What is mesotherapy

Daniel Judd BSc, MBiol
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What is Rejuvenation Mesotherapy?

Since its invention as a medical procedure in the 1950s, mesotherapy has become a popular cosmetic treatment for facial rejuvenation, particularly across Europe. Mesotherapy is a drug delivery technique that involves hundreds of tiny injections into the subcutaneous layer of the skin instead of one large injection into the blood stream. When used for skin rejuvenation, a cocktail of vitamins and other small molecules is injected in 0.01 mL doses across the target area.

Mesotherapy is controversial as a lack of regulations means that many practitioners use formulations of vitamins not approved for injection. Organisations like the Society of Mesotherapy hope to improve this situation through tighter regulation on the use of the word ‘mesotherapy’ so that only practitioners using ingredients marked ‘CE’ or ‘conformite european’ (conforming to European standards) may provide the treatment.

 

How does it work?

The premise behind rejuvenation mesotherapy is that by delivering a mix of vitamins and nutrients directly to the deeper layers of the skin, you can ‘wake up’ skin cells called fibroblasts and have them start building new collagen fibres, helping to reverse the signs of aging in your skin.

A rejuvenation cocktail will typically contain vitamin C which is known to increase collagen building and protect collagen form breakdown. Other common ingredients include hyaluronic acid which is normally injected in larger quantities as a popular dermal filler. Besides those, a cocktail may include any number of vitamins, organic molecules and even plant extracts and homeopathic mixtures depending on the practitioner. Clinical studies looking at the effects of these cocktails are few and far between and also suffer from poor study design, lack of controls and conflicting results.

At a basic level, it’s been shown that laboratory cultures of human fibroblasts do respond well to a rejuvenation cocktail of vitamins, with treated cells being healthier and producing more collagen than untreated cells. However, when you at look at studies where actual people were treated the results become less clear. Some small, uncontrolled studies of vitamin cocktails found no significant improvement in their patients where as others saw some improvement using only hyaluronic acid and no vitamin cocktail.

What is it like?

The mesotherapy procedure can vary considerably depending on the clinic. It is typically done without topical anaesthetic as the needles used are small. One common method is called ‘nappage’ where by hand the practitioner will deliver many quick shallow injections along a line with rapid up and down motions. ‘Papule’ mesotherapy injections are slightly shallower, injecting the cocktail just below the upper most layer of the skin. This will initially produce a small bump, or papule, which will fade within minutes. ‘Point by point’ injections are deeper injections, delivering the cocktail 2 to 3 times deeper than nappage or papule techniques. As a session can involve hundreds of injections, the process can be time consuming. It will also typically require a course of several treatments over the future weeks and months.

What is the recovery time?

Rejuvenation mesotherapy does not require any serious recovery time. It is however suggested that you avoid hot showers for 8 hours after treatment and avoid strenuous activity for at least 48 hours.

What are the risks and side effects?

Mesotherapy comes with several risks and side effects, both superficial and serious.

During and following treatment, you may experience pain and discomfort from the injections. This can be followed by temporary bruising, redness and swelling. As some cocktails contain plant extracts it’s important to check for possible allergic reactions to the cocktail.

As an injection method, mesotherapy carries the risk of infection if proper hygiene procedures aren’t followed. There have been many cases of bacterial infection across multiple injection sites due to the use of non-sterile needles. Infection at injection sites can lead to abscesses, pain, fatigue, fever and scarring.

How much does it cost?

A single treatment session may cost around £200 and a full course of treatments could cost between £1000 and £2000.

So is it worth it?

As it stands, mesotherapy is a poorly researched procedure where the alternatives are better understood and often cheaper. The vitamins in the cocktails, such as vitamin C have plenty of topical cream versions that penetrate the skin layers and give the rejuvenating effect. If you can buy an easy to apply cream that delivers the same vitamins and nutrients as hundreds of injections, why would you spend 10 or even 100 times the money on the injections?

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  1. Geesin, J.C., et al., Ascorbic acid specifically increases type I and type III procollagen messenger RNA levels in human skin fibroblast. J Invest Dermatol, 1988. 90(4): p. 420-4.
  2. Nusgens, B.V., et al., Topically applied vitamin C enhances the mRNA level of collagens I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis. J Invest Dermatol, 2001. 116(6): p. 8539. https://www.ncbi.nlm.nih.gov/pubmed/11407971
  3. Deglesne, P.-A., et al., In vitro study of RRS HA injectable mesotherapy/biorevitalization product on human skin fibroblasts and its clinical utilization. Clinical, Cosmetic and Investigational Dermatology, 2016. 9: p. 41-53.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770068/
  4. Amin, S.P., R.G. Phelps, and D.J. Goldberg, Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation. Dermatol Surg, 2006. 32(12): p. 1467-72.  https://www.ncbi.nlm.nih.gov/pubmed/17199654
  5. El-Domyati, M., et al., Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation. International journal of dermatology, 2012. 51(8): p. 913-919.
  6. Baspeyras, M., et al., Clinical and biometrological efficacy of a hyaluronic acid-based mesotherapy product: a randomised controlled study. Archives of Dermatological Research, 2013. 305(8): p. 673-682.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778226/
  7. Lacarrubba, F., et al., Mesotherapy for skin rejuvenation: assessment of the subepidermal low-echogenic band by ultrasound evaluation with cross-sectional B-mode scanning. Dermatologic Therapy, 2008. 21: p. S1-S5. https://www.ncbi.nlm.nih.gov/pubmed/19076625
  8. http://www.healthcentre.org.uk/cosmetic-treatments/mesotherapy-recovery.html