Mesotherapy Injections Research Articles

Efficacy of Platelet-Rich Plasma versus Mesotherapy with Recombinant Growth Factors and Stem Cell-Conditioned Media in Androgenetic Alopecia: A Retrospective Study

Introduction: Androgenetic alopecia (AGA) is the most common type of hair loss. Platelet-rich plasma (PRP) and mesotherapy (MZT) injections of various solutions fortified with growth factors are popular treatment options for AGA. The aim of this study was to compare the efficacy of RPP and MZT products in the treatment of AGA. Methods: This retrospective study included 72 AGA patients treated with two PRP formulations and two MZT products, administered manually or with a gun injector. Hair parameters (hair thickness, hair density, and hair count) on frontal and vertex areas were measured before and after 6 months. Results: Over 6 months, trichoscopic parameters showed significant intragroup and intergroup variability. MZT1 and PRP2 groups exhibited statistically significant improvement in most parameters, while MZT2 significantly increased vertex hair density. Hair thickness changes differed significantly between PRP1 and PRP2 groups (unadjusted p value <0.001) and possibly between MZT1 and PRP1 groups (unadjusted p value = 0.049) in both regions. Discussion: Injections of PRP and MZT formulations can significantly enhance trichoscopic parameters in AGA patients within a 6-month period, but the extent of improvement varies among different PRP and MZT products.

Clinical features of mesotherapy-associated non-tuberculous mycobacterial infections: A systematic review

Background: Cutaneous infections from non-tuberculous mycobacteria (NTM) are a well-documented but poorly characterized adverse event following mesotherapy injections. Objective: This study aims to consolidate the available literature to characterize demographic and clinical features of mesotherapy-associated NTM infections. Methods: Using PRISMA guidelines, a systematic review of PubMed, Scopus, and Embase databases was undertaken for articles reporting cases of NTM skin infections following mesotherapy. Data were analyzed using Microsoft Excel. Results: Of 1966 search results, 30 articles (N = 423 patients) met inclusion criteria. Studies were largely from South America, and patients were mostly women aged 16-55 with NTM infections arising in the abdomen, buttocks, or thighs. Nearly all patients developed multiple, well-localized lesions without systemic symptoms. Effect summary by meta-analysis revealed most infections resolved after antibiotic therapy, though many patients required multiple antibiotic courses and/or agents to resolve infection. Infections often took weeks to resolve and were complicated by post-treatment scarring. Limitations: The main limitation of this study was the heterogeneity and lack of consistency between case reports. Conclusion: Cutaneous NTM infections associated with mesotherapy generally occur in women of childbearing age, arise from injections contaminated by the environment, and are often complicated by scarring/poor cosmesis and prolonged treatment course.

Recent modalities in treatment of telogen effluvium: Comparative study.

Telogen effluvium is one of the most common forms of diffuse, non-scarring hair loss for which patients present for clinical evaluation. It is usually a reactive and reversible disorder. Identifying and correcting the underlying cause is the most important component in management, yet there is always a need for therapeutic options. This study aims to evaluate the efficacy of single session botulinum toxin A injection versus multiple sessions of multivitamins mesotherapy in the treatment of telogen effluvium. A randomized clinical trial was conducted in the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Zagazig University Hospitals. Twenty-four patients with telogen effluvium were randomly divided into two groups each group included 12 patients. Group I received a single session of Botulinum toxin A injection and group II received multiple sessions of multivitamins mesotherapy injection. Both botulinum toxin A and multivitamins mesotherapy are effective in the treatment of telogen effluvium, which was reflected on the improvement of hair parameters as terminal hair and multiple follicular units. Both treatment modalities had minimal and well-tolerated side effects. Although both therapies have equivalent success rates, single session of botulinum toxin A is a better choice than multiple mesotherapy sessions.

Alopecia After Cosmetic Injection Procedures: A Review.

