Doctors Explain: Dermapen Improves Atopic Skin? Synergistic Effects with Exosome

The contents of this column do not "assert" that "exosomes" can cure atopic skin. It is only a reference to the possibility of treatment.

I hear the dermapen is good, but will it clean up my atopic skin?"
To begin with, can you do a dermapen with atopy?"
I heard that dermapen and exosomes can improve my skin texture, can they improve my atopic skin too?"

Hello, I am a doctor at Smart Skin Clinic.

Do you have any of these questions?

Atopic patients will always have skin problems, including redness, dryness, eczema, itching, and other symptoms, as well as the roughness and pigmentation of the skin caused by atopy.

However, while you want to do something about such skin problems, your skin is sensitive and you hesitate to use cosmetics or undergo various procedures... You may be facing such a dilemma.

In current medical practice, symptomatic treatment of atopic disease with oral medications and steroid ointments is the mainstay of treatment. However,In recent years, it has been reported that the use of regenerative medicine exosomes may be able to improve the skin texture of atopic skin itself.

In this article, we will explain in an easy-to-understand manner, based on medical evidence from the standpoint of a physician, how atopic skin can be improved by the combination of the Dermapen procedure and Exosome.

Can I get a dermapen if I have atopic disease?

Conclusion,Atopic patients can also undergo the dermapen procedure.However, it is assumed that at least the atopy in the treatment area is in a stable phase.

In other words,

This is the case.

Although atopic patients may have a sense of the skin conditions during the stable and active phases, specific skin conditions are described below.

To begin with, dermapen is a procedure in which an ultrafine needle is inserted into the skin to intentionally scar it.

When performed on healthy skin, it is expected to improve skin texture by stimulating the skin's innate regenerative power to heal wounds. However, skin in the active stage of atopic disease is particularly sensitive and has a reduced barrier function, which can spread new infection, inflammation, and damage, increasing the risk of exacerbation or spread of atopic symptoms.

Ultimately, the determination of whether atopic dermatitis is in a "stable" or "active" stage, or whether a dermapen can be performed, is based on the professional judgment of the physician.

If you are concerned about your case, please consult the clinic.

Why the combination of dermapen and exosomes may improve atopic skin

From here, the dermapen and exosome are used together,Why atopic skin may improveI would like to explain the following with medical evidence.

Do you all know what an exosome is?

First, let me briefly explain about exosomes as a basic knowledge.

Does the combination of dermapen and exosome improve atopic skin?

In conclusion, atopic skin can be improved.

The reason is that the dermapen allows exosomes, which are effective in improving atopic skin, to be delivered directly deep into the skin.

Three reasons why atopic skin may improve

Why might exosomes be effective in improving atopic skin?

This is because exosomes have the following three actions.

We will explain how each of these actions affects atopic skin.
I have also presented the medical papers that provide the evidence, so if you are interested, please read them.

(1) Anti-inflammatory action

As explained in the previous section on basic knowledge of exosomes, exosomes contain substances called cytokines. These cytokines are mainlyInvolved in immune system function and regulation of inflammationIt is responsible for conveying information.

There are many different types of cytokines, which can be divided into several different roles. One of these roles isCytokines (IL-10, TGF-β, etc.) that inhibit inflammation."are. These cytokines are responsible for reducing excessive inflammatory responses and preventing inflammation from becoming chronic.

Atopy is a chronic inflammation of the skin in a specific part of the bodyIt is. The anti-inflammatory action of exosomes via cytokines is expected to improve atopic skin by suppressing this inflammation.

Two medical papers are cited below that provide evidence to suggest that exosomes may ameliorate atopy through this mechanism.

After the skin tissue is damaged, the local inflammatory processes occur, accompanied by changes in the secretion of inflammatory factors. For example, the concentrations of local TNF-α and IL-1β were increased in patients with burns and diabetes, and excessive inflammatory responses may lead to multiple organ failures and even death. For example, the concentrations of local TNF-α and IL-1β were increased in patients with burns and diabetes, and excessive inflammatory responses may lead to multiple organ failures and even death. The overexpression of exosomal miR-181c effectively reduced the inflammatory factors secreted by macrophages stimulated by lipopolysaccharide, inhibited the TLR-4 and NF-κB/p65 signaling pathways, and suppressed the inflammation caused by burns.[145] Therefore, Exos may promote skin repair by regulating the inflammatory responses.

