The short answer. Mesenchymal stem cells (MSCs) and exosomes are being studied for their potential to calm the immune activity behind psoriasis, eczema and chronic hives. The human evidence is still early: small studies, mostly without a placebo group, with mixed results. The one late-stage eczema trial did not outperform placebo. Modern biologic and targeted treatments have far stronger evidence, and regenerative treatment can only be considered alongside them, not instead of them.
Stem-cell and exosome treatment for psoriasis, psoriatic arthritis, eczema and chronic hives remains investigational and should be considered only as an adjunct to established dermatology and rheumatology care, not a replacement for it.
Why patients with inflammatory skin disease ask about stem cells
Psoriasis, eczema (atopic dermatitis) and chronic hives (chronic spontaneous urticaria) are all driven by the immune system. In psoriasis, an overactive IL-23 and IL-17 pathway drives skin cells to multiply too fast, and up to about a third of patients also develop psoriatic arthritis.1 Eczema is driven largely by a different, allergy-type immune pathway, and chronic hives by mast cells releasing histamine in the skin.
Targeted treatments have transformed psoriasis care: biologics that block IL-17 or IL-23 now clear or almost clear the skin in many patients.1 But not everyone responds, some lose their response over time, and some are reluctant to stay on long-term treatment. That is usually when the question of stem cells comes up.
Can stem cells help psoriasis?
The largest study so far gave donor umbilical cord MSCs by drip to 17 patients with psoriasis. Eight (47%) improved by at least 40% on the standard severity score (PASI), and three had clear or almost clear skin. No obvious side effects were seen over six months. In the patients who responded, regulatory T cells, the cells that keep the immune system in check, rose, and the inflammatory Th17 cells and IL-17 fell.2 There was no placebo group.
A second pilot study gave fat-derived MSCs by drip to seven patients. Only four completed treatment, there was no significant change in severity at 12 weeks, and no one reached a 50% improvement during the trial, although two continued to improve during follow-up.3
A 2025 case series treated three women whose psoriasis had failed four to six biologics. One improved by 87% within four weeks. The other two regained a response to biologics that had previously stopped working for them, and stayed almost clear for more than two years.4 That is an interesting signal, but it is three patients, and two were also taking biologics.
A systematic review in 2022 found that the human evidence for MSCs in psoriasis came only from case reports and small series, with no randomised controlled trials.5 Since then, the studies above have added small, uncontrolled data, not proof.
For exosomes, the evidence is laboratory only: applied to the skin of mice with a psoriasis-like disease, MSC exosomes reduced inflammation and IL-17 levels.6 That has not yet been tested in patients.
What about psoriatic arthritis?
Here the evidence is thinner still. In one published case, a patient with psoriatic arthritis treated with their own fat-derived MSCs saw their skin improve, from a PASI of 21.6 to 9.0, but their joint pain did not improve until biologic drugs were added.7 There are no controlled trials of MSCs for the joints in psoriatic arthritis. Joint disease needs your rheumatologist, because untreated inflammation can damage joints permanently.
Considering regenerative treatment for psoriasis? Bring your current treatment history, including any biologics you have tried, and your most recent severity scores or photographs. I will tell you honestly whether it is reasonable to consider. WhatsApp +971 52 328 6185.
Can stem cells help eczema?
In an early Korean study, 34 adults with moderate-to-severe eczema received a single injection of donor cord blood MSCs under the skin. About 55% of those given the higher dose improved by at least 50% on the eczema severity score (EASI), itch fell, and no serious side effects were reported.8 There was no placebo group.
When the same product was tested in a larger phase 3 trial against placebo, it did not meet its main goal: 21 of 66 treated patients reached a 50% improvement, compared with 22 of 81 on placebo.9 A repeat phase 3 trial has been run, but as far as I could find, its results have not yet been published in a peer-reviewed journal.
Exosomes from fat-derived MSCs repaired the skin barrier in mice with eczema-like disease, by increasing the skin’s own production of ceramides, the fats that hold the barrier together, and reduced inflammatory signals.10 Again, this is animal work.
Can stem cells help chronic hives?
Only one small study has been published. Ten patients whose chronic hives had not responded to standard treatment received their own fat-derived MSCs. Their hives activity scores and medication use fell over six months, compared with ten untreated patients with similar disease, but the immune markers the researchers measured did not change.11 It was not randomised and has not been repeated. For now, it is a reason for more research, not a basis for treatment.
How would stem cells calm the skin’s immune response?
MSCs given by drip do not travel to the skin and replace cells. Their effect is thought to come from the signals they release, which shift the immune system away from attack and towards tolerance. In psoriasis, that showed up as more regulatory T cells and fewer Th17 cells in the patients who responded.2 Interestingly, responders started with lower regulatory T cell levels than non-responders, which may one day help predict who is worth treating.2
Stem cells or exosomes?
Exosomes are a cell-free option for patients who prefer not to receive living cells; MSCs are a cell-based option. In my clinical experience, some patients report earlier changes following exosome treatment, whereas responses following MSC treatment may develop more gradually. No comparative trial in skin disease has shown this. It is clinical observation, not trial evidence.
Should I stop my current treatment?
No. Continue your biologic, methotrexate, creams or antihistamines exactly as prescribed. In the most encouraging psoriasis cases, patients were taking biologics alongside the cells.4 Any change to your medication is made by your dermatologist or rheumatologist. I am happy to write to them so your treatment is coordinated.
