BackgroundDespite the interest in mesenchymal stem cells (MSC), their potential to treat abnormal scarring, especially keloids, is yet to be described. The present study aimed to investigate the therapeutic potential of exosomes derived from human bone marrow MSCs (hBMSC‐Exos) in alleviating keloid formation.MethodsExosomes were isolated from hBMSC, and keloid fibroblasts (KFs) were treated with hBMSC‐Exos. Cell counting kit‐8, wound healing, transwell invasion, immunofluorescence, and western blot assays were conducted to study the malignant phenotype of KFs. Mice were induced with keloids and treated with hBMSC‐Exos. The effect of hBMSC‐Exos on keloid formation in vivo was evaluated by hematoxylin and eosin staining, Masson staining, immunohistochemistry, and western blotting. The GSE182192 dataset was screened for differentially expressed long non‐coding RNA during keloid formation. Next, maternally expressed gene 3 (MEG3) was knocked down in hBMSC to obtain hBMSC‐Exossh‐MEG3. The molecular mechanism of MEG3 was investigated by bioinformatic screening, and the relationship between MEG3 and TP53 or MCM5 was verified.ResultshBMSC‐Exos inhibited the malignant proliferation, migration, and invasion of KFs at same time as promoting their apoptosis, Moreover, hBMSC‐Exos reduced the expression of fibrosis‐ and collagen‐related proteins in the cells and the formation of keloids caused by KFs. The reduction in MEG3 enrichment in hBMSC‐Exos weakened the inhibitory effect of hBMSC‐Exos on KF activity. hBMSC‐Exos delivered MEG3 to promote MCM5 transcription by TP53 in KFs. Overexpression of MCM5 in KFs reversed the effects of hBMSC‐Exossh‐MEG3, leading to reduced KF activity.ConclusionshBMSC‐Exos delivered MEG3 to promote the protein stability of TP53, thereby activating MCM5 and promoting KF activity.