Cosmetic procedures for antiaging carry inherent risks of adverse events. One that has not yet been well characterized is transitory or permanent alopecia. This is attributable to numerous mechanisms including pressure, ischemia, inflammation, and necrosis. Cases of postcosmetic procedure alopecia have been reported after mesotherapy as well as hyaluronic acid filler, deoxycholic acid, and botulinum toxin injections. This review serves to describe the currently known causes of postcosmetic procedure alopecia and the mechanisms by which alopecia is attained. Furthermore, this review highlights the risk of unregulated mesotherapy injections for cosmetic enhancement and to bring attention to the increasing number reports of alopecia after these procedures. A systematic review of the literature from 2000 to 2022 was conducted looking for keywords such as "alopecia," "cosmetic procedures," "mesotherapy," and "hyaluronic acid" in Google Scholar and PubMed. Ten articles met the criteria set forth in the authors' literature review. Many of the procedures resulted in partial or complete resolution of alopecia. Alopecia after cosmetic injection procedures is an underreported adverse effect. More research is needed to further characterize the risk of alopecia after mesotherapy and other injection procedures.

Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

BackgroundAchilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments.The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment.ResultsForty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness.ConclusionESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

Use of vibrating anesthetic device reduces the pain of mesotherapy injections: A randomized split-scalp study.

Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients' comfort.This is a randomized split-scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self-reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration-assisted side was 8.0±1.0 while pain score for the vibration side was 2.3±1.5, for AGA (P<.001) and 7.4±1.2 and 2.1±1.3, respectively, for AA (P<.001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.

&lt;p&gt;Vitiligo – New Treatment Approach&lt;/p&gt;

IntroductionVitiligo is one of the most common hypomelanoses. Current treatments include ultraviolet, topical corticosteroids, calcineurin inhibitors. Orally administered vitamins, acting as anti-oxidants and in combination with ultraviolet light have also demonstrated skin re-pigmentation. In our pilot study of seven patients, we injected skin affected with vitiligo intra-dermally with a complex of vitamins and minerals and assessed the outcome.AimThe aim of this study was to evaluate a novel treatment modality for vitiligo.MethodsWe present a pilot study of seven patients; each having been diagnosed with generalized progressive vitiligo. In all cases, multiple therapies had been previously attempted. All patients were subjected to intradermal injections of biorevitalizant NCTF 135 (3 mls) in the hypo-pigmented areas of skin, once a week for 5 weeks. A 30Gx13 mm needle was used for the 0.025 mls intradermal injections to create micro-papules with a 1 cm distance between the injection sites. The results were assessed at 2 weeks and 5 weeks and were considered successful if partial or complete repigmentation was achieved.ResultsPartial or complete skin re-pigmentation post-treatment was observed in vitiligo macules of all patients (100%). No significant side effects, or exacerbation of vitiligo were observed during or after treatment with NCTF 135 in the following 6 months (five patients) and 12 months (two patients).DiscussionIncreasing the armamentarium of new treatments of vitiligo is important. Previous studies showed the effectiveness of oral and intramuscularly injected multivitamins in the treatment of vitiligo, explaining the results by the antioxidative qualities of the above. Our study demonstrated that intradermal mesotherapy injections of NCTF135, rich with vitamins and other antioxidants are well tolerated and effective in achieving significant re-pigmentation of de-pigmented skin in all patients studied, including five who had been resistant to previous standard therapies.

Panniculitis due to Mycobacterium abscessus associated with mesotherapy injection

Panniculitis due to Mycobacterium abscessus associated with mesotherapy injection

The influence of peptide bioregulators on skin aging in 3D culture model

He effect of mesotherapy injection (Meso-Wharton R199TM) on the dermal fibroblasts culture, simulating condition of (mature) aging skin cells are studied. Material and methods. The culture of 4th passage fibroblasts (P4), that corresponds to young skin fibroblasts (control) and the culture of 18th passage fibroblasts (P18), that has all the signs of aging dermal fibroblasts (predominance of large cells, slow cell division) were used. Bioactivity was assessed by cell morphology, epithelium-mesenchyme plasticity and expression of fibroblasts markers: cytokeratin 19, elastin, a-smooth muscle actin (aSMA), PCNA (proliferation marker), collagen types I, III, IV and fibronectin. The formation of spheroids occur when fibroblasts P18 are cultivating with the injection medication, on terms comparable to the formation of spheroids from P4 young fibroblasts. From culture of fibroblasts P18, that was cultured without medication, does not form the full spheroid, but aggregation of cells and their gradual destruction with necrotic masses within the unit are observed. The presence of the medication stimulates the “rejuvenation” of cells and subsequent recovery of the mesenchyme-epithelial plasticity of cultured fibroblasts due to the reduced ability to synthesize sufficient to establish the amount of intercellular contacts the extracellular matrix components (fibronectin and collagen), which affects the ability to form spheroids. Culturing spheroids formed with the medication stimulates expression of elastin, collagen type IV, fibronectin extracellular matrix protein that supports the skin elasticity and superficial cells actively express cytokeratin 19. The study results clearly demonstrate the effectiveness of mesotherapeutic treatment for skin rejuvenation.

