In the field of esthetic dermatology, the increasing use of therapeutic enzymes, characterized by their high affinity and specificity on their corresponding substrates, stands out. These enzymes are synthesized in heterologous organisms by means of recombinant DNA technology and are characterized by lower immunoreactivity compared to enzymes of eukaryotic origin. The aim of the present review is to synthesize the available data on the rationale for the use of these products in esthetic dermatology. A bibliographic search was carried out in PubMed, Scielo, Cochrane and Imbiomed networks; those studies in which the use of hyaluronidases, collagenases and lipases was based on the pathogenesis of the conditions to be treated were considered. Available evidence confirms the efficacy and safety of the combined application of recombinant enzymes in indications such as facial rejuvenation, jowls, hypertrophic scars and fibrosclerotic edematous panniculopathy. Further research is expected to add to the current body of evidence in this promising and evolving therapeutic area.