(Japanese translation) When skin tissue is damaged, a local inflammatory process occurs, accompanied by changes in the secretion of inflammatory factors. For example, burns and diabetic patients have increased local TNF-α and IL-1β concentrations, and excessive inflammatory responses can lead to multiple organ failure and death.Exosome (Exosome) was found to suppress inflammatory responses by down-regulating the expression of inflammatory factors TNF-α and IL-1β while promoting the expression of anti-inflammatory factor IL-10.Overexpression of exosomal miR-181c effectively reduced inflammatory factors secreted by macrophages stimulated by lipopolysaccharides, inhibited TLR-4 and NF-κB/p65 signaling pathways, and suppressed burn-induced inflammation.Thus, Exos may promote skin repair by modulating the inflammatory response.

Exosomes for Regenerative Medicine Applications

4.8. Skin Diseases
Inappropriate responses by cells of the skin immune system can cause chronic skin diseases [129]. Cho et al. reported that EVs from human AD-MSCs decreased serum levels of pro-inflammatory cytokines (IL-4, IL-31, IL-23, and TNF-α) in the NC/Nga mouse model of atopic dermatitis. The serum IgE level and the number of eosinophils also decreased [130]. In another study, AD-MSC-derived EVs showed anti-inflammatory effects in the hairless SKH-1 mouse model in which atopic dermatitis was induced. EVs decreased the levels of IL-4, IL-5, IL-13, TNF-α, IFN-γ, IL-17, IgE, and thymic stromal lymphopoietin [131]. Recently, such EVs were shown to promote Recently, such EVs were shown to promote polarization of THP-1 cells to macrophages that have an M2b phenotype in vitro. The EVs also induced secretion of IL-10 by human skin organ cultures, suggesting that Lactobacillus plantarum-derived EVs have therapeutic potential in skin inflammation [132]. Moreover, human BM-MSC- and human jaw BM-MSC-derived EVs promoted M2 polarization of human monocytes in vitro and accelerated cutaneous wound healing in vivo [133].
(Japanese translation) 4.8. skin diseases
Inappropriate reactions by cells of the skin immune system can cause chronic skin diseases. such as Cho,Human AD (adipocyte)-MSC (mesenchymal stem cell) We reported that EVs (extracellular vesicles ≈ exosomes) reduced serum levels of pro-inflammatory cytokines (IL-4, IL-31, IL-23, and TNF-α) in a NC/Nga mouse model of atopic dermatitis.Serum IgE levels and eosinophil counts also decreased. In another study,EVs (≈exosomes) derived from AD-MSCs showed anti-inflammatory effects in a hairless SKH-1 mouse model of induced atopic dermatitis.EVs reduced levels of IL-4, IL-5, IL-13, TNF-α, IFN-γ, IL-17, IgE, and thymic stromal phosphopoietin EVs are also derived from prokaryotic cells, including the probiotic bacterium Lactobacillus plantarum. Recently, such EVs were shown to promote polarization of THP-1 cells into macrophages with the M2b phenotype in vitro. Also,EV also induces IL-10 secretion by human skin organ cultures, suggesting that EV from Lactobacillus plantarum has therapeutic potential in skin inflammation.Furthermore, EVs derived from human BM-MSCs and human jaw BM-MSCs promoted M2 polarization of human monocytes in vitro and skin wound healing in vivo.

Therapeutic Applications of Exosomes in Inflammatory Diseases

(2) Immunomodulating action

The background of atopic dermatitis is thought to be influenced by the activation of Th2 cells.Th2 cells produce cytokines that promote allergic reactions and produce excessive immune responses.