Frontal Edema Due to Topical Application of %5 Minoxidil Solution Following Mesotherapy Injections.

Sir, A 37‑year‑old woman referred to our clinic complaining of hair loss. On dermatological examination, thinning of the hair on vertex was noticed. Laboratory findings were in normal limits. She was diagnosed as female androgenetic alopecia and decided to perform scalp mesotherapy. Three sessions of multiple intradermal biotin injections were performed by point by point mesotherapy injection technique [1] at 15 days intervals. There were not detected any complications after these biotin mesotherapy sessions. Fourth biotin mesotherapy treatment was performed similar to previous sessions, additionally, immediately after mesotherapy injections, approximately in 10 min, topical %5 minoxidil solution was topically applied with gentle massage. 16 h after the fourth session a firm frontal edema was developed, erythema and pain were not associated to edema [Figure 1]. Frontal edema resolved gradually in 2 days. After 2 weeks, the fifth biotin mesotherapy treatment was performed again without topical application of minoxidil and no complication was detected after the fifth session. Minoxidil solution can be used in the treatment of alopecia by topical application or by mesotherapy injection. It is shown that minoxidil enhances hair growth by prolonging the anagen phase and induces new hair growth. [2] It is instructed not to use minoxidil over than 1–2 cc within mesotherapy cocktail because the hypotension can be seen due to excess vasodilatation. [2,3] The vasodilator effect of minoxidil is well‑known, and vasodilatory edema is a well‑known side effect of vasodilators. [4] With respect of these knowledges, we comment the reason of frontal edema in this patient is due to the excessive absorption of topical applicated %5 minoxidil after hundreds of mesotherapy injections. Though minoxidil was applicated topically, it was absorpted too much by the pores of injected sites and effected as a locally vasodilator and caused the frontal edema. The previous mesotherapy sessions and the last mesotherapy sessions were not complicated, so we suggest the biotin mesotherapy injection does not have a role in this side effect. In the medical literature, we could not found a reported case describing facial edema due to minoxidil application neither by topically nor by mesotherapy injection. However, in patient forum sites we detected that patients noticed “puffy face” due to topical application of minoxidil solution. We present this case to remind the locally edematous effect of minoxidil solution.

Expression of transforming growth factor-β after different non-invasive facial rejuvenation modalities.

Transforming growth factor-β (TGF-β) is a major regulator of the synthesis of extracellular matrix (ECM) proteins in human skin as it stimulates fibroblast proliferation and collagen production. Perturbed TGF-β expression may play a key role in the pathogenesis of skin aging. This study was conducted to objectively evaluate the effects of different modalities of non-invasive facial rejuvenation on TGF-β expression and to correlate its level with that of newly synthesized collagen. A total of 36 patients with Fitzpatrick skin types III and IV were divided into six groups. Each group of six patients was subjected to a different non-invasive modality for the treatment of skin aging, including radiofrequency (RF), Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels, intense pulsed light (IPL), mesotherapy injection, and electro-optical synergy (ELOS). Skin biopsies were obtained before treatment, at the end of treatment, and at threemonths post-treatment. In addition, biopsies were obtained from 30 control subjects. Levels of TGF-β were quantitatively evaluated using computerized image analysis of immunostained sections. The expression of TGF-β was statistically significantly increased (P<0.05) at the end of Nd:YAG 1320-nm and Er:YAG 2940-nm mini-peel treatments compared with baseline levels, and at threemonths post-treatment with RF and ELOS compared with pretreatment and end-of-treatment levels. However, no significant differences (P>0.05) were observed in TGF-β level in response to IPL or mesotherapy treatments in comparison with baseline. The level of TGF-β was positively correlated (P<0.05) to that of newly synthesized collagen at the end of Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels, as well as at threemonths after RF and ELOS treatments. Radiofrequency, ELOS, and Nd:YAG 1320-nm laser and Er:YAG 2940-nm laser mini-peels resulted in an increase in TGF-β expression, which may mediate the effects of these modalities in enhancing dermal collagen expression through the activation of fibroblasts and thereby reverse the photoaging of skin.

