Visible signs of skin aging, including enlarged pores, rosacea, and melasma, are often difficult to treat due to their multifactorial etiology. Most conventional therapies offer only temporary improvement and require ongoing maintenance. Exosome-based treatments present a regenerative approach that targets key biological dysfunctions associated with aging skin. A healthy female in her late 40s with Grade 3 pore enlargement, Subtype I rosacea, and epidermal-type melasma (MASI score 10) underwent two sessions of topical exosome application following superficial microneedling at 0.3 mm depth, performed on Day 1 and Day 21. Clinical progress was documented at baseline, 3 weeks, 5.5 months, and 21 months using standardized photography, AI-assisted 3D imaging, and validated scales (MASI, CEA, GAIS). Progressive, multidimensional improvements were observed: pore size reduced by up to 41%, erythema by 42%, and melanin deposition by 31% at 5.5 months. These effects were largely sustained at 21 months. Surface roughness metrics (Ra, Rq, Rmax, Rz, Rp, Rv) also improved significantly. The results indicate that topical exosome therapy combined with superficial microneedling promotes lasting improvements in key clinical markers of skin aging. The sustained effects over 21 months suggest biological remodeling rather than transient cosmetic correction. No adverse events occurred throughout the follow-up period, confirming the safety and tolerability of the protocol. A short protocol of topical exosomes with superficial microneedling achieved durable improvements in pore size, redness, and pigmentation that persisted for nearly two years without retreatment. These findings support its potential as a low-risk, regenerative modality for long-term facial rejuvenation. Many people struggle with visible signs of facial aging, such as enlarged pores, persistent redness, and uneven pigmentation. These changes are often difficult to treat, and available options may require multiple sessions or produce only short-term effects. In this case study, we explored the use of a topical exosome-based therapy combined with microneedling to improve these concerns. The subject received just two treatment sessions, spaced 21 days apart, and was followed for nearly 2 years. We monitored outcomes using high-resolution 3D imaging, clinical photography, and validated scoring systems to measure pore size, skin redness, and pigmentation levels over time. The results showed significant improvement in all parameters, with changes visible as early as 3 weeks and sustained through the 21-month follow-up. Objective measurements confirmed smoother skin texture, reduced erythema, and decreased hyperpigmentation. No adverse events were reported, and no additional treatments were needed during the follow-up period. These findings suggest that a short course of exosome-based therapy may offer safe, long-lasting results for age-related skin concerns.
Young Seob Lee (Thu,) studied this question.