Chitosan in aesthetic practice: A clinical narrative review of skin, scar, and scalp applications

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Chitosan is a cationic polysaccharide derived from chitin with film-forming, bioadhesive, antimicrobial, and wound-modulating properties, supporting increasing interest in aesthetic dermatology. Objective To synthesize clinically relevant evidence on chitosan and its derivatives in aesthetic practice, focusing on skin barrier support, post-procedure recovery, acne, pigmentary disorders, and scalp applications. Methods A narrative review of PubMed/Medline literature through February 2026 was conducted, prioritizing clinical trials, split-face studies, and relevant human data, supported by mechanistic and formulation evidence. Results Clinical studies suggest that chitosan hydrogels can support post-procedural recovery after ablative laser treatments with outcomes comparable to standard regimens and improved tolerability. Chitosan-based delivery systems enhance topical performance of actives such as nicotinamide, spironolactone, and α-arbutin in acne and melasma. In scalp applications, microneedling-assisted topical chitosan demonstrated improvements in hair density comparable to minoxidil in small studies. Conclusions Chitosan shows potential as a barrier-supportive material, a delivery platform for topical actives, and an adjunct in scalp therapies. However, heterogeneity in formulations and limited study sizes restrict generalizability. Larger, standardized clinical

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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