Un effet indésirable rare de la mésothérapie : la dermite de Nicolau

Nicolau's livedoid dermatitis is associated with drug-induced embolism in the cutaneous arterial bed, generally as a result of accidental intra-arterial injection. Herein, we report a case that is somewhat surprising because of its late onset following mesotherapy injections. A 53-year-old man, with a history solely of tendinopathy for which he underwent mesotherapy sessions, consulted for livedoid lesions of the front of the knee with central necrosis. History-taking revealed a final course of mesotherapy three weeks earlier for patellar tendinitis below the left kneecap; intradermal injection of procaine and piroxicam had been unusually and intensely painful. The remainder of the clinical examination revealed additional livedoid lesions on the outside of the left ankle as well as purpuric lesions on the pads of the toes on the left foot. Laboratory tests revealed nothing of note. Skin biopsies of the livedoid circumference of the lesion showed arteriolar emboli of an amorphous material within the dermis obliterating the arteriolar lumen. The clinical appearance of skin lesions after mesotherapy led us to a diagnosis of Nicolau livedoid dermatitis. Nicolau dermatitis is a rare skin complication described as occurring mainly as a result of intramuscular injections. The reported case is special because it comprises Nicolau dermatitis arising out of a session of mesotherapy employing an intradermal injection. However, there are only very few cases in which subcutaneous injections have induced Nicolau dermatitis. The pathophysiology is not well known, but several mechanisms are involved: arterial ischaemia by vasospasm or thrombosis. In this case, the semiotic appearance of the lesions and histological analysis militate in favour of accidental injection of a skin product into an arteriole, resulting in obliteration of the latter. Mesotherapy can induce Nicolau dermatitis.

Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation

Mesotherapy, commonly known as "biorejuvenation" or "biorevitalization", is a technique used to rejuvenate the skin by means of a transdermal injection of a multivitamin solution and natural plant extracts that are thought to improve the signs of skin aging. This prospective study aimed to evaluate the clinical effect of mesotherapy applied to periorbital wrinkles and to quantitatively evaluate histological changes in the skin occurring in response to the same treatment. Six volunteers with Fitzpatrick skin types III or IV and Glogau class I-III wrinkles were subjected to a three-month course of mesotherapy injections in the periocular area (six sessions administered at two-week intervals). Standard photographs and skin biopsies were obtained from the treatment area at baseline, at the end of treatment, and at three months post-treatment. Quantitative evaluation of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin was performed using a computerized morphometric analysis. The clinical evaluation of volunteers at baseline, end of treatment, and three months post-treatment revealed no significant differences. Histological and immunostaining analysis of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin showed no statistically significant changes (P > 0.05) after mesotherapy injection. The present study indicates that mesotherapy for skin rejuvenation does not result in statistically significant histological changes or clinical improvement.

Abdominal mesotherapy injection extended the absorption of follicle-stimulating hormone

Abdominal mesotherapy injection of recombinant human FSH (rhFSH) was well tolerated with increased net absorption (AUC0-∞ 4,655.3 IU·h/L and t1/2 247.6 h) up to 360 hours compared with those of 120 hours (AUC0-∞ 1,915.7 IU·h/L and t1/2 101.8 h). The extended absorption of rhFSH suggests that abdominal mesotherapy injection mode be considered for future administration of rhFSH in controlled ovarian hyperstimulation.

