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IMCAS Paris 2026

Thermo Mechanical Drug Delivery (Tixel): Exosomes

Presented by Dr. Erlich Guy, MD, MSc (Aesthetic Medicine), Plastic Surgery, Hillel Yaffe Medical Center, Israel

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At IMCAS World Congress 2026, Dr. Erlich Guy presents clinical insights on the use of Tixel® thermo-mechanical technology to enhance transdermal delivery of synthetic exosomes for skin rejuvenation. By generating uniform micro-channels through brief contact of heated titanium pyramids, Tixel® enables needle-free penetration while preserving the dermal–epidermal junction and supporting rapid healing. The protocol was well tolerated across multiple patients and was associated with visible improvements in skin smoothness, firmness, uniformity, and overall skin tone, supporting its potential as a safe and effective approach to advanced skin rejuvenation.

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Complete List of References:Anchor

  1. Kokolakis, G., Grawert, L., Ulrich, M., Lademann, J., Zuberbier, T. and Hofmann, M.A. (2020). ‘Wound Healing Process After Thermomechanical Skin Ablation’. Lasers in Surgery and Medicine.
  2. FDA.com: https://www.accessdata.fda.gov/cdrh_docs/pdf24/K240512.pdf
  3. Shah, S., Dutta, D., Barua, A., Hanneken, L. and Naroo, S.A. (2023). The effect of non-ablative thermomechanical skin treatment (Tixel®) on dry eye disease: A prospective two centre open-label trial. Contact lens & anterior eye : the journal of the British Contact Lens Association.
  4. Safir, M., Inbar Waizer, Safir, A., Hartstein, M.E. and Ofir Artzi (2024). Percutaneous delivery of liquid tetracycline using a thermal resurfacing drug delivery system for the treatment of festoons. Lasers in Surgery and Medicine.
  5. Wang, J.V., Mehrabi, J.N., Zachary, C.B. and Geronemus, R.G. (2021). Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery. Dermatologic surgery
  6. Shavit, R. and Dierickx, C. (2020). A New Method for Percutaneous Drug Delivery by Thermo-Mechanical Fractional Injury. Lasers in Surgery and Medicine.
  7. Sintov, A.C. and Hofmann, M.A. (2016). A novel thermo-mechanical system enhanced transdermal delivery of hydrophilic active agents by fractional ablation. International Journal of Pharmaceutics.
  8. Artzi, O., Mehrabi, J.N., Heyman, L., Friedman, O. and Mashiah, J. (2019). Treatment of port wine stain with Tixel ‐induced rapamycin delivery following pulsed dye laser application. Dermatologic Therapy.
  9. Bar‐Ilan, E., Koren, A., Shehadeh, W., Mashiah, J., Sprecher, E. and Artzi, O. (2019). An enhanced transcutaneous delivery of botulinum toxin for the treatment of Hailey–Hailey disease. Dermatologic Therapy.
  10. Friedman, O., Koren, A., Niv, R., Mehrabi, J.N. and Artzi, O. (2018). The toxic edge—A novel treatment for refractory erythema and flushing of rosacea. Lasers in Surgery and Medicine.
  11. Ofir Artzi, Koren, A., Niv, R., Mehrabi, J.N., Mashiah, J. and Friedman, O. (2019). A new approach in the treatment of pediatric hypertrophic burn scars: Tixel‐associated topical triamcinolone acetonide and 5‐fluorouracil delivery. Journal of Cosmetic Dermatology.
  12. Ofir Artzi, Koren, A., Niv, R., Mehrabi, J.N. and Friedman, O. (2019). The Scar Bane, Without the Pain: A New Approach in the Treatment of Elevated Scars: Thermomechanical Delivery of Topical Triamcinolone Acetonide and 5-Fluorouracil. Dermatologic Therapy.
  13. Kehinde Raji Olumesi and Goldberg, D.J. (2023). A review of exosomes and their application in cutaneous medical aesthetics. Journal of Cosmetic Dermatology
  14. Tienda-Vázquez, M.A., Hanel, J.M., Márquez-Arteaga, E.M., Salgado-Álvarez, A.P., Scheckhuber, C.Q., Alanis-Gómez, J.R., Espinoza-Silva, J.I., Ramos-Kuri, M., Hernández-Rosas, F., Melchor-Martínez, E.M. and Parra-Saldívar, R. (2023). Exosomes: A Promising Strategy for Repair, Regeneration and Treatment of Skin Disorders. Cells.
  15. Liang, C., Yi, Y., Li, J., Aghayants, S., Chen, X., Cao, W. and Zhang, Q. (2025). Unveiling exosomes in combating skin aging: insights into resources, mechanisms and challenges. Stem Cell Research & Therapy.
  16. Clementi, A., Cassalia, F., Cannarozzo, G., Guarino, L., Zappia, E., Bennardo, L., Mazzetto, R., Danese, A., Longo, C. and Nisticò, S. (2025). Laser-Assisted Exosome Delivery (LAED) with Fractional CO2 Laser: A Pilot Two-Case Report and Narrative Review. Cosmetics.
  17. Vitale, M., Ruri, P., Marini, S., Zappia, E. and Yi, K.-H. (2025). Clinical Outcomes of Exosome-Augmented Microneedling and Laser Therapies in Full-Face Skin Rejuvenation: A Split-Face Observational Study. The Journal of craniofacial surgery.‌
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