Mesotherapy Vedamurthy M - Indian J Dermatol Venereol Leprol http://www.ijdvl.com/article.asp?issn=0378-6323;year=2007;volume=...

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Previous article Year : 2007 | Volume : 73 | Issue : 1 | Page : 60-62
Table of Contents
Mesotherapy
Resource links Maya Vedamurthy
Similar in PUBMED Consultant Dermatologist, Malar Hospital, Chennai, India
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Vedamurthy M Correspondence Address:

Maya Vedamurthy
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Vedamurthy M
DOI: 10.4103/0378-6323.30661
Related articles
PMID: 17314456
Current status
Mesotherapy

Article in PDF (141 KB) Abstract

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

In this article
Abstract
Conclusion How to cite this article:
References Vedamurthy M. Mesotherapy. Indian J Dermatol Venereol Leprol 2007;73:60-2
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Article Tables How to cite this URL:
Vedamurthy M. Mesotherapy. Indian J Dermatol Venereol Leprol [serial online] 2007 [cited 2010 Dec
Article Access Statistics 5];73:60-2. Available from: http://www.ijdvl.com/text.asp?2007/73/1/60/30661
Viewed 8133
Printed 153
Emailed 10 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
PDF Downloaded 987
American experience began when Dr. Lionel Bissoon learned the technique in France and later popularized it in
Comments [Add] America. Its cosmetic applications, particularly for removal of fat and cellulite have recently received attention in
Cited by others 7 the United States.

Total downloads in Applications of mesotherapy in dermatology

last 2 months
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81 Mesotherapy is used in the treatment of:
2010
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2010

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Dermatology 2. Local fat deposits - xanthelasma, lipoma[1]
Mesotherapy
3. Alopecia
Melasma
Hair Products 4. Rejuvenation - wrinkles, skin tightening
Cosmetic Dermatology Best 5. Hyperpigmentation and melasma
6. Body contouring[2]

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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
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Translate 6. Following chemicals are claimed to stimulate hair growth:

Buflomedial
Minoxidil
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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

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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. [PUBMED] [FULLTEXT]
2. Matarasso A, Pfeifer TM; Plastic Surgery Educational Foundation DATA Committee. Mesotherapy for
body contouring. Plast Reconstr Surg 2005;115:1420-4. [PUBMED] [FULLTEXT]
3. Rose PT, Morgan M. Histological changes associated with mesotherapy for fat dissolution. J Cosmet Laser
Ther 2005;7:17-9. [PUBMED] [FULLTEXT]
4. Mathew M. Avram cellulite: A review of its physiology and treatment. J Cosmet Laser Ther 2005;7:18.

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.

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Figures

[Figure - 1]

Tables

[Table - 1]

This article has been cited by

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EFSTATHIOS RALLIS, STEPHANOS KINTZOGLOU, VASSILIKI MOUSSATOU, PANAGIOTA RIGA
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2 Ischemic colitis after mesotherapy combined with anti-obesity medications
Kim, J.B., Moon, W., Park, S.J., Park, M.I., Kim, K.-J., Lee, J.N., Kang, S.J., Chang, H.K.
World Journal of Gastroenterology. 2010; 16(12): 1537-1540
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3 Alopecia secondary to mesotherapy
Duque-Estrada, B., Vincenzi, C., Misciali, C., Tosti, A.
Journal of the American Academy of Dermatology. 2009; 61(4): 707-709
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Cervical lymphoadenopathy due to Pseudomonas aeruginosa following mesotherapy |
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[Linfoadenopatia cervicale da Pseudomonas aeruginosa dopo trattamento con mesoterapia]
Shaladi, A.M., Crestani, F., Bocchi, A., Saltari, M.R., Piva, B., Tartari, S.
Infezioni in Medicina. 2009; 17(3): 169-172
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5 Cutaneous granulomatous reaction from mesotherapy
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Dermatologic Surgery. 2009; 35(2): 291-293
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Atiyeh, B.S., Ibrahim, A.E., Dibo, S.A.
Aesthetic Plastic Surgery. 2008; 32(6): 842-849
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7 Delirium with psychotic features possibly associated with mesotherapy
Tor, P.-C., Lee, T.-S.
Psychosomatics. 2008; 49(3): 273-274
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