An outbreak of Mycobacterium fortuitum cutaneous infection associated with mesotherapy

We describe an outbreak of Mycobacterium fortuitum cutaneous infections associated with mesotherapy in La Rioja, Spain. Descriptive epidemiology. Private practice. Case subjects were customers of a single beauty salon who were treated with mesotherapy injections. Two skin biopsies were taken from each patient. Over the designated period, 138 women received mesotherapy. Of these women, 39, or 28.3%, developed lesions ultimately thought to be caused by Mycobacterium fortuitum infection. The number of lesions per patient varied from 3 to 20 in the most severe case. Most of the lesions were indurated, erythematous or violaceous papules, some progressing to become fluctuant boils with suppuration, fistulization and scarring. The individual lesions varied in diameter from 0.5 to 6 cm. Two patients (5.1%) developed inguinal or axillary adenopathy. Two others presented with fever. One reported muscular pain. In 12 of the 39 cases, M. fortuitum was isolated from the wound cultures. The patients were all successfully treated with clarithromycin and levofloxacin. We identified a large outbreak of rapidly growing mycobacterial lesions among women who received mesotherapy injections in a single beauty salon.

Clinical Management of Rapidly Growing Mycobacterial Cutaneous Infections in Patients after Mesotherapy

Increasing numbers of patients are expressing an interest in mesotherapy as a method of reducing body fat. Cutaneous infections due to rapidly growing mycobacteria are a common complication of such procedures. We followed up patients who had developed cutaneous infections after undergoing mesotherapy during the period October 2006-January 2007. Sixteen patients were infected after mesotherapy injections performed by the same physician. All patients presented with painful, erythematous, draining subcutaneous nodules at the injection sites. All patients were treated with surgical drainage. Microbiological examination was performed on specimens that were obtained before and during the surgical procedure. Direct examination of skin smears demonstrated acid-fast bacilli in 25% of the specimens that were obtained before the procedure and 37% of the specimens obtained during the procedure; culture results were positive in 75% of the patients. Mycobacterium chelonae was identified in 11 patients, and Mycobacterium frederiksbergense was identified in 2 patients. Fourteen patients were treated with antibiotics, 6 received triple therapy as first-line treatment (tigecycline, tobramycin, and clarithromycin), and 8 received dual therapy (clarithromycin and ciprofloxacin). The mean duration of treatment was 14 weeks (range, 1-24 weeks). All of the patients except 1 were fully recovered 2 years after the onset of infection, with the mean time to healing estimated at 6.2 months (range, 1-15 months). This series of rapidly growing mycobacterial cutaneous infections highlights the difficulties in treating such infections and suggests that in vitro susceptibility to antibiotics does not accurately predict their clinical efficacy.

Outbreak of Nontuberculous Mycobacterial Subcutaneous Infections Related to Multiple Mesotherapy Injections

We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water.

Avaliação objetiva da síndrome dolorosa miofascial: uso da termografia antes e após tratamento associando mesoterapia a bloqueio anestésico

A Síndrome miofascial é um diagnóstico comum em pacientes com dor segmentar. As queixas costumam ser inespecíficas; o uso da técnica de Fischer associando algometria de pressão e técnicas especiais de palpação auxiliam a identificar os pontos gatilhos ativos. A mesoterapia (intradermoterapia) mostra-se muitas vezes mais eficaz quando associada às técnicas de bloqueio paraespinal e bloqueio de pontos gatilhos com lidocaína. O resultado deste tratamento pode ser documentado através da termografia, além dos meios clínicos já citados. O padrão de cores (vermelho a verde, no caso da imagem colorida ou tons de cinza na imagem em preto e branco) indica gradiente de temperatura. Neste estudo, descrevemos o caso clinico de uma paciente feminina, de 54 anos de idade, com queixa de dor severa em região cervical, referida ao membro superior direito. A mesma foi tratada com mesoterapia associada a bloqueio paraespinal e bloqueio de pontos-gatilho ativos e o resultado deste tratamento foi avaliado clinicamente e pela termografia 25 minutos após e 03 dias após o tratamento. Os autores concluíram que a termografia é um método promissor na avaliação da dor miofascial. Mais estudos são necessários para usar a termografia como método auxiliar na triagem de casos de LER/DORT, visto que, em nossa experiência, é freqüente a associação desta síndrome, como fator agravante.