as diabetic ulcers, and severe burns heal slowly and are hard to treat. Stem cell products and exosomes are being studied to speed closure and improve the quality of the new tissue. Most of this evidence is still from laboratory and animal studies; stem cells and exosomes in wound healing sets it out.

Inflammatory skin disease

Exosomes calm inflammation in laboratory studies, which is why they are being tested in conditions such as psoriasis. A small clinical study of 12 patients is covered in exosomes for the skin.

Hair

The same tools are used for hair loss. PRP and exosomes for hair are covered in the hair restoration guide.

What does research add?

Research is moving from cells to the molecules that direct them. A 2026 review co-authored by Professor Nilforoushzadeh describes how microRNAs, small RNA molecules that switch genes on and off, regulate wound repair, inflammation, collagen and skin ageing, and why they are candidates for future treatment. The same review is clear that these approaches face challenges before they can be used in patients.

How strong is the evidence?

It varies widely, and this guide says so for each treatment. PRP has been studied in many trials. Fibroblast therapy and combination treatments have small randomised studies behind them. Exosomes and microRNA treatments are early: promising laboratory results and small pilot studies, not yet large trials. In the United States, no exosome product is approved by the FDA to treat any condition. A dermatologist can explain what is established for a particular problem and what would be experimental.