Exosomes, nano-sized extracellular vesicles derived from various cell types, have emerged as a promising therapeutic modality in trichology. These vesicles deliver bioactive molecules, such as growth factors, cytokines, and microRNAs, that regulate key cellular processes, including proliferation, differentiation, and signaling, which are critical for hair follicle regeneration. This review synthesizes findings from preclinical and clinical studies published on the applications of exosomes for treating hair loss conditions such as androgenetic alopecia (AGA), alopecia areata (AA), and chemotherapy-induced alopecia (CIA). A comprehensive literature search was conducted using databases including MEDLINE, PubMed and Ovid databases for relevant studies published on clinical trials, diagnosis and treatment. Some papers were further reviewed using a double-blinding approach, sample size, control usage, randomization usage and objective endpoint measurements. All studies were classified according to the Oxford Center for evidence-based medicine evidence hierarchy. Preclinical studies demonstrate that exosomes derived from mesenchymal stem cells (MSCs), adipose stem cells (ASCs), dermal papilla cells (DPCs) and plant sources enhance dermal papilla cell (DPC) proliferation, activate signaling pathways such as Wnt/β-catenin, VEGF, and PI3K/AKT, and promote the transition of hair follicles from the telogen to anagen phase. Clinical data, although limited, show promising results, with improvements in hair density, thickness, and follicular health. Systematic reviews and case series have highlighted the favorable safety profile of exosome-based therapies, with minimal adverse effects reported. Exosome therapy is a promising, minimally invasive approach for AGA, AA, and CIA, supported by robust preclinical biology but preliminary and heterogeneous clinical data. Progress to routine practice will require adequately powered, multicenter randomized trials with standardized outcomes, along with harmonized manufacturing and regulatory frameworks (GMP-compliant production, batch-level quality control) to ensure reproducibility and safety.

Injectable biostimulatory agents such as poly-L-lactic acid (PLLA), polycaprolactone (PCL), and calcium hydroxyapatite (CaHA) have emerged as key tools in regenerative aesthetics due to their ability to stimulate adipogenesis and adipocyte metabolic activity, enhance collagen production, and improve dermal quality. This review aimed to provide an updated synthesis of the role of these agents in adipocyte stimulation, focusing on their mechanisms of action, clinical efficacy, and therapeutic applications. A comprehensive search of the MEDLINE, PubMed, and Ovid databases was conducted for studies published from 2018 onward, including in vitro and in vivo experiments, randomized controlled trials, and observational studies, which were evaluated according to the Oxford Centre for Evidence-Based Medicine hierarchy. The findings demonstrated that PCL promotes adipose-derived stem cell differentiation and extracellular matrix remodeling, while PLLA exhibits dual effects on collagen synthesis and adipocyte stimulation, with clinical trials such as the SPLASH study confirming significant improvements in dermal thickness and adipogenesis. CaHA provided immediate volumizing benefits with long-term tissue regeneration, and innovative approaches including combination therapies and novel injection protocols expanded clinical applications. Overall, PLLA, PCL, and CaHA represent effective and versatile biostimulatory agents that support natural and durable outcomes in aesthetic practice. Nevertheless, the absence of large-scale trials and standardized protocols highlights the need for further research to optimize safety, efficacy, and long-term treatment strategies.

Aesthetic procedures such as laser resurfacing, microneedling, and injectable treatments intentionally disrupt the skin barrier, increasing susceptibility to microbial colonization, inflammation, and delayed healing. Post-procedural care therefore requires biomaterials that provide antimicrobial protection while supporting controlled inflammation and tissue regeneration. Chitosan, a naturally derived polysaccharide, exhibits a unique combination of antimicrobial activity, immunomodulatory effects, and wound-healing support. These properties are influenced by molecular weight, degree of deacetylation, and formulation, allowing chitosan to function as a barrier material, bioactive dressing, and drug-delivery platform in aesthetic settings. Due to its ultra-low molecular weight (below 600 Da), Ideal Size Chitosan (ISC) manufactured by Arche (Doum Inc., Korea) is topically effective, as it can penetrate the skin barrier to target deeper dermal layers and deliver enhanced bioactive effects. In post-aesthetic care, chitosan-based films, hydrogels, and nanoparticles may reduce infection risk, modulate excessive inflammatory responses, and promote re-epithelialization. However, variability among chitosan formulations and limited procedure-specific clinical data remain important considerations. This short communication highlights the rationale for using chitosan as a multifunctional biomaterial in aesthetic aftercare and underscores the need for standardized formulations and targeted clinical studies.

Objective: To critically evaluate whether local hypertonic dextrose has sufficient biological and clinical support to be considered an independent dermal biostimulant in aesthetic dermatology. Methods: PubMed/MEDLINE was searched from inception through June, 2026, with backward and forward citation tracking. Direct evidence included human aesthetic or dermatologic studies using local dextrose and translational studies examining dermal delivery or tissue response. Evidence was appraised by design, comparator, blinding, cointerventions, outcome validity, follow-up, and directness to a dextrose-specific effect. Results: Six human reports enrolled 125 participants in aggregate, and 2 translational studies examined pneumatic delivery. Favorable signals were reported for facial laxity, atrophic lesions, pores, fine wrinkles, and acne-scar volume. However, every human protocol included pneumatic pressure, microneedling, focused ultrasound, hyaluronic acid, or another active cointervention. A 5% versus 20% split-face study supports a concentration-dependent or osmolarity-dependent signal within pneumatic delivery, not glucose-specific neocollagenesis. Translational studies demonstrate device-induced tissue injury and penetration into fat and fascia. Reported adverse events were mainly transient; 2 cases of postinflammatory hyperpigmentation occurred in one 30-patient series. Conclusion: Hypertonic dextrose should be regarded as an investigational, route-dependent adjunct rather than an established stand-alone biostimulant. Controlled trials should isolate device, vehicle, osmolarity, and glucose-specific effects and include objective structural endpoints and long-term safety follow-up.