Objectives: 1. To find that ASCE can attenuate severe inflammation and promote skin barrier reconstruction in atopic dermatitis model 2. To understand that adipose stem cell exosome (ASCE) can be a paradigm shift in regenerative aesthetics & therapeutics Introduction: Exosomes, nano-sized extracellular vesicles, are the most important mediator for intercellular communication. For last years, the dual function of skin regeneration and anti-inflammation of ASCE (Adipose Stem Cell Exosome) has been well known from a number of research. These days, ASCEs are being developed as next generation regenerative therapeutics and aesthetics as well. From our various studies, it has been shown that ASCE can be an innovative biomaterial as regenerative therapeutics as well as regenerative aesthetics for treatment of atopic dermatitis & skin rejuvenation. Materials / method: Human adipose mesenchymal stem cell-derived exosomes (ASCE) were applied via SC or ID injection to in vitro cell models & in vivo animal models. In addition, one patient of atopic dermatitis was applied topically with ASCE in combination with iontophoresis. Results: 1. ASCE could reduce or modulate over-reactive inflammation in skin in atopic dermatitis model. The AD score was significantly improved up to 30% in a dose-dependent manner. Further, major proinflammatory cytokines including IL-4, IL-13, TLSP, & others were down-regulated by up to 30-50% in a dose-dependent manner. 2. ASCE could promote, by 40-70% in a dose-dependent manner, the de novo synthesis of ceramides and dihydroceramides, key lipid molecules in skin barrier formation, which led to the significant improvement of skin barrier disruption model. Conclusion: ASCE was proved to have strong regenerative and anti-inflammatory efficacy and may serve as next generation regenerative therapeutics for a variety of inflammatory skin diseases including atopic dermatitis.