How would we know whether it helped?
We record a baseline and repeat the same measures at about three and six months:
- Psoriasis: PASI score and standardised clinical photographs.
- Psoriatic arthritis: tender and swollen joint count, recorded with your rheumatologist.
- Eczema: EASI score and itch score.
- Chronic hives: weekly urticaria activity score (UAS7) and antihistamine use.
- Your medication, and whether it has needed to change.
Is it safe?
Across 55 randomised trials and 2,696 patients in other conditions, the only side effect clearly linked to MSC drips was a short-lived fever. The pooled analysis did not detect an increased rate of infection, thrombotic events or malignancy during the available follow-up.12 That does not exclude rare or long-term risks.
In the skin studies, side effects were mostly mild, such as short-lived fever.3 In one psoriasis pilot, a participant was diagnosed with stomach cancer six months after treatment; testing showed it had not come from the donor cells, and the investigators judged it unlikely to be related.3
At our clinic, cells and exosomes are prepared by two established, regulated laboratories: one Italian, operating since 2009 and in Dubai since 2013, and one British, in Dubai since 2017. Every patient is screened and assessed before treatment.
Who should not have it
- Anyone with active cancer or a recent cancer history.
- Pregnancy, or actively trying to conceive.
- Active infection, including infected skin.
- A severe flare that needs urgent treatment; that is managed first.
Frequently asked questions
Can stem cells cure psoriasis?
No. They are being studied for their potential to calm the immune activity behind psoriasis, but they are not a cure, and the human studies are small.
Can stem cells replace my biologic?
No. Biologics have far stronger evidence. In the most encouraging cases, MSCs were used alongside biologics, not instead of them.4
Do stem cells help the joints in psoriatic arthritis?
This has not been shown. In the one published case, the skin improved but joint pain did not until biologics were added.7
Is there any evidence for eczema?
An early study was encouraging,8 but a larger phase 3 trial against placebo did not show a benefit.9
Can stem cells help chronic hives?
Only one small, non-randomised study has been published.11 It is too early to recommend.
Do exosome creams or facials help psoriasis or eczema?
Exosomes applied to the skin have been tested in mice, not in controlled trials in patients.6,10 They should not replace your prescribed treatment.
Book a regenerative consultation. An honest assessment of whether regenerative treatment makes sense for your skin, alongside your current care. WhatsApp +971 52 328 6185.
About the author Dr Shiva Faramarzi, MD, is an aesthetic, regenerative and longevity physician at Apogee Clinic, JBR, Dubai (DHA licence 43705219). She offers autologous and donor stem cell therapy and exosome IV treatment. This article is patient education and does not replace the advice of your dermatologist or rheumatologist.
References
- Armstrong AW, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA. 2020;323(19):1945–1960. doi:10.1001/jama.2020.4006
- Cheng L, et al. Human umbilical cord mesenchymal stem cells for psoriasis: a phase 1/2a, single-arm study. Signal Transduct Target Ther. 2022;7:263. doi:10.1038/s41392-022-01059-y
- Yao D, Ye S, He Z, et al. Adipose-derived mesenchymal stem cells (AD-MSCs) in the treatment for psoriasis: results of a single-arm pilot trial. Ann Transl Med. 2021;9(22):1653. doi:10.21037/atm-21-5028
- Lwin SM, et al. Mesenchymal stromal cells as rescue therapy in biologic-refractory psoriasis: insights from a case study. Front Immunol. 2025;16:1656724. doi:10.3389/fimmu.2025.1656724
- Diotallevi F, Di Vincenzo M, Martina E, et al. Mesenchymal stem cells and psoriasis: systematic review. Int J Mol Sci. 2022;23(23):15080. doi:10.3390/ijms232315080
- Zhang B, Lai RC, Sim WK, et al. Topical application of mesenchymal stem cell exosomes alleviates the imiquimod induced psoriasis-like inflammation. Int J Mol Sci. 2021;22(2):720. doi:10.3390/ijms22020720
- De Jesus MM, Santiago JS, Trinidad CV, et al. Autologous adipose-derived mesenchymal stromal cells for the treatment of psoriasis vulgaris and psoriatic arthritis: a case report. Cell Transplant. 2016;25(11). PubMed 27931515
- Kim HS, Lee JH, Roh KH, Jun HJ, Kang KS, Kim TY. Clinical trial of human umbilical cord blood-derived stem cells for the treatment of moderate-to-severe atopic dermatitis: phase I/IIa studies. Stem Cells. 2017;35(1):248–255. doi:10.1002/stem.2401
- GeneOnline News. A re-challenge of Kangstem Biotech’s new stem cell drug against atopic dermatitis (report of phase 3 FURESTEM-AD results). geneonline.com
- Shin KO, et al. Exosomes from human adipose tissue-derived mesenchymal stem cells promote epidermal barrier repair by inducing de novo synthesis of ceramides in atopic dermatitis. Cells. 2020;9(3):680. doi:10.3390/cells9030680
- Ozdemir RBO, Ozdemir AT, Kirmaz C, et al. Mesenchymal stem cells: a potential treatment approach for refractory chronic spontaneous urticaria. Stem Cell Rev Rep. 2020. doi:10.1007/s12015-020-10059-w
- Thompson M, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: an updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249. doi:10.1016/j.eclinm.2019.100249
