Mesotherapy is a technique used to inject medications or active substances into the middle layer of the skin, known as the mesoderm. By stimulating the mesoderm, mesotherapy significantly reduces the symptoms and complaints of pathologies originating from this layer.

First applied in 1952 in France by Dr. Michel Pistor, mesotherapy demonstrated improvement in temporomandibular joint pain in a patient with acute asthma and hearing loss, who received procaine injections around the ears. Dr. Pistor coined the term “mesotherapy” for all these treatments targeting mesoderm-originated tissues. Over the years, this method has been further developed and is practiced by physicians with legal mesotherapy certification in many countries, including Turkey.

Selected drug mixtures, tailored to the purpose, are injected into the skin in regional, small doses using special needles and techniques. Mesotherapy has been shown to provide clinical benefits by injecting small doses of active products into the skin corresponding to the lesion in pathological conditions such as back pain where other treatments are ineffective or inapplicable. Additionally, it has been demonstrated that administering active substances intradermally with other systemic treatments may have synergistic effects, and consequently, mesotherapy has dose-sparing effects.

The procedure must be carried out under strict control, adhering to proper hygiene and sterilization conditions, utilizing aseptic techniques. Performing this procedure by non-medical personnel, failure to comply with hygiene standards, using incorrect techniques, and preparing incorrect drug mixtures have led to reported cases of various side effects in the literature.

Mesotherapy is fundamentally a method performed with the trio of hand-syringe-needle. Skilled medical hands are required to inject active products into the skin in microinjection style, as fast and painless as possible, without bleeding. The injection angle must be given according to the thickness of the skin. Particularly in the nappage technique, injecting microdoses intradermally-epidermally at very close intervals is crucial.

This mechanism, which also serves the same function in acupuncture, auriculotherapy, manual-electric stimulation techniques, occurs through dermal inhibitory stimuli, both mechanically (via needles and droplets) and through the pharmacological effects of drugs. Vasoactivity at the needle site, triggering of endorphin secretion, and activation of enkephalin and gate-control mechanisms take place. Thus, mesotherapy significantly reduces the symptoms and complaints of pathologies originating from mesoderm-derived tissues. Consequently, its application areas are pathologies of tissues originating from mesenchymal tissue (fibrous tissues, cartilage, bone, muscle, fat, bone marrow, blood, lymphatic tissue, urogenital system, and vascular system).

Mesotherapy is highly effective in the treatment of musculoskeletal diseases such as osteoarthritis, fibromyalgia, tendinitis, bursitis, and back pain. It is also used in the treatment of skin diseases such as cellulite, alopecia (hair loss), xanthelasma (fat accumulation in eyelids), hyperpigmentation, and melasma (sunspots). Additionally, it is employed in conditions like asthma and tinnitus.

Mesotherapy is particularly effective in pain management. The applied procedure involves injecting small volumes of an analgesic substance around the painful area. It is commonly used in conjunction with muscle relaxants.

Precautions before and after Mesotherapy:

  • It should not be performed during menstruation.
  • Painkillers and anti-rheumatic drugs should not be used.
  • Attend the session after showering, wearing loose and clean clothes.
  • Do not use creams and moisturizers on the application area.
  • Treated areas should be protected from direct sunlight for 48 hours.
  • Avoid bathing and showering immediately after the session.

Aesthetic Applications:

  • Cellulite
  • Hair loss
  • Stretch marks occurring during adolescence and pregnancy
  • Facial rejuvenation
  • Scar treatment

Other Applications:

  • Neck and back pain
  • Shoulder and elbow pain
  • Hand and wrist pain
  • Lower back pain
  • Hip and knee pain
  • Foot and ankle pain
  • Circulatory problems (varicose veins, varicose ulcers)
  • Rheumatic diseases
  • Osteoarthritis
  • Migraine
  • Sports injuries

Mesotherapy can be performed on anyone with good general health. However, it is not applied to patients with a history of allergic reactions, coagulation disorders (hemophiliacs, those undergoing treatment with anticoagulants or antiplatelet agents), pregnant or breastfeeding women, and cancer patients undergoing chemotherapy.

REFERENCES

  • Atiyeh BS, Ibrahim AE, Dibo SA. Cosmetic mesotherapy: between scientific evidence, science fiction, and lucrative business. Aesthetic Plast Surg. 2008;32(6):842–849.
  • Chen L, Li D, Zhong J, et al. Therapeutic effectiveness and safety of mesotherapy in patients with osteoarthritis of the knee. Evidence-Based Compl Altern Med. 2018;4:6513049.
  • Mammucari M, Gatti A, Maggiori S, Sabato AF. Role of mesotherapy in musculoskeletal pain: opinions from the italian society of mesotherapy. Evid Based Complement Alternat Med. 2012;2012:436959.
  • Mammucari M, Maggiori E, Russo D, et al. Mesotherapy: from historical notes to scientific evidence and future prospects. Sci World J. 2020.
  • Paolucci T, Bellomo RG, Centra MA, Giannandrea N, Pezzi L, Saggini R. Mesotherapy in the treatment of musculoskeletal pain in rehabilitation: the state of the art. J Pain Res. 2019;12:2391-2401.
  • Ronconi G, Ferriero G, Nigito C, et al. Efficacy of intradermal administration of diclofenac for the treatment of non specific chronic low back pain: result from a retrospective observational study. Eur J Phys Rehabil Med. 2019;54–55.