Stem Cell Therapies in Dermatology: Current Status, Clinical Translation, Challenges, and Emerging Future Directions

ABSTRACT Background Stem cell‐based therapies are rapidly reshaping dermatology, driven by advances in regenerative medicine, tissue engineering, and molecular therapeutics. The skin, with its intrinsic regenerative capacity and well‐defined stem cell niches, represents a uniquely accessible model for translational application. Objectives To provide a critical overview of stem cell biology in dermatology, evaluate current and emerging clinical applications, and examine the key translational, regulatory, and safety challenges shaping the field. Methods A narrative review of the literature was conducted, incorporating recent clinical trials, systematic reviews, translational studies, and seminal mechanistic reports, with a targeted update through April 2026 to capture major subsequent clinical and regulatory developments. Results Cutaneous stem cells‐including epidermal, hair follicle, melanocyte, and mesenchymal stromal cells‐play central roles in tissue homeostasis, repair, and immune regulation. A paradigm shift has emerged from traditional cell‐replacement strategies toward microenvironmental modulation, with therapeutic effects now understood to be largely mediated by paracrine signalling and extracellular vesicle‐driven mechanisms. Clinical applications have been explored across inflammatory, autoimmune, pigmentary, and wound‐related disorders, as well as in aesthetic dermatology. Among these, gene‐corrected epidermal stem cell transplantation in epidermolysis bullosa represents a landmark example of successful clinical translation with durable outcomes. In contrast, most other indications remain investigational, limited by heterogeneity in study design, variability in cell processing, and insufficient long‐term safety data. Conclusions While stem cell–based therapies hold substantial promise, their integration into routine dermatological practice remains constrained by biological, technical, and regulatory challenges. Emerging approaches‐including extracellular vesicle‐based therapies, gene editing, induced pluripotent stem cell platforms, and precision regenerative strategies‐are poised to define the next phase of the field. Robust clinical validation, standardization of protocols, and stringent regulatory oversight will be essential to translate this promise into safe, effective, and scalable therapies.