Immunomodulatory functions of ginsenosides in skin diseases: molecular mechanisms and therapeutic prospects

Ginsenosides, the primary bioactive constituents of Panax ginseng C.A.Mey. (Araliaceae), have attracted growing attention in dermatological research. A wide range of in vitro and in vivo studies has demonstrated that ginsenosides exert diverse biological effects encompassing anti-inflammatory, antioxidant, immunomodulatory, wound-healing, and antitumor activities. Given the multifactorial pathogenesis of most skin disorders, the multitarget potential of ginsenosides renders them particularly promising for cutaneous diseases. In this review, we summarize the chemical composition and classification of ginsenosides, as well as recent advances in their application against major skin conditions, including psoriasis, dermatitis, photoaging, chronic non-healing wounds, and skin melanoma. Mechanistically, ginsenosides modulate multiple signaling pathways related to inflammation, oxidative stress, skin barrier function, and tissue repair, such as NF-κB/NLRP3, PI3K/Akt/mTOR/MAPK, Nrf2/HO-1, and TGF-β/Smads. We also discuss the synergistic effects among different ginsenoside metabolites and their combined targeted interventions. Despite promising preclinical findings, challenges remain in clinical translation, such as low oral bioavailability and insufficient clinical evidence. Future studies should focus on novel delivery systems, precise target identification, and high-quality clinical trials to promote the development and application of ginsenoside-based therapies in dermatology.