Gene Editing Technologies in Aesthetic Dermatology—Mechanisms, Emerging Applications, and Patient Safety Paradigms

Background: Gene editing technologies, particularly Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR-Cas) systems, have transformed biomedical research by enabling precise genetic modifications. These advancements hold significant potential for aesthetic dermatology, addressing concerns such as skin aging, pigmentation disorders, hair restoration, and scar revision. However, their clinical translation requires careful consideration of patient safety, including off-target effects, immunogenicity, and long-term genomic stability, alongside ethical and regulatory challenges.Methods: A systematic literature search was conducted across PubMed and PMC, covering articles from January 1, 2015, to May 28, 2025. Key terms included "gene editing," "CRISPR," "TALENs," "ZFNs," "aesthetic dermatology," "patient safety," and "ethical implications." Peer-reviewed studies detailing molecular mechanisms, preclinical or clinical outcomes, and safety considerations were included. Data were synthesized through thematic analysis, categorizing technologies, applications, and safety strategies.Results: CRISPR-Cas9, base editing, prime editing, Zinc-Finger Nucleases (ZFNs), and Transcription Activator-Like Effector Nucleases (TALENs) demonstrate high precision in targeting genes for aesthetic applications. Applications include enhancing collagen production for skin rejuvenation, modulating melanin pathways for pigmentation disorders, activating hair follicle growth for restoration, and inhibiting fibrotic pathways for scar revision. Safety strategies address off-target effects (e.g., high-fidelity Cas variants), immunogenicity (e.g., non-viral vectors), and genomic instability (e.g., ex vivo editing). Ethical debates center on therapy versus enhancement, with regulatory frameworks (FDA, EMA) evolving to address aesthetic applications.Conclusions: Gene editing offers transformative potential for personalized aesthetic interventions, moving beyond symptomatic treatments. However, challenges in delivery efficiency, long-term safety, and ethical considerations necessitate rigorous research and robust regulatory oversight to ensure responsible clinical integration.