Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Focus
2007:73:1;60-62
doi: 10.4103/0378-6323.30661
PMID: 17314456

Mesotherapy

Maya Vedamurthy
 Consultant Dermatologist, Malar Hospital, Chennai, India

Correspondence Address:
Maya Vedamurthy
AB-76, 1st Street, Anna Nagar, Chennai-600010
India
How to cite this article:
Vedamurthy M. Mesotherapy. Indian J Dermatol Venereol Leprol 2007;73:60-62
Copyright: (C)2007 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

Mesotherapy is a technique which involves microinjections of conventional homeopathic medication and/ or vitamins into the mesoderm or middle layer of the skin to promote healing or corrective treatment to a specific area of the body. It is a debatable addition in the therapeutic armamentarium in the management of skin rejuvenation. However, dermatologists have to use this cautiously and judiciously as at present there is a lot of controversy regarding its efficacy and safety despite the fact that mesotherapy is gaining popularity in the West.
Keywords: Current status, Mesotherapy
Depth of injections of mesotherapy techniques
Depth of injections of mesotherapy techniques
Mesogun
Mesogun

Mesotherapy was invented by the Frenchman Dr. Michel Pistor in 1958 to treat conditions in rheumatology, sports, traumatology, infectious diseases, vascular diseases and mainly as a pain-relieving technique. The North American experience began when Dr. Lionel Bissoon learned the technique in France and later popularized it in America. Its cosmetic applications, particularly for removal of fat and cellulite have recently received attention in the United States.

Applications of mesotherapy in dermatology

Mesotherapy is used in the treatment of:

  1. Cellulite
  2. Local fat deposits - xanthelasma, lipoma[1]
  3. Alopecia
  4. Rejuvenation - wrinkles, skin tightening
  5. Hyperpigmentation and melasma
  6. Body contouring[2]

Products commonly used in mesotherapy

  1. Phosphatidyl choline- dissolves fat[3],[4]
  2. Organic silicuim - increases collagen production
  3. CRP 1000 - has cytokines for cellular stimulation and copper peptide which improves collagen and elastin sysnthesis
  4. Hyaluronic acid- improves hydration
  5. Following chemicals act as antioxidants and are claimed to decrease pigmentation:
    • Glutathione
    • Ascorbic acid
    • Glycolic acid
    • Pyruvate
  6. Following chemicals are claimed to stimulate hair growth:
    • Buflomedial
    • Minoxidil
    • Finasteride
  7. Vitamins

          i. Vitamin C is used for hyperpigmenation and melasma. It acts as an antioxidant and helps in collagen and elastin production.

          ii. Vitamin A is used in antiaging treatment to improve fine lines and

          iii. Biotin is used in the treatment of alopecia.

  8. Minerals like copper peptide are used for increasing the skin elasticity.

Contraindications

Contraindications to mesotherapy include:

  • Pregnancy
  • Insulin-dependent diabetes
  • History of strokes
  • History of recent cancer
  • Thromboembolic phenomena
  • Patients on medications like aspirin, warfarin, heparin etc.

Materials required for undertaking this therapy include:

  • Mesotherapy products
  • Mesogun [Figure - 1]
  • Mesoneedles (30 G. 12 mm needles)

Techniques of injections

Mesotherapy involves injecting microquanities of medicine in the right place, using one of the following techniques [Table - 1]

  • Intra-epidermal
  • Papular
  • Nappage
  • Point-by-point

Intra-epidermal technique involves placing small quantities of the medicine within the epidermis. It is simple, painless and there is no bleeding. This technique is useful for patients with low pain threshold and is ideal for facial rejuvenation.

Papular technique involves injecting the medicine at the dermoepidermal junction. It is useful for treatment of wrinkles and alopecia. This is the technique used for mesobotox.

Nappage - Here injections are given at a depth of 2- 4 mm at an angle of 30-60°. It is used mainly on the scalp and in the treatment of cellulite.

Point-by-point - This is a precise single injection into the deep dermis. It is used mainly for fat reduction.

Treatment protocol

Usually, mesotherapy treatments are given initially as once per week for four weeks, once every two weeks for two months and once per month for one to two months to achieve best results.

Adverse effects

Adverse effects are common and depend on the product used

  • Bruising and edema are common due to the inflammatory response provoked by some of the chemicals used in mesotherapy.
  • Skin necrosis can occur due to the irritant effect of the chemicals used.
  • Liver toxicity and demyelination of nerves have been reported with large doses of phosphatidyl choline.
  • Atypical mycobacterial infections is a rare side effect.[5] Following mesotherapy there have been reports of atypical mycobacterial infections at sites of injections necessitating antimycobacterial therapy.

Needle-less mesotherapy

This is a newer technique which delivers the mesotherapy products by using ultrasound and/ or iontophoresis. Although it is less traumatic and painless the efficacy of this treatment is only 20% compared to traditional mesotherapy. It may be an option if patients insist on a painless procedure.

Controversial aspects

Since the scientific basis of mesotherapy is not established there is a lot of controversy regarding mesotherapy. The products used here are a combination of herbal and allopathic medicines, the mechanism of action of which is either unknown or doubtful. There are no well-controlled studies to prove the efficacy of this treatment. It is not yet approved by the US FDA and scientific data to support its efficacy is lacking. Adverse effects have been reported with some of the chemicals used in this therapy and there are no clear-cut guidelines on the dosage and efficacy of these products. However, scientific data is likely to evolve with the continued use of these products. Until such time the use of this technique will probably remain a subject of controversy.

Conclusion

Although mesotherapy sounds like a new technique in dermatology, dermatologists have been using similar injection techniques to treat keloids and hypertrophic scars with steroids. The misuse of mesotherapy products in an unsafe manner has even led to the ban of these products in some countries. Therefore caution should be exercised while selecting the right and safe products. Products whose mechanism of action is well understood and whose adverse effects and doses are well studied should be chosen.

Despite the boom in mesotherapy in the West, we must remember that mesotherapy is a controversial therapy at the moment and that it is still in its infancy. More controlled and published studies in the literature are awaited for dermatologists to decide the future of this technique in their practice. Additional clinical and experimental studies are necessary to establish the safety and efficacy of this treatment.

References
1.
Rotunda AM, Suzuki H, Moy RL, Kolodney MS. Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidyl choline formulation used for localized fat dissolution. Dermatol Surg 2004;30:1001-8.
[Google Scholar]
2.
Matarasso A, Pfeifer TM; Plastic Surgery Educational Foundation DATA Committee. Mesotherapy for body contouring. Plast Reconstr Surg 2005;115:1420-4.
[Google Scholar]
3.
Rose PT, Morgan M. Histological changes associated with mesotherapy for fat dissolution. J Cosmet Laser Ther 2005;7:17-9.
[Google Scholar]
4.
Mathew M. Avram cellulite: A review of its physiology and treatment. J Cosmet Laser Ther 2005;7:18.
[Google Scholar]
5.
Nagore E, Ramos P, Botella Estrada R, Ramos-Niguez JA, Sanmritan O, Castejon P. Cutaneous infection with Mycobacterium fortuitum after localized microinjections (Mesotherapy) treated successfully with a triple drug regimen. Acta Derm Venreol 2001;81:291-3.
[Google Scholar]

Fulltext Views
8,796

PDF downloads
3,122
Show Sections