A New Therapeutic Approach With Rose Stem-Cell-Derived Exosomes and Non-Thermal Microneedling for the Treatment of Facial Pigmentation

Abstract

Background: Facial dyspigmentation is a challenging concern which cannot easily be corrected. Although the application of topical exosomes has shown some efficacy, there is still scarce data addressing the role of plant-derived exosomes for skin hyperpigmentation.

Objectives: This study using rose stem-cell-derived exosomes (RSCE) was performed as a proof-of-concept case series to evaluate the efficacy and safety of microneedling and topical RSCE, for the reduction of pigmentation and photoaging in adult volunteers.

Methods: Twelve female volunteers were recruited, with a mean age of 46.64 years and a moderate-to-severe facial pigmentation, due to solar lentigines, melasma, postinflammatory hyperpigmentation, and periorbital hyperpigmentation. Three treatments were performed at 3 weeks intervals. These consisted of the topical application of RSCE with microneedling and a 20 min LED light with an RSCE-infused mask. A 3D facial analyzer was used to quantify improvement in superficial, deep pigmentation, skin redness, and wrinkles at baseline, Weeks 3, 6, and 12. Global Aesthetic Improvement Scale (GAIS), Dermatology Life and Quality Index (DLQI), and Melasma Quality of Life Scale (MELASQoL) scores were noted at the same time points.

Results: GAIS scores improved by at least 1 scale point. Superficial pigmentation and spots decreased by 12.95% and deep pigmentation improved by 15.9%, by Week 12. Skin redness was reduced by 7.34% at the same time point. The measured wrinkle reduction was 6.34%. DLQI scores were reduced by 10 points, and MELASQoL scores had a mean reduction of 30 points at Week 12.

Conclusions: Improvement of facial pigmentation is possible when combining nonthermal microneedling and the use of topical RSCE.

Figure 1.

Global Aesthetic Improvement Scale (GAIS) scores. The bar chart shows the significant improvement of aesthetic perceptions in GAIS as recorded by both study patients and an independent evaluator, at different time points. Patients underwent 3 subsequent treatments at baseline, Week 3, and Week 6, with topical application of rose stem-cell-derived exosomes and microneedling. *P < .05, **P < .01, ***P < .001.

Figure 2.

The effect of rose stem-cell-derived exosomes (RSCE) on photodamaged, hyperpigmented skin. The diagram shows the percentage of improvement of ultraviolet-induced pigmentation in the superficial and deep layers of the skin, the percentage of improvement of red inflamed areas of the face, and the percentage of increase of nonwrinkled skin, at the different study visits. Patients underwent 3 subsequent treatments at baseline, Week 3, and Week 6, with topical application of RSCE and microneedling. *P ≤ .001.

Figure 3.

Imaging analysis of long-term ultraviolet-induced pigmentation (age spots), in a 60-year-old female patient. (A) Facial pigmentation before treatment. (B-D) Improvement of pigmentation at Weeks 3, 6, and 12, respectively.

Figure 4.

Imaging analysis of deep pigmentation, in a 44-year-old female patient. (A) The distribution of pigmentation, before the treatment. (B-D) The improvement of deep pigmentation at Weeks 3, 6, and 12, respectively.

Figure 5.

Imaging analysis of facial wrinkles, in a 57-year-old female patient. (A) The distribution of facial wrinkles before treatment. (B-D) The improvement of facial wrinkles at Weeks 3, 6, and 12, respectively.

Figure 6.

Imaging analysis of sensitive skin, in a 50-year-old female patient. (A) The intensity and distribution of sensitive skin, prone to rosacea, inflammation, and telangiectasia, before treatment. (B-D) The improvement of sensitive skin, at Weeks 3, 6, and 12, respectively.

Figure 7.

The effect of rose stem-cell-derived exosomes (RSCE) on the psychosocial functioning of patients with hyperpigmentation. The diagram shows the decrease in Dermatology Life Quality Index (DLQI) and Melasma Quality of Life scale (MELASQoL), at the end of the study (Week 12), indicating improvement of self-perceptions and psychosocial functioning posttreatment. Patients underwent 3 subsequent treatments at baseline, Week 3, and Week 6, with topical application of RSCE and microneedling. **P < .01.

Figure 8.

Sources of exosome-derived products currently used for skin rejuvenation. The figure shows the different sources (human and plant) of exosomes for the skin, currently used by healthcare providers in many different countries of the globe, while having relevant benchmark and/or clinical evidence.

Figure 9.

Clinical photography of a 49-year-old female patient, with melasma: (A) before treatment and (B) at the end of the study.

Figure 10.

Clinical photography of a 39-year-old female patient, with postinflammatory hyperpigmentation after laser hair removal and melasma postpregnancy: (A) before treatment and (B) at the end of the study.

Figure 11.

Clinical photography of a 50-year-old female patient with photodamaged skin: (A) before treatment and (B) at the end of the study.