Objective To observe the therapeutic effects of mesenchymal stem cell-derived exosomes on rosacea. Methods Seventy-eight patients with rosacea, including 39 PPR type and 39 ETR type, were enrolled at the Changsha Mylike Cosmetic Hospital from January 2021 to January 2022. All patients were treated with microneedling infusion of mesenchymal stem cell-derived exosomes (MSC-exo) once a month for three months. The clinical efficacy, adverse reactions, erythema assessment scale (CEA), patient physical evaluation (PSA), investigators' global assessment (IGA) scale and skin barrier function were compared between the two groups. Results Treatment with MSC-exo significantly decreased both CEA and IGA scales, EI and TEWL, while increasing stratum corneum hydration (P
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