Exosomes have been shown to increase and activate Treg cells and other cells that play a role in regulating the immune response, and it is believed that suppression of the immune response by Treg cells may quell the excessive immune response in atopic dermatitis.

The following medical papers are,Tregs regulate the immune response."This will be an indication that

In this study, focusing on the relationship between skin barrier function and Tregs, we created a mouse model of skin barrier failure by repeated application of surfactant (SDS) and analyzed its skin. The results showed that the epidermis was thickened and infiltrated by Tregs due to the skin barrier disruption treatment, and that the Tregs were also infiltrated by the epidermis at this time.Tregs were found to produce the inhibitory cytokines IL-10 *5 and Transforming Growth Factor (TGF)-β *6.
-- (omitted) -- (omitted)
From the above results,It has been suggested that the disruption of the skin barrier releases IL-33 from epidermal keratinocytes, which infiltrates and accumulates Tregs, thereby maintaining skin homeostasis to prevent inflammation..

Elucidating the mechanisms that suppress inflammation and maintain skin homeostasis - Role of regulatory T cells in the disruption of the skin barrier

The following medical paper shows that exosomes areIncreases and activates Tregs."This will be an indication that

Exosomes from MDSC have also been shown to carry TGF-β1 which participates in the inhibition of NK-cells [137]. Further research also showed that exosomes from MDSC, in vitro, promoted Treg differentiation and proliferation from CD4+ T cells in the presence of TGF- β and inhibited CD4+ cell proliferation [138]. MDSC exosomes have also been implicated in the suppression of the innate arm of immune system by their ability to polarize macrophages to the type 2 tumor While implicated in tumorogenesis primarily [139]. While implicated in tumorogenesis primarily, further research may shed light on whether MDSC and their exosomes cause immune modulation in non-tumorous setup.

Exosomes from MDSCs have also been shown to carry TGF-β1 , which is implicated in NK cell inhibition. Further studies have also shown that MDSC-derived exosomes promote Treg differentiation and proliferation from CD4+ T cells in vitro in the presence of TGF-β and inhibit CD4+ cell proliferationThe MDSC exosome is also involved in suppression of the innate divisions of the immune system through its ability to polarize macrophages into a type 2 tumor-promoting phenotype. Although thought to be primarily involved in tumorigenesis, further studies may reveal whether MDSCs and their exosomes cause immunomodulation in non-tumor environments.

Exosomes for Regulation of Immune Responses and Immunotherapy

To summarize briefly so far, Tregs are cells that regulate immune responses. And it is said that exosomes may increase Tregs. Therefore,Exosomes → increase Treg → increased regulation of immune response → improvement of atopyThe process may occur such as

(iii) Tissue repair promotion

Exosomes are responsible for transporting components from stem cells (cytokines and growth factors to promote cell proliferation, migration, and differentiation) to target cells.

This role is believed to promote tissue repair, and this characteristic has attracted attention in the field of regenerative medicine.

In atopy, the skin barrier function is impaired, which facilitates the entry of external stimuli and allergens, leading to a vicious cycle of further inflammation.

When the tissue repair-promoting effect of exosomes stimulates the regeneration of damaged skin, this vicious cycle can be broken, and atopic skin is thought to be improved.

Atopic dermatitis (AD) is a multifactorial, heterogeneous disease associated with epidermal barrier disruption and intense systemic inflammation. Previously, we showed that exosomes derived from human adipose tissue-derived mesenchymal stem cells (ASC-exosomes) attenuate AD-like symptoms by Here, we investigated ASC-exosomes' effects on skin barrier restoration by analyzing protein and lipid contents. We found that subcutaneous injection of ASC-exosomes in an oxazolone-induced dermatitis model remarkably reduced trans- We found that subcutaneous injection of ASC-exosomes in an oxazolone-induced dermatitis model remarkably reduced trans- epidermal water loss, while enhancing stratum corneum (SC) hydration and markedly decreasing the levels of inflammatory cytokines such as IL-4, IL-5, IL-13, TNF-α Interestingly, ASC-exosomes induced the production of ceramides and Interestingly, ASC-exosomes induced the production of ceramides and dihydroceramides.

(Atopic dermatitis (AD) is a multifactorial, heterogeneous disease with epidermal barrier disruption and severe systemic inflammation.Previously, we showed that exosomes derived from human adipose tissue-derived mesenchymal stem cells (ASC-exosomes) reduce AD-like symptoms by decreasing multiple inflammatory cytokine levels.Here we investigated the effect of ASC exosomes on skin barrier repair by analyzing protein and lipid content. Subcutaneous injection of ASC exosomes in an oxazolone-induced dermatitis model enhanced stratum corneum (SC) hydration, with IL-4, IL-5, IL-13, TNF-α, IFN-γ, IL-17, and TSLP all being dose dependent. Interestingly, ASC exosomes induced the production of ceramide and dihydroceramide. Electron microscopic analysis revealed that ASC exosome treatment enhanced the stratified body of the epidermis, forming a stratified layer at the interface between the SC and the granular layer. Deep RNA sequencing analysis of skin lesions demonstrated that ASC exosomes restore expression of genes involved in the skin barrier, lipid metabolism, cell cycle, and inflammatory response in affected areas. In summary, our results are,We suggest that ASC exosomes effectively restore epidermal barrier function in AD by promoting new ceramide synthesis, and thus represent a promising option for cell-free therapy in the treatment of AD.

Exosomes derived from human adipose tissue-derived mesenchymal stem cells promote epidermal barrier repair by inducing new ceramide synthesis in atopic dermatitis

Synergistic effects seen when Dermapen and Exosome are used together

When Dermapen and Exosome are used together, the active ingredients of Exosome can efficiently penetrate to the deeper layers of the skin. In other words, localized skin problems can be intensively approached through the Exosome's three effects of "suppressing inflammation and promoting repair," "regulating immunity," and "improving skin regeneration and quality.

Disadvantages of exosomes

If you have read this far, you have only seen the advantages of exosomes, so we will describe the disadvantages neutrally as well.

Two disadvantages of exosomes include the following

• Expensive
• It takes time to achieve the desired effect

(1) Expensive

Because exosomes are extracted from specific cells and purified using sophisticated techniques, their production costs are high. Because this manufacturing cost is reflected in the final treatment cost, exosome therapy is often more expensive than other therapies.
In addition, several repeat treatments may be necessary to maximize the effectiveness of the treatment, which may lead to further cost increases.

(2) It takes time to achieve the desired effect.

Exosome therapy works by promoting cell repair and tissue regeneration. These effects at the cellular level are not immediately visible. Therefore, there may not be a marked improvement immediately after treatment.
In addition, the way the effect is produced and the duration of the effect depends on the patient's constitution, the degree of symptoms, the type and concentration of exosomes used, and other factors, so individual differences are likely to occur.

Exosome therapy other than dermapen

Exosome treatments other than dermapen include injections and infusions.

We have discussed the effects of exosomes on the skin with a dermapen. However, as explained at the beginning, if the skin that is about to undergo a dermapen procedure is in the active stage of atopy, the dermapen procedure itself may not be possible.

Others may be concerned about irritating delicate skin with a dermapen in the first place.

In these cases, exosome therapy by injection or intravenous infusion is available.

Given that atopy is a systemic disease, I would expect that an approach that carries exosomes throughout the body would bring about improvement.

Unlike the dermapen, the exosome treatment performed by intravenous drip or injection does not act directly on the skin problem. Therefore, although it may take longer than the Dermapen in terms of skin cleanliness, there is a possibility that the injections and infusions will improve the atopic condition.

Which treatment to choose should be based on your individual symptoms, needs, and lifestyle, and should be discussed with your health care provider.

For exosome treatment, go to Smart Skin Clinic.

At Smart Skin Clinic,

Exosome infusion
Exosome x Dermapen

The company handles the following

We use a Japanese exosome infusion of 991 TP3T purity derived from umbilical cord. We also use the official Dermapen exosome induction solution.

If you are interested, please feel free to contact us.