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

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 trials are needed to define its role in aesthetic protocols.