Messages in a vesicle: exosomes at the crossroads of skin pathology and healing.

Exosomes are pivotal biological entities implicated in both pathogenesis and treatment of various dermal disorders. Their unique structure comprising intracellular proteins, growth factors, and diverse nucleic acids such as mRNA and siRNA enables them to act as key regulators of intercellular communication. Therefore, exosomes can be considered as a double-edged weapon in dermal health, contributing to both disease progression and tissue repair. Given the increasing prevalence of skin disorders ranging from acute to chronic disorders, and the well-known adverse effects associated with conventional chemical treatments, exploring personalized, biologically-based strategies for the study, diagnosis, and treatment of skin diseases have become essential. Moreover, exosomes hold promise as synergistic agents when combined with physical dermal therapies, cosmetic formulations, and targeted drug delivery systems for conditions such as atopic dermatitis, vitiligo and melanoma. This review highlights the emerging roles of exosomes in skin disease pathogenesis, their therapeutic potential, and their novel applications in cosmetic dermatology for skin regeneration